Evde Parenteral Nütrisyon Alan Hastalarda Kateter İlişkili Kan Dolaşımı Enfeksiyonları

Yıl 2025, Cilt: 15 Sayı: 2, 321 - 325, 22.05.2025

Ali Tamer , Tunahan Zengin , Oğuz Karabay

https://doi.org/10.33631/sabd.1446059

Öz

Evde Parenteral Nütrisyon (EPN) tedavisi kısa bağırsak hastaları gibi özel tıbbi koşullara sahip hastalar için hayati bir tedavidir. EPN tedavisinde, santral kateterler (SVK) kritik rol oynamaktadır. Kateter ilişkili kan dolaşımı enfeksiyonu (KİKDE) EPN tedavisinde kateter ile ilişkili önemli morbidite ve mortaliteye yol açan bir komplikasyon olarak karşımıza çıkmaktadır.
KİKDE endo-luminal (kateter içi) veya ekstra-luminal (kateter dışı) kaynaklı olabilir. KİKDE fizyopatolojisinde barsak translokasyonu (BT), bağışıklık sistemi yapısının bağırsakta bozulması, kateter yüzeylerinde gelişen biyofilm tabakası gibi mekanizmalar rol oynamaktadır.
Kateter ile ilgili kan dolaşımı enfeksiyonları mono ve polimikrobiyal olabilir. Sıklık sırasına göre Gram pozitif bakteriler, Gram negatif bakteriler, mantarlar ve daha nadir enfeksiyonlar KİKDE etyolojisinde saptanan etkenlerdir. Koagülaz negatif stafilakoklar en yaygın nedensel patojendir. Ateş, spesifik olmamakla birlikte en yaygın klinik bulgudur.
Sonuç olarak, EPN tedavisi uygulanan hastalarda, KİKDE açısından hasta yönetim planı yapılmalıdır.

Anahtar Kelimeler

kronik barsak yetmezliği , Evde parenteral nütrisyon , kateter ilişkili kan dolaşımı enfeksiyonu

Catheter-Related Bloodstream Infections in Patients Receiving Home Parenteral Nutrition

Öz

Home Parenteral Nutrition (HPN) therapy is a vital treatment for patients with special medical conditions, such as Short Bowel Syndrome (SBS). Central venous catheters (CVC) play a critical role in the treatment of HPN. Catheter related bloodstream infection (CRBSI) is a complication in HPN treatment that causes significant catheter-related morbidity and mortality. CRBSI may be endo-luminal (inside the catheter) or extra-luminal (outside the catheter). Mechanisms such as bacterial translocation (BT), disruption of the immune system structure in the intestines, and biofilm layer developing on catheter surfaces play a role in the pathophysiology of CRBSI. CRBSI infections can be mono or polymicrobial. In order of frequency, Gram-positive bacteria, Gram-negative bacteria, fungi and rarer infections are the factors detected in the etiology of CRBSI. Coagulase-negative staphylococci is the most common causative pathogen. Fever, although nonspecific, is the most common clinical finding.
As a result, in patients receiving HPN treatment, a patient management plan should be made in terms of CRBSI.

Anahtar Kelimeler

Home parenteral nutrition , ; catheter related bloodstream infection , chronic intestinal failure

Kaynakça

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