Yoğun bakım ünitelerinde santral venöz kateter ilişkili kan dolaşımı infeksiyonu sıklığı, mikrobiyolojik etkenleri, antibiyotiklere duyarlılıkları ve risk faktörlerinin belirlenmesi

Öz

Amaç: Santral venöz kateterler (SVK), yoğun bakım ünitelerinde hastaların tedavisi ve izlemi için sık kullanılan aletlerdir. Santral venöz kateter ilişkili infeksiyonları belirlemek, uygun ampirik antibiyotik tedavisi açısından yol gösterici olmak ve sonraki çalışmalar için karşılaştırılabilir veri sağlamak amaçlanmıştır. Gereç ve Yöntemler: Yoğun bakım ünitelerinde, aktif prospektif sürveyans kapsamında takip edilen ve Centers for Disease Control and Prevention (CDC) kriterlerine göre SVK ilişkili kan dolaşımı infeksiyonu tanısı konulan hastaların, retrospektif olarak SVK kullanım oranları, kateter ilişkili kan dolaşımı infeksiyon (KİKDİ) hızları, mikrobiyolojik etkenleri, antibiyotiklere duyarlılık sonuçları ve risk faktörleri değerlendirilmiştir. Veriler SPSS 17.0 istatistik paket programına kaydedilerek, analiz edilmiştir. Bulgular: Santral kateter kullanım oranı %48 ve infeksiyon hızı 8,07 olarak saptanmıştır. . İzole edilen 72 patojenin, 28’ i gram pozitif (% 28,9), 31’i gram negatif ( % 43,6), 13’ ü mantar (%18,5) olup, koagülaz negatif stafilokok (%22), Candida spp. (%18,8) Acinetobacter spp. (%16,6) en sık saptanan etkenler olmuştur. Koagülaz negatif stafilokoklarda metisilin direnci %75, S. aureus’ da %67 saptanmıştır. Sonuç: Gereksiz santral kateter kullanımından kaçınılması, endikasyon kalkınca çıkarılması ve altta yatan hastalıkların tedavi edilmesi ile KİKDİ oranlarında azalma sağlanabileceği düşünülmektedir.

Anahtar Kelimeler

• Santral venöz kateter;
• infeksiyon;
• yoğun bakım ünitesi

Determination of incidence, causative agents, antimicrobial susceptibilities, and risk factors of central venous catheter-related bloodstream infections in intensive care units

Öz

Aim: Central venous catheters (CVCs) are widely utilized for patient therapy and monitoring in intensive care units . Its goal is to identify infections caused by central venous catheters, to recommend appropriate empirical antibiotic therapy in intensive care units, and to offer comparable data for future investigations. Material and Methods:Patients who were followed up in intensive care units as part of an active prospective surveillance program and were found to have CVC-related bloodstream infections according to Centers for Disease Control and Prevention (CDC) criteria were spared. Retrospectively, the rates of catheter-related bloodstream infections (CRBSI), CVC use, microbiological agents, antibiotic sensitivity, and risk factors were evaluated. The data was analyzed and recorded using the SPSS 17.0 statistical package application. Results: The rate of central venous catheter use was 0.48 and the rate of central catheter-related infection was determined as 8.07. The 72 pathogens identified were 28 gram-positive (28.9%), 31 gram-negative (43.6%) and 13 fungi (18.5%) and coagulase-negative staphylococci (22%), Candida spp. (18.8%), Acinetobacter spp. (16.6%) were the most commonly found agents. The methicillin resistance was detected in 75% of coagulase-negative staphylococci and 67% of S. aureus strains. Conclusion: It is believed that reducing the incidence of CRBSI can be achieved by avoiding needless CVCs use, removing it when the indication is no longer needed, and treating the underlying medical conditions.

Anahtar Kelimeler

• Central venous catheter;
• infection;
• intensive care unit

Kaynakça

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