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ÖZET Amaç: Kandida enfeksiyonları ciddi, hayatı tehdit edici hastalıklardır. Böyle bir hastalığın epidemiyolojisini ve risk faktörlerini anlamak hastalığa daha erken tanı konulmasını ve erken, etkin tedavi planlanmasına yardımcı olacaktır. Gereç ve Yöntemler: Çalışmamızda hastanemiz üçüncü basamak yoğun bakım ünitesinde (YBÜ) takip edilen erişkin hastalarda çeşitli örneklerden üreyen kandida türlerini ve kandidemi risk faktörlerini belirlemeyi amaçladık. YBÜ’de bir yıl boyunca takip edilen erişkin hastaların verileri retrospektif olarak incelendi. Bulgular: Hastaların 30’unda kan kültüründe, 58’inde idrar kültüründe, 5’inde yara kültüründe, 32’sinde trakeal aspirat kültüründe kandida üremesi oldu. Santral venöz katater bulunması, total parenteral nutrisyon verilmesi ve cerrahi operasyon geçirilmesi kandidemi için önemli bir risk faktörü olarak gözlendi (p=0,019, p=0,001, p=0,001). Kandidemi gelişen hastaların kandidemi tespit edildiği sırada ve diğer hastalardan mevcut üremeleri esnasında alınan laboratuvar parametrelerinin karşılaştırılmasında sodyum, magnezyum, CRP, lökosit, prokalsitonin düzeylerinde kandidemi gelişen hastalarda daha yüksek olmak üzere istatistiksel olarak anlamlı fark gözlenmişken (p=0,001,0,027,0,001,0,034,0,001), albümin düzeyi kandidemi gelişmeyen hastalarda istatistiksel olarak anlamlı düzeyde yüksek idi (0,04). Non-C.albicans üremesi olan hastaların yoğun bakım yatış süreleri C.albicans üreyen hastalara nazaran daha yüksek olarak gözlendi (p=0,032). Tüm nedenlere bağlı kandidemi sonrası 30 günlük mortalite oranı %57,1 olarak tespit edildi. Sonuç: Çalışmamız verileri doğrultusunda santral venöz katater kullanımı, total parenteral nutrisyon verilmesi ve geçirilmiş cerrahi operasyon kandidemi için risk faktörlerinin başında gelmekteydi. Ayrıca non-C. albicans üremesi olan hastalarda yoğun bakım yatış süresi C.albicans üremesi olanlara nazaran daha uzun olarak gözlendi. Anahtar Kelimeler: Kandida Kandidemi Yoğun Bakım ABSTRACT Objective: Candida bloodstream infection is a serious, life-threatening condition. A better understanding of the epidemiology and risk factors of this disease would facilitate earlier diagnosis and effective treatment planning. Material and Methods: We aimed to identify Candida species in various specimens and the risk factors for candidemia in adult patients in the level 3 intensive care unit (ICU) of our center. Data of adult patients treated in our ICU over a period of one year were evaluated retrospectively. Results: Candida growth was detected in various samples from a total of 72 patients, including blood culture in 30 patients, urine culture in 58 patients, wound culture in 5 patients, and tracheal aspirate culture in 32 patients. Presence of a central venous catheter, total parenteral nutrition, and surgical history were identified as significant risk factors for candidemia (p=0.019, p=0.001, p=0.001). Comparison of laboratory parameters in patients with candidemia at time of positive blood culture and other patients at time of positive urine, wound, or tracheal aspirate cultures showed significant differences in sodium (p=0.001), magnesium (p=0.027), C-reactive protein (p=0.001), leukocyte (p=0.034), and procalcitonin (p=0.001) levels, while albumin levels were significantly higher in patients who did not develop candidemia (p=0.04). Length of ICU stay was significantly greater in patients with non-C. albicans growth compared to patients with C. albicans growth (p=0.032). The 30-day all-cause mortality rate after candidemia was 57.1%. Conclusion: Our results indicate that central venous catheter, total parenteral nutrition, and surgical history are the leading risk factors for candidemia. In addition, non-C. albicans growth was associated with longer ICU stay than C. albicans growth. Keywords: Candida Candidemia Care Unit
Canadian infections are serious, life-threatening diseases. Understanding the epidemicology and risk factors of such a disease will help diagnose the disease earlier and plan early, effective treatment. Tools and Methods: In our study, we aimed at identifying the types of candida and risk factors that are reproduced from different samples in adult patients followed in our hospital’s third stage intensive care unit (YBU). The data of adult patients followed for a year in the UBS were examined retrospectively. Results: In 30 patients there was candida reproduction in the blood culture, in 58 in the urine culture, in 5 in the wound culture, in 32 in the trakeal aspirat culture. The presence of central venous catathers, total parenteral nutrition and surgery were observed as an important risk factor for candidemia (p=0,019, p=0,001, p=0,001). When candidiasis was detected and compared the laboratory parameters received from other patients during their existing reproductions, the levels of sodium, magnesium, CRP, leukocyte, procalcitonin were statistically significantly differentiated (p=0,001,0,027,0,001,0,034,0,001), while the levels of albumin were statistically significantly high in non-developed patients (0,04). In patients with non-C.albicans reproduction, intensive care periods were observed higher than in patients with C.albicans reproduction (p=0,032). The 30-day mortality rate after candidemia due to all causes was 57.1%. The result: Our study, according to the data, was at the top of the risk factors for central venous catathers use, total parenteral nutrition and carried out surgery candidemia. In patients with non-C. albicans reproduction, the intensive care period was observed longer than in patients with non-C. albicans reproduction. Keywords: Candida; Candidemia; Intensive Care ABSTRACT Objective: Candida bloodstream infection is a serious, life-threatening condition. A better understanding of the epidemiology and risk factors of this disease would facilitate earlier diagnosis and effective treatment planning. Material and Methods: We aimed to identify Candida species in various specimens and the risk factors for candidemia in adult patients in the level 3 intensive care unit (ICU) of our center. Data of adult patients treated in our ICU over a period of one year were evaluated retrospectively. Results: Candida growth was detected in various samples from a total of 72 patients, including blood culture in 30 patients, urine culture in 58 patients, wound culture in 5 patients, and tracheal aspirate culture in 32 patients. Presence of a central venous catheter, total parenteral nutrition, and surgical history were identified as significant risk factors for candidemia (p=0.019, p=0.001, p=0.001). Comparison of laboratory parameters in patients with candidemia at time of positive blood culture and other patients at time of positive urine, wound, or tracheal aspirate cultures showed significant differences in sodium (p=0.001), magnesium (p=0.027), C-reactive protein (p=0.001), leukocyte (p=0.034), and procalcitonin (p=0.001) levels, while albumin levels were significantly higher in patients who did not develop candidemia (p=0.04). The length of ICU stay was significantly greater in patients with non-C. albicans growth compared to patients with C. albicans growth (p=0.032). The 30-day all-cause mortality rate after candidemia was 57.1%. Conclusion: Our results indicate that central venous catheter, total parenteral nutrition, and surgical history are the leading risk factors for candidemia. In addition, non-C. albicans growth was associated with longer ICU stay than C. albicans growth. Keywords: Candida; Candidemia; Care Unit
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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