İsmail Necati HAKYEMEZ, Abdulkadir KÜÇÜKBAYRAK, Hayrettin AKDENİZ

Damar İçi Kateter İnfeksiyonlarına Güncel Yaklaşım

Hastanelerin riskli ünitelerinde yatan hastalarda nozokomiyal kan dolaşımı infeksiyonlarının önemli bir kısmı damar içi kateter infeksiyonlarından kaynaklanmaktadır. Kateterle ilişkili kan dolaşımı infeksiyonu KİKDİ , önemli bir morbidite ve mortalite nedenidir. Hastanede kalış süresi ve bakım maliyetlerini artırır. İnfeksiyon sıklıkla kateter giriş yeri ve birleşim yerinden kaynaklanmaktadır. KİKDİ için en sık etken mikroorganizmalar koagülaz-negatif stafilokok, Staphylococcus aureus, Enterokoklar ve Candida türleridir. Kateter ile periferik kanda aynı etkenin üremesi tanının temelini oluşturur. Tedavide, genellikle kateter çıkarılır ve sistemik antibiyotik başlanır. Kanıta dayalı stratejiler eşliğinde paket önlemlerin uygulanması, multidisipliner eğitimlerin verilmesi, geriye dönük bildirimlerin sağlanması, infeksiyon kontrol sürveyansının düzgün çalışması ve kalite açısından akreditasyonun sağlanması KİKDİ’lerin önlenmesi için zorunludur.

Anahtar Kelimeler:

kateter, infeksiyon, tanı, önlem

Current Approach To Intravascular Catheter Infection

A great majority of nosocomial bloodstream infections in hospitalized patients in risky departments of hospitals originate from an infected central venous catheter CVC . Catheter-related bloodstream infection CRBSI is one of the considerable reason for morbidity and mortality and causes an increase in both duration and cost of hospital care. CRBSI usually arises around the catheter inserion site and at the hub of the catheters. Coagulase-negative staphylococci, Staphylococcus aureus, enterococci, and Candida species are the most common causative organisms for CRBSI. Isolation of the same organism from the catheter and peripheral blood contitutes the basis for the diagnosis of CRBSI. CRBSI is usually treated by withdrawal of the catheter and using systemic antibiotics. Applying prevention bundles accompanied with the evidence based strategies, planning multidisciplinary trainings, analysing retrospective data of the cases, doing infection control surveyances properly and providing acreditation in terms of quality is compulsory to avoid from CRBSI.

Keywords:

catheter, infection, diagnosis, prevention,

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