KATETER İLE İLİŞKİLİ DAMAR İÇİ ENFEKSİYONETKENLERİ; KEÇİÖREN EĞİTİM VE ARAŞTIRMAHASTANESİ YOĞUN BAKIM ÜNİTESİ 2018 VERİLERİ

Amaç: Damar içi kateterler (DİK) günümüz tıp pratiğinde sık olarak kullanılmaktadır ve özellikle yoğun bakım ünitelerinde bazı durumlarda kaçınılmaz olarak karşımıza çıkmaktadır. Bu yaygın kullanım alanlarına bağlı olarak sebep oldukları komplikasyonlar nedeniyle artmış morbidite ve mortalite ile ilişkilidirler. Bu komplikasyonlardan biri enfeksiyöz komplikasyonlardır ve bunlar içerisinde en önemlisi kateter ile ilişkili kan dolaşımı enfeksiyonudur (KİKDE). Bu çalışmamızda hastanemiz yoğun bakım ünitesinde tanı koyduğumuz KİKDE etkenlerini ortaya koymayı amaçladık.Materyal ve Metot: Bizim çalışmamıza konu olan DİK ile ilişkili kan dolaşımı enfeksiyon (KİKDE) etkenlerini belirlemek amacıyla Keçiören Eğitim ve Araştırma Hastanesi İç Hastalıkları Yoğun Bakım Ünitesi’nde Ocak 2018-Aralık 2018 tarihleri arasında yatmış olan ve eş zamanlı kateter içi kan kültürü ve periferik kan kültürü alınan 216 hasta retrospektif olarak değerlendirilmiştir. Bu hastaların antibiyotik duyarlılık testleri "Clinical and Laboratory Standards Institute (CLSI)" kriterlerine göre disk difüzyon yöntemi kullanılarak yapılmıştır. Kateterden alınan kan ile periferik venöz kandan alınan kan kültürleri için BACTEC 9120 (Becton Dickinson, ABD) sistemi kullanılmıştır.Bulgular: Hastaların %20.3’ünde KİKDE saptanmış olup bu olguların 6’sında E. faecium, 6’sında K. pneumonia, 6’sında A. baumanii, 6’sında S. epidermidis, 4’ünde S. capitis, 4’ünde E. faecalis ve 2’şer hastada S. aureusP.aeroginosa-S. haemolyticus-C. albicans ve E.coli izole edilmiştir. Çalışmamizda KİKDE etkeni olarak en sık E. faecium, S. epidermidis, A. baumanii ve K. pneumoniae saptanırken 2. en sık etkenler S. capitis ve E. faecalistir. Çalışmamızı değerlendirdiğimizde KİKDE etkeni olarak 1. sırada koagülaz negatif stafilokoklar karşımıza çıkmakta 2. sırada ise enterokoklar bulunmaktadır.Sonuç: Hastanemiz yoğun bakım ünitesinin KİKDE etkenlerinin dağılım sonuçları Türkiye’nin ulusal hastane enfeksiyonları sürveyans sistemi 2012 verileri ile uyumludur.

THE PATHOGENS OF CATHETER RELATED BLOODSTREAM INFECTIONS IN THE INTENSIVE CARE UNIT OF KEÇIÖREN TRAINING AND RESEARCH HOSPITAL IN 2018

Objectives: Intravenous catheters are frequently used in today's medical practice and are inevitable in somecases, especially in intensive care units. Due to these common areas of use, they are associated with increasedmorbidity and mortality due to the complications they cause. One of these complications is infectiouscomplications, the most important of which is catheter-related bloodstream infection (CRBI). In this study, weaimed to reveal the factors of catheter-related bloodstream infection that we diagnosed in the intensive careunit of our hospital. Materials and Methods: In order to determine the factors and antibiotic susceptibility catheter-relatedbloodstream infections which were the subjects of our study, who had been hospitalized between January 2018and December 2018 at Keçiören Training and Research Hospital Intensive Care Unit and concurrent in catheterblood culture and peripheral blood.216 patients who were cultured were evaluated retrospectively. Results: In 20.3% of the patients, catheter-related bloodstream infection was detected, in which 6 of thesecases were E. faecium, 6 of them were K. pneumonia, 6 of them were A. baumanii, and 6 of them were S.epidermidis. In 4 patients we detected S. capitis and E. faecalis. S. aureus-P.aeroginosa-S.haemolyticus-C.albicans and E.coli were isolated in both 2 patients. In our study, E. faecium, S. epidermidis, A. baumanii and K.pneumoniae were the most common agents, while the second most frequent agents were S. capitis and Efaecalis. When we evaluate our study, coagulase-negative staphylococci are in the first place as the cause ofCRBI and enterococci are in the second place. Conclusion: The distribution results of the causes of CRBI of our hospital’s intensive care unit was compatiblewith Turkey's national nosocomial infections surveillance system-2012.

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