İlhan AFŞAR, Nükhet KURULTAY, Süreyya Gül YURTSEVER, Metin TÜRKER, Özlem Yüksel ERGİN, Karaayak Berrin UZUN

Yoğun bakım ünitelerindeki hastalarda intravasküler kateter kültürlerinin değerlendirilmesi

Çalışmamızın amacı, hastanemizin yoğun bakım ünitelerinde yatan 100 hastada kateter (subklavian, femoral, brakial) kültür sonuçlarını araştırmaktır. Üreme saptanan 47 kateterli hastanın eş zamanlı olarak alınan kan kültürlerinin 35’inde (% 74) üreme saptanmazken, 12’sinde (% 26) kateter ve kan kültür örneğinde aynı bakteri saptanmıştır. Yalnızca kateterde üremesi olan 35 hasta kolonizasyon olarak değerlendirilmiştir. Kateter infeksiyonu etkeni olarak 6 metisiline dirençli Staphylococcus aureus, 1 metisiline duyarlı S.aureus, 2 koagülaz negatif stafilokok, 2 Acinetobacter spp., 1 Klebsiella pneumoniae izole edilmiştir. Gram pozitif bakterilerde glikopeptit ve Gram negatif bakterilerde karbepenem direncine rastlanmamıştır. Alınan tüm önlemlere ve geliştirilen yeni yöntemlere rağmen kateter infeksiyonlarının günümüzde hâlâ sorun olmaya devam ettiği sonucuna varılmıştır.

Anahtar Kelimeler:

Yoğun bakım üniteleri, Glikopeptidler, Kateterizasyon, Kültür ortamı, Metsilin-dirençli Staphylococcus aureus, Kateter ilişkili enfeksiyonlar, Klebsiella, Gram-pozitif bakteriler, Gram-negatif bakteriler

The evaluation of cultures of intravascular catheters in intensive care units

The catheter (subclavian, femoral, branchial) cultures from 100 patients hospitalized in intensive care units were investigated. Of the 47 catheterized patients from whom bacterial growth was obtained, 35 (74 %) had no bacterial growth in their blood culture which were taken simultaneously, and 12 (26%) were found to be positive for the growth of the same bacteria in both catheter and blood culture samples. The microbial growth only in catheter cultures from 35 patients were evaluated as colonization. The microorganisms isolated from catheters as infection agents were as follows: 6 methicillin-resistant Staphylococcus aureus, 1 methicillin-susceptible S.aureus, 2 coagulase negative staphylococci, 2 Acinetobacter spp. and 1 Klebsiella pneumoniae. Glycopeptide resistance was not observed in Gram positive and carbapenem resistance in Gram negative bacteria. It is concluded that the catheter infections continue to be an important issue in intensive care units in spite of all the measures taken and newly developed methods.

Keywords:

Intensive Care Units, Glycopeptides, Catheterization, Culture Media, Methicillin-Resistant Staphylococcus aureus, Catheter-Related Infections, Klebsiella, Gram-Positive Bacteria, Gram-Negative Bacteria,

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