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Hemodiyaliz Hastalarında Kateter İlişkili Kan Dolaşım Enfeksiyonlarının Değerlendirilmesi

Amaç: Bu çalışmanın amacı, hemodiyaliz hastalarında kateter ilişkili kan dolaşımı enfeksiyonlarını (KİKDE) incelemektir. Yöntemler: Çalışmamızda hastanemizde 1 Ocak 2013 ve 1 Nisan 2019 tarihleri arasında kateter ilişkili kan dolaşım enfeksiyonları gelişen hastaların verileri retrospektif olarak değerlendirildi. Çalışmaya 18 yaş üstü, kan ve kateter kültürlerinde aynı mikroorganizma üremesi saptanan hastalar alındı. 18 yaş altı, kan ve kateter kültürlerinde farklı mikroorganizma üremesi saptanan hastalar çalışmaya alınmadı. Çalışma kriterlerini karşılayan 65 hastadan 109 kateter ilişkili kan dolaşımı enfeksiyonu vakası alındı. Bulgular: Çalışmaya 109 kateter ilişkili kan dolaşım enfeksiyonları epizodu alındı. Kan kültürlerine bakıldığında 10'unda (%9,2) Klebsiella pneumoniae, 9'unda (%8,3) Escherichia coli, 23'ünde (%21,1) metisiline dirençli koagülaz-negatif stafilokok (MRKNS), 1'isinde (%0,9) metisiline duyarlı koagülaz negatif stafilokok (MSKNS), 15'inde (%13,8) metisiline dirençli Staphylococcus aureus (MRSA), 23'ünde (%21,1) metisiline duyarlı Staphylococcus aureus (MSSA), 5'inde (%4,6) Acinetobacter spp, 7'sinde (%6,4) Enterobacter spp., 5'inde (%4,6) Streptococcus spp., 6'sında (%5,5) Enterococcus faecalis, 2'sinde (%1,8) Stenotrophomonas maltophilia, 2'sinde (%1,82) Pseudomonas aeruginosa, ve 1'inde (%0,9) Morganellamorgani üremesi saptandı. Sonuç: Hemodiyaliz hastalarında ciddi morbidite ve mortaliteye yol açan KİKDE'nin tedavisi hayati önem arz etmektedir. Bu nedenle her hastane ve diyaliz merkezleri kendi etken dağılımlarını bilmelidir. Böylece kültür sonuçları çıkana kadar başlanacak olan ampirik tedavi seçiminde uluslararası kılavuzlara ek olarak merkez verileri de değerlendirilebilir.

Evaluation Of Catheter-Related Bloodstream Infections In Hemodialysis Patients

Objective: The purposes of this study was to investigate catheter-related bloodstream infections (CRBSI) in hemodialysis patients. Methods: Our s tudy w as p lanned a s a r etrospective study. Patients who developed catheter-related bloodstream infections between January 2013 and april 2019 were included. The study included patients over the age of 18 who had the same microorganisms in their blood and catheter cultures. Patients who were under 18 years of age with different blood and blood cultures were excluded from the study. 109 episodes of catheter-related blood circulation infections were taken from 65 patients who met the study criteria. Results: In total, we identified 109 episodes of catheter-related bloodstream infections. Ten of them caused by Klebsiella pneumoniae, 9 were caused by Escherichia coli, 24 were caused by Staphylococcus, including 23 by methicillin-resistant coagulase negative Staphylococcus and 1 by methicillin-sensitive coagulase negative Staphylococcus , 28 were caused by staphylococcus aureus, including 15 by methicillin resistance staphylococcus aureus and 23 methicillin sensitive Staphylococcus aureus, 5 them caused by Acinetobacter sp., 7 of them caused by Enterobacter sp., 5 of them caused by Streptococcus sp., 6 of them caused by Enterococcus faecalis, 2 of them caused by Stenotrophomonas maltophilia, 2 of them caused by Pseudomonas aeruginosa, and 1of them caused by Morganella morgani. Conclusıon: As a result, treatment of catheter-related bloodstream infections, which leads to serious morbidity and mortality in hemodialysis patients, is vital. For this reason, every hospital and dialysis centers should know their own distribution of agents. Thus, in addition to international guidelines, center data can be evaluated in the selection of empirical treatment to be initiated until culture results are obtained

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