Yenidoğan Yoğun Bakım Ünitesinde Prematürelerde Nozokomiyal Sepsis

Amaç: Yenidoğan Yoğun Bakım Ünitesi (YYBÜ)'ndeki prematüre bebeklerde nozokomiyal sepsis gelişme oranını, risk faktörlerini ve en sık görülen mikroorganizmaları saptamayı amaçladık Gereç ve Yöntem: Nozokomiyal sepsis grubunda (NSG) 46, kontrol grubunda (KG) ise 124 hasta olarak toplam 170 prematüre çalışma kapsamına alınmıştır. Tüm hastaların cinsiyet, doğum ağırlığı (DA), gestasyon yaşı (GY), doğum ağırlığı (DA), yatış süresi ve doğum şekilleri, klinik ve labaratuar bulguları kaydedilmiştir. Sepsis düşünülen hastalarda kan, Beyin Omirilik Sıvısı (BOS) Endo Trakeal Aspirat (ETA), boğaz, idrar ve göbek kültürleri alınmıştır. Bulgular: Sepsis risk faktörlerini belirlemek için yapılan lojistik regresyon analizi sonucunda yatış süresi, düşük DA, emmeme, mama ile beslenme, ventilatör tedavisi, kan transfuzyonu, prematürelerde nozokomiyal sepsisi istatiksel olarak anlamlı olarak artırdığı saptamıştır. Ayrıca klinik bulgulardan kusma, ateş, apne, konvülziyon, menenjit ve hipoterminin nozokomiyal sepsis gelişmesi bakımından anlamlı risk faktörleri olduğu tespit edilmiştir (p<0.05). CRP, MPV ↗ ve TG (+) NSG daha fazla olup istatiksel olarak anlamlı bulunmuştur (p=0.00000). Nozokomiyal sepsisli hastaların %50 de kan, %20.37 de idrar kültüründe üreme gözlenmiş. 46 hastanı 11 de klebsiella pneumonia (%40.74) izole edilirken sırasıyla S.Aureus (%18.51), pseudomonas ve E.coli (%11.11) üremesi görülmüştür. Sonuç: Nozokomiyal sepsis YD de önemli morbidite ve mortalite nedeni olduğu için risk faktörlerinin ve enfeksiyon etkenlerinin saptanarak gerekli önlemlerin alınmasının morbidite ve mortaliteyi azaltacağını düşünüyoruz.

Anahtar Kelimeler:

Yenidoğan yoğun bakım üniteleri, sepsis

Nosocomial Sepsis in Premature İnfants at Neonatal İntensive Care Unit.

Aim: We aimed to establish the nosocomial sepsis development rate, risk factors, and most frequently found microorganisms in premature infants observed in Neonatal Intensive Care Units (NICU).Materials and Method: A total of 170 premature infants with 46 from nosocomial sepsis group (NSG) and 124 premature infants from the control group (CG) were included in this study. Gender, birth weight (BW), gestational age (GA) hospital stay and birth types, the laboratory and clinical findings of all patients were recorded. Blood, cerebrospinal fluid(CSF), endotracheal aspirate (ETA), throat, urine, and umbilical culture samples of the patients believed to have sepsis were obtained. Results: As a result of the logistic regression analysis conducted to establish sepsis risk factors, hospital stays, low BW, lack of sucking, ventilation treatment, and blood transfusion were established to statistically significantly increase nosocomial sepsis. In addition, vomiting, fever, apnoea, convulsion, meningitis, and hypothermia that are among clinical symptoms were found as the significant risk factors in terms of sepsis development. CRP, MPV↗ and TG(+) were higher in NSG and were found as statistically significant. Of the nosocomial sepsis patients, growth was observed in the blood of 50%, and in urine of 20.37%. While klebsiella pneumonia was isolated in 11 of the 46 patients (40.74%), also observed were S. Aureus(18.51%), pseudomonas, and E. coli(11.11%) growth, respectively. Conclusion: Since nosocomial sepsis constitutes a significant cause of morbidity and mortality in infants, we believe that establishing risk factors and infection factors and taking necessary precautions would lower morbidity and mortality.

Keywords:

Neonatal intensive care ünits, Sepsis,

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