Evaluation of infections in neurological diseases in a palliative care centre

In this study on neurologic diseases treated in palliative care, we aimed to identify the factors predisposing the sites in the body to develop infections and the factors affecting the quantities of growth in the cultures. The medical records of patients with neurologic diseases in the palliative care centre (PCC) were retrospectively reviewed covering the years between 2014 and 2018. The patient data including the age, gender, length of stay (LOS) in PCC; their diagnoses and comorbid diseases, nutritional status, pressure ulcers (PU) and their emergence; and the quantities of growth in blood, urine, wound, rectal, and tracheal aspirate cultures (TA) were collected and compared. One hundred and forty-three patients were included in the study. The highest quantity of growth was observed in urine cultures. The rates of growth were statistically higher in blood cultures of patients with a percutaneous endoscopic gastrostomy (PEG) and a tracheostomy (p=0.001, p=0.013). The quantities of growth in wound cultures were lower in the cancer patients, whereas, those in the wound and rectal cultures were significantly higher in the patients with PU. The growth quantities were higher in the TA cultures of the patients with hypoxic brain injury and tracheostomies (p=0.033, p

___

1. World Health Organization (WHO). WHO Definition of Palliative CareAvailable at: http://www.who.int/cancer/palliative/definition/en/ access date 30 September 2020.

2. Boersma I, Miyasaki J, Kutner J et al. Palliative care and neurology: time for a paradigm shift. Neurology. 2014;83:561-7.

3. Vitetta L, Kenner D, Sali A. Bacterial infections in terminally ill hospice patients. J Pain Symptom Manage. 2000;20:326-34.

4. Datta, R, Juthani-Mehta M. Burden and management of multidrug-resistant organisms in palliative care. Palliat Care. 2017;10:1178224217749233.

5. Homsi J, Walsh D, Panta R et al. Infectious complications of advanced cancer. Support Care Cancer. 2000;8:487-92.

6. Rosenberg JH, Albrecht JS, Fromme EK et al. Antimicrobial use for symptom management in patients receiving hospice and palliative care: a systematic review. J Palliat Med. 2013;16:1568-74.

7. Reinbolt RE, Shenk AM, White PH et al. Symptomatic treatment of infections in patients with advanced cancer receiving hospice care. J Pain Symptom Manage. 2005;30:175-82.

8. Baghban A, Juthani-Mehta M. Antimicrobial use at the end of life. Infect Dis Clin North Am. 2017;31:639-47.

9. Juthani-Mehta M., Malani PN, Mitchell SL. Antimicrobials at the end of life: an opportunity to improve palliative care and infection management. Jama. 2015;314:2017-8.

10. Yajima R, Ise Y, Wako T et al. A retrospective study of risk factors for infection in cancer patients receiving specialist palliative care. J Nippon Med Sch. 2013;80:481-5.

11. Rivera-Lara L, Ziai W, Nyquist P. Management of infections associated with neurocritical care. Handb Clin Neurol. 2017;140:365-378.

12. O'Horo JC, Sampathkumar P. Infections in Neurocritical Care. Neurocrit Care. 2017;27:458-67.

13. White PH, Kuhlenschmidt HL, Vancura BG et al. Antimicrobial use in patients with advanced cancer receiving hospice care. J Pain Symptom Manage. 2003;25:438-43.

14. Schönenberger S, Al-Suwaidan F, Kieser M et al. The SETscore to predict tracheostomy need in cerebrovascular neurocritical care patients. Neurocrit Care. 2016;25:94-104.

15. Allareddy V, Rampa S, Nalliah RP, et al. Prevalence and predictors of gastrostomy tube and tracheostomy placement in anoxic/hypoxic ischemic encephalopathic survivors of in-hospital cardiopulmonary resuscitation in the united states. PLoS One. 2015;10:e0132612.

16. Pignatti P, Balestrino A, Herr C et al. Tracheostomy and related hostpathogen interaction are associated with airway inflammation as characterized by tracheal aspirate analysis. Respir Med. 2009;103:201-8.

17. Lusuardi M, Capelli A, Cerutti CG et al. Influence of clinical history on airways bacterial colonization in subjects with chronic tracheostomy. Respir Med. 2000;94:436-40.

18. Davies E, Higginson I (eds). Palliative care. The solid facts. http://www. euro.who.int/__data/assets/pdf_file/0003/98418/E82931.pdf access date 29 September 2020.

19. Lynn J, Adamson DM. Living well at the end of life. Adapting health care to serious chronic illness in old age. RAND CORP SANTA MONICA CA.2003

20. Halperin JJ, Moran S, Prasek D et al. Reducing hospital-acquired infections among the neurologically critically Ill. Neurocrit Care. 2016;25:170-7.

21. Kaye KS, Marchaim D, Chen TY et al. Effect of nosocomial bloodstream infections on mortality, length of stay, and hospital costs in older adults. J Am Geriatr Soc. 2014;62:306-11.

22. Gleeson A, Larkin P, Walsh C et al. Methicillin-resistant Staphylococcus aureus: Prevalence, incidence, risk factors, and effects on survival of patients in a specialist palliative care unit: A prospective observational study. Palliat Med. 2016;30:374-81.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: 4
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
Sayıdaki Diğer Makaleler

Comperative outcomes of the patients undergoing percutaneous and open trigger finger release

Duran TOPAK, Fatih DOĞAR, Burak KUŞCU, Ali Aydın KARADENİZ, Ökkeş BİLAL

The value of routine blood test parameters obtained at admission to predict acute stent thrombosis in patients with st-segment elevation myocardial infarction

Yusuf ÇEKİCİ

Bibliometric analysis of journal articles indexed in TR Index published with a pediatric dentist author: A snapshot of $21^{th}$ Century

MUSTAFA SARP KAYA

Corona Virus Disease 2019 pandemic and the role of Quarantine in containment of the infection

Saurabh RamBihariLal SHRIVASTAVA, Prateek Saurabh SHRIVASTAVA

Changes in mean platelet volume in the course of upper gastrointestinal bleeding

Gökhan KARAKAYA, Ömer KAN, Gökhan TAZEGÜL, Orhan ARAS

Evaluating the effectiveness of the national hip dysplasia early diagnosis and treatment program

Emre ERGEN, Ersen TÜRKMEN, Mehmet Fethi CEYLAN, Mehmet ASLAN, Selma FELEK

Evaluation of infections in neurological diseases in a palliative care centre

Doğan AKDOĞAN, Gülhan SARIÇAM, Kadriye KAHVECİ

Strengthening the global diagnostic capacity in the battle against Corona Virus

Saurabh RamBihariLal SHRİVASTAVA, Prateek Saurabh SHRİVASTAVA

Assessment of the risks of the workplace and the awareness of healthcare professionals

Itir ERKAN, Murat AKBABA

Trauma during pregnancy: Assessment of cases from a forensic medical aspect

Özlem ÖZGÜR GÜRSOY, Tuğrul KILIBOZ, Beycan DOĞAN, Kenan KARBEYAZ