Gülşen HAZIROLAN

Ankara Numune Eğitim ve Araştırma Hastanesinde Hastane Enfeksiyonu Etkeni Olarak İzole Edilen Candida Suşlarının Dağılımı 2010-2015

Amaç: Son yıllarda nozokomiyal Candida enfeksiyonlarının epidemiyolojisinde ve tedavisinde kullanılan antifungallerle ilgili önemli değişiklikler ortaya çıkmıştır. Nozokomiyal Candida enfeksiyonlarının en sık etkeni Candida albicans olmakla birlikte, son zamanlarda albicans dışı Candida türlerinin de sıklığı artmaktadır. Bu çalışmada nozokomiyal Candida enfeksiyonlarından izole edilen Candida türlerinin dağılımı değerlendirilerek hastanemiz ve ülkemiz epidemiyolojik verilerine katkı sağlanması amaçlanmıştır. Yöntem: Çalışmada Ocak 2010-Aralık 2015 tarihleri arasında Ankara Numune Eğitim ve Araştırma Hastanesi yoğun bakım ve klinik sevislerinde yatarak tedavi gören hastalarda gelişen 3840 nozokomiyal enfeksiyondan izole edilen etkenler değerlendirilmiştir. Çeşitli klinik örneklerden izole edilen Candida suşları Hastane Enfeksiyon Kontrol Komitesi tarafından Hastalık Kontrol ve Önleme Merkezi CDC kriterlerine göre nozokomiyal enfeksiyon etkeni olarak kabul edilmiştir. Nozokomiyal enfeksiyon etkeni olarak tespit edilen 350 Candida suşunun dağılımı incelenmiştir.Bulgular: İzlenen dönem içinde Ankara Numune Eğitim ve Araştırma Hastanesi yoğun bakım ünitelerinde 2559, klinik ünitelerinde 1281 nozokomiyal enfeksiyon tespit edilmiştir.Nozokomiyal enfeksiyon etkenleri içinde Candida türleri, yoğun bakım ünitelerinde %11,2, klinik ünitelerde %3,7 oranında olarak saptanmıştır. Candida albicans %39,7 , nozokomiyal kandida enfeksiyonlarına neden olan türler arasında en sık görülen etken olarak tespit edilmiştir. Albicans dışı kandida türleri arasında ise en sık görülen etkenin C. parapsilosis %20,9 olduğu saptanmış, bunu C. glabrata %17,4 ve C. tropicalis %15,1 izlemiştir. En sık karşılaşılan nozokomiyal kandida enfeksiyonu, üriner sistem enfeksiyonu olarak tespit edilmiştir.Sonuç: Nozokomiyal Candida enfeksiyonlarının epidemiyolojisi yıllara göre ve merkezlere göre değişebilmektedir. Nozokomiyal Candida enfeksiyonlarının uygun yönetilebilmesi için hastanelerde düzenli aralıklarla epidemiyolojik çalışmaların yapılması gereklidir

Anahtar Kelimeler:

nozokomiyal enfeksiyon, Candida türleri, kandidemi, epidemiyoloji

Distribution of Candida species isolated from Nosocomial infections of Ankara Numune Training and Research Hospital 2010-2015

Objective: In the recent years, the epidemiology of nosocomial Candida infections and antifungals used in the treatment have changed significantly. Although Candida albicans is the most frequently identified species, but incidence of non-albicans Candida species are increased lately. In this study, it is aimed to contribute to the epidemiological database of our hospital and country by evaluating the distribution of Candida species isolated from nosocomial Candida infections. Methods: It was evaluated that agents isolated from 3840 nosocomial infections that detected in patients hospitalized in intensive care units and clinical departments of Ankara Research and Training Hospital during January 2010 and December 2015. Candida species isolated from various clinical specimens were evaluated by Infection Control Committee according to the “Centers for Disease Control and Prevention CDC ” criteria. Distrubition of 350 Candida species isolated from nosocomial infections were investigated. Results: During the study period, the number of nosocomial infections determined among the patients hospitalized at the intensive care units and clinical departments of Ankara Research and Training Hospital were 2559 and 1281 respectively. The rate of Candida species detected from nosocomial infections in intensive care units and clinical departments were 11.2%, 3.7% respectively. The most common Candida species identified as an agent of nosocomial Candida infections was Candida albicans 39.7% . Among the non-albicans Candida group, C. parapsilosis 20.9% was the most common agent followed by C. glabrata 17.4% and C. tropicalis 15.1% . The most common nosocomial Candida infections were detected as Urinary tract infections. Conclusion: Epidemiology of nosocomial Candida infections can change to years and by hospital. Epidemiological studies should be performed at regular intervals in all hospitals in order to appropriate control of nosocomial Candida infections.

Keywords:

nosocomial infection, Candida species, candidemia, epidemiology,

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