Yenidoğan Yoğun Bakım Ünitesinde Prematürelerde Nozokomiyal Sepsis

Year 2019, Volume: 9 Issue: 1, 37 - 42, 27.03.2019

Eyüp Sarı

https://doi.org/10.16899/gopctd.490920

Abstract

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.

 

Keywords

Yenidoğan yoğun bakım üniteleri, sepsis

Nosocomial Sepsis in Premature İnfants at Neonatal İntensive Care Unit.

Abstract

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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