Türkiye'de Bir Yenidoğan Yoğun Bakım Ünitesinde Sağlık Hizmetlerine Bağlı Enfeksiyonların Özellikleri

Year 2023, Volume: 20 Issue: 2, 1691 - 1700, 03.07.2023

Akan Yaman , Aslı Memişoğlu , Yasemin Masal , Uluhan Sili , Ahmet Soysal , Hülya Selva Bilgen , Volkan Korten , Eren Özek

https://doi.org/10.38136/jgon.994734

Abstract

Giriş: Sağlık hizmeti ile ilişkili enfeksiyonlar (SHİE), yenidoğan yoğun bakım ünitelerinde (YYBU) neonatal mortalite, morbidite ve sağlık bakım maliyetini artıran risklerden biridir. SHİE'lerin özellikleri farklı bölgelerde ve zaman içinde önemli ölçüde farklılık gösterdiğinden, sürekli SHİE sürveyansı, enfeksiyon kontrolü için SHİE oranlarını ve sağlık bakımıyla ilişkili patojenleri belirlemek açısından önemlidir.
Gereç ve Yöntemler: Türkiye'de üçüncü basamak bir referans merkezindeki SHİE'nin özelliklerini incelemeyi amaçladık. 2011-2013 yılları arasında YYBU'ye kabul edilen tüm yenidoğanlar bu çalışmaya dahil edildi. SHİE ile ilgili bilgiler “Ulusal Hastane Enfeksiyon Gözetim Ağı” ve Hastalık Kontrol ve Önleme Merkezleri(CDC)’nin standartlarına göre toplanmıştır.
Bulgular: Toplam yatan hasta sayısı 1030 idi. Bunların% 29'unda SHİE gelişti. SHİE'nin genel oranı ve yoğunluğu sırasıyla% 29.0 ve% 24.0 idi. Kan dolaşımı enfeksiyonları, SHİE 'lerin% 36.4'ü idi. En sık izole edilen mikro-organizmalar koagülaz negatif Staphylococci ve Klebsiella pneumonia idi. Ortalama metisilin direnci % 87, ESBL oranı% 79 ve VRE oranı % 40 idi.
Sonuçlar: Bu çalışma, SHİE 'nin YYBU'de hala ciddi bir sorun teşkil ettiğini belirlemiştir. Sağlık bakımıyla ilişkili patojenler hakkında zamanında ve doğru epidemiyolojik bilgilerin mevcudiyeti, enfeksiyon kontrolü ve uygun ampirik antibiyotik seçimi için gereklidir.

Keywords

Yenidoğan Yoğun Bakım, Sağlık bakımı ile ilişkili enfeksiyon, yenidoğan

Characteristics of Healthcare Associated Infections in a Neonatal Intensive Care Unit in Turkey

Abstract

Introduction: Healthcare associated infections (HCAI) is one of the risks which increase neonatal mortality, morbidity, and health care cost in neonatal intensive care units (NICU). As the characteristics of HCAI’s vary considerably in different regions and over time, continual HCAI surveillance is important to determine HCAI' s rates and healthcare associated pathogens for infection control.
Material and Methods: We aimed to analyze the characteristics of HCAI in a tertiary referring centre in Turkey. All newborns admitted to the NICU between 2011-2013 were included in this study. HCAI related information has been collected according to the “National Hospital Infection Surveillance Network" and the standards of Centers for Disease of Control and Prevention.
Results: The total number of inpatients was 1030. Out of them, 29% have developed HCAI. Overall rate and density of HCAI were 29.0% and 24.0%, respectively. Bloodstream infections were 36.4% of HCAI’s. The most frequently isolated organisms were coagulase-negative Staphylococci. and Klebsiella pneumonia. Overall meticiline resistance was 87%, ESBL rate was 79%, and VRE rate was 40%.
Conclusions: This study determined that HCAI still presents a serious problem in NICU. The availability of timely and accurate epidemiological information on healthcare associated pathogens is necessary for infection control and the appropriate selection of empiric antibiotics.

Keywords

Neonatal Intensive Care, Healthcare associated infection, neonate

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