The investigation of risk factors in patients with hospitalized candidiuria

Yıl 2019, Cilt: 3 Sayı: 1, 72 - 77, 25.04.2019

Derya Korkmaz Neşe Demirtürk , Recep Keşli , Petek Konya

https://doi.org/10.30565/medalanya.519111

Cited By: 1

Öz

Aim: Urinary tract infections (UTI) are the most common infections in hospitalized patients. Although the bacteries are the most common agents of UTI, fungal agents are isolated from %10 of all cases and Candida species are most common in these cases. This study is aimed to determine the risk factors of candiduria in hospitalized patients. 

Patients and Method: The study included above-18-year-old patients with positive urine cultures for Candida spp who were hospitalized in Afyon Kocatepe University Medical Faculty Hospital between August 2012 and August 2013. We recorded the general risk factors, physical examination findings, biochemical and microbiological laboratory results for each patient. Candida species which are isolat-ed from the patient identified with Phoenix yeast ID automatize system and antifungal sensitivity tested with integral system yeast plus kit. 

Results: The study included 90 patients; the study group 45 patients who had candiduria, and control group 45 patient who had bacteriuria. Among investigated risk factors, DM (p=0.057), urinary catheter usage (p=0.015), invasive procedure performed in last 30 days (p=0.024), long term hospitalization (p=0.017), antibiotic usage (p=0.001), history of intensive care unite (ICU) admition (p=0.058) were found more frequent in study group then the control group. The most frequent isolated Candida species was C.albicans. 

Conclusion: Controlled use of antibiotics, performing urinary catheterization with ap 

propriate indications, regulation of blood sugar in diabetic patients and the shortest appropriate period of hospitalization are thought to be effective in reducing frequency of candidiuria. 

Anahtar Kelimeler

Candida, urinary system disorders, risc factor

Hospitalize kandidürili hastalarda risk faktörlerinin araştırılması

Öz

Amaç: Üriner sistem infeksiyonları (ÜSİ), hastanede yatan hastalarda en sık görülen infeksiyonlardır. ÜSİ’larından sorumlu etkenler genellikle bakteriler olmakla birlikte, %10’unda fungal etkenler saptanmakta, bunlar arasında da Candida türleri ilk sırada yer almaktadır. Bu çalışmada hastanede yatan hastalarda kandidüri için risk faktörlerinin belirlenmesi amaçlanmıştır. 

Hastalar ve Yöntem: Çalışmaya Ağustos 2012 – Ağustos 2013 tarihleri arasında Afyon Kocatepe Üniversitesi Tıp Fakültesi Hastanesinde yatan ve idrar kültürlerinde kandida türleri üreyen 18 yaş üstü hastalar dahil edildi. Her hasta için genel risk faktörleri, üriner sisteme yönelik risk faktörleri, kateter kullanım bilgileri, fizik muayene bulguları, biyokimyasal ve mikrobiyolojik laboratuar bulguları izlem formumuza kaydedildi. İzole edilen candida türleri Phoenix yeast ID otomatize sistem ile tiplendirildi. Integral system yeast plus kiti ile antifungal duyarlılık testleri gerçekleştirildi. 

Bulgular: Çalışmaya 45’i kandidüri saptanan çalışma grubu, 45’i bakteriüri saptanan kontrol grubu olmak üzere 90 hasta alındı. Araştırılan risk faktörlerinden DM (p=0.057), üriner kateter kullanımı (p=0.015), son 30 gün içerisinde invaziv girişim öyküsü (p=0.024) , hastanede yatış süresi (p=0.017), antibiyotik kullanımı (p=0.001), yoğun bakım ünitesinde yatış öyküsü (p=0.058) çalışma grubunda, kontrol grubuna göre anlamlı derecede sık tespit edildi. En sık izole edilen Candida türü C.albicans'tır. 

Sonuç: Antibiyotiklerin kontrollü kullanımının, üriner katater girişiminin uygun endikasyonlarda yapılmasının, diyabetik hastalarda kan şekeri regülasyonun sağlanmasının ve gerek hastane gerekse yoğun bakım ünitelerinde yatış sürelerinin kısaltılmasının kandidüri sıklığının azaltılmasında etkili olacağı düşünülmüştür. 

Anahtar Kelimeler

Kandida, İdrar yolu İnfeksiyonu, risk faktör

Kaynakça

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