Evaluation of health-care associated Candida infections in an intensive care unit Yoğun bakim ünitesinde gelişen sağlik bakimi ile ilişkili Candida enfeksiyonlarinin değerlendirilmesi

Creative Commons License

ÇETİN Ş., Sav H., ÇELİK İ., Bolat E., Afsar-Çagir F., Bulut T., ...Daha Fazla

Turk Hijyen ve Deneysel Biyoloji Dergisi, cilt.76, sa.2, ss.169-176, 2019 (Scopus)

Özet

Objective: Candida species are one of the pathogens with difficult to treat and that cause Healthcare-Associated Infections (HAIs) mortality highest. Candida infection is 0.8-4.5 per 1000 patient days and the mortality between 5.8% and 83.3%. The aim of this study was to investigate the incidence of HAIs Candida infection, and the risk factors of causing infections, Candida species and mortality. Methods: A total of 3399 patients who were hospitalized to Internal Medicine Intensive Care Unit between January 01, 2014 and December 31, 2016 were included in the study. It was retrospectively investigated forty-one patients who were diagnosed with clinic of patient's, laboratory based surveillance method and Centers for Disease Control and Prevention diagnostic criteria with Candida infections. Results: The incidence of HAIs Candida infection is 3.7 per thousand patient days. 53.7% (n=22) of the patients were female and 85.3% (n=35) were over 65 years old. 73.1% of Candida infections were urinary catheter associated urinary tract infection. Nonalbicans were isolated in rate 73.2% (n=30). The mortality of patients with Candida infection were 70.7% (n=29). Fifteen of seventeen patients with mechanical ventilation (MV) died (p=0.038). Seventeen of nineteen patients who underwent total parenteral nutrition (TPN) treatment were found to have died (p=0.01). When investigated mortality by type of Candida, one of eleven patients with C. albicans and 19 of 30 patients with non-albicans died (p=0.08). There was no correlation between mortality with risk factors such as sex, age, chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), cardiovascular disease (CVD), renal disease (RD), urinary catheter (UC) and central venous catheter (CVC) (p > 0.05). Conclusion: n the study, length of hospital stay, MV support, TPN therapy and Candida species were determined to affect mortality. Health professionals working in the ICU are recommended to practice hand hygiene, aseptic techniques in invasive procedures, infection control and prevention procedures. In addition, periodic education of health professionals and development of healthcare standards can reduce the incidence and the mortality of HAIs Candida infection.