�ZM�R�DE ���NC� BASAMAK B�R HASTANEDE AC�NETOBACTER BAUMANN�ݒYE BA�LI VENT�LAT�R �LE �L��K�L� PN�MON� OLGULARININ DE�ERLEND�R�LMES�

ATALAY, Sabri; KI�, Tuba; S�NMEZ, Ufuk; ERSAN, G�rsel; K�SE, ��kran

Cilt : 37 Say� : 3 Y�l : 2023

37/3Son Say� Erken Bask� Ar�iv Pop�ler Makaleler

Yazar Katk� Formu

�ZM�R�DE ��NC� BASAMAK B�R HASTANEDE AC�NETOBACTER BAUMANN�ݒYE BA�LI VENT�LAT�R �LE �L��K�L� PN�MON� OLGULARININ DE�ERLEND�R�LMES� [G��s Hastanesi Dergisi]

G��s Hastanesi Dergisi. 2019; 33(1): 7-14

�ZM�R�DE ��NC� BASAMAK B�R HASTANEDE AC�NETOBACTER BAUMANN�ݒYE BA�LI VENT�LAT�R �LE �L��K�L� PN�MON� OLGULARININ DE�ERLEND�R�LMES�

Sabri ATALAY¹, Tuba KI�¹, Ufuk S�NMEZ², G�rsel ERSAN¹, ��kran K�SE¹
¹Sa�l�k Bilimleri �niversitesi Tepecik E�itim ve Ara�t�rma Hastanesi, Enfeksiyon Hastal�klar� ve Klinik Mikrobiyoloji Klini�i, Izmir, T�rkiye
²Sa�l�k Bilimleri �niversitesi Bozyaka E�itim ve Ara�t�rma Hastanesi, Enfeksiyon Hastal�klar� ve Klinik Mikrobiyoloji Klini�i, Izmir, T�rkiye

Ama�: Ventilat�r ile ili�kili pn�moni (V�P)�ler �nemli bir morbidite ve mortalite nedenidirler. Son veriler g�steriyor ki; �lkemizde ve d�nyada Acinetobacter baumannii (A. baumannii) �nemli bir V�P patojenidir. Bu �al��mada YBܒde A.baumannii�ye ba�l� V�P geli�en olgulardaki risk fakt�rlerinin, altta yatan hastal�klar�n, etken mikroorganizman�n �e�itli antibiyotiklere duyarl�l�k oranlar�n�n, tedavi yan�t�n�n ve tedavi yan�t�n� etkileyen fakt�rlerin de�erlendirilmesi ama�lanm��t�r. Y�ntem ve Gere�: �al��mada YBܒde V�P tan�s� konan ve derin trakeal aspirasyon (DTA) k�lt�r�nde A. baumannii �reyen hastalar retrospektif olarak de�erlendirilmi�tir. Bulgular: �al��maya A. baumannii�ye ba�l� V�P tan�s� konulan toplam 43 olgu dahil edilmi�tir. Olgular�n ya� ortalamas� 66.8 (19-99) y�l, 25�i (%58) erkektir. Hastalarda herhangi bir kronik hastal�k bulunma oran� %69.8 ve son 1 ay i�inde antibiyotik kullan�m oran� %95.3 olarak belirlenmi�tir. En y�ksek duyarl�l�k saptanan �� antibiyotik s�ras�yla; %81.8 ile kolistin, %32.4 ile levofloksasin ve %11.6 ile tigesiklin olarak tespit edilmi�tir. Tedavi sonu�lar� de�erlendirildi�inde; 18 (%41.9) olguda k�r sa�lan�rken, be� olguda (%11.6) n�ks geli�mi�, 20 (%46.5) olgu ise eksitus olmu�tur. Klinik gidi� ile beslenme �ekli, antibiyotik kullan�m �yk�s�, PP� kullan�m�, MV uygulanma s�resi, tan� an�ndaki l�kosit ve CRP d�zeyi, cinsiyet aras�nda istatistiksel olarak anlaml� bir fark saptanmam��t�r (p>0.05). Sonu�: Sonu� olarak �al��mam�zda; A. baumannii� ye ba�l� V�P geli�iminin ileri ya�ta, kronik hastal�� olan ki�ilerde geli�ti�i, uygulanan kombine antibiyotik tedavisine ra�men mortalitenin hala y�ksek oldu�u tespit edilmi�tir.

Anahtar Kelimeler: Acinetobacter baumannii, ventilat�r ile ili�kili pn�moni, yo�un bak�m �niteleri

EVALUATION OF CASES WITH VENTILATOR-ASSOCIATED PNEUMONIA CAUSED BY ACINETOBACTER BAUMANII AT A TERTIARY CARE HOSPITAL IN IZMIR

Aim: Ventilator-associated pneumonia (VAP) is an important cause of morbidity and mortality. Recent data suggest that Acinetobacter baumannii (A. baumannii) is an important VAP pathogen in our country and in the world. This study aimed to evaluate the risk factors of VAP caused by A. baumannii in the intensive care unit (ICU), underlying diseases, susceptibility rates, treatment response and the factors affecting the treatment outcome. Material and Methods: Patients who were diagnosed with VAP in the ICU and whom A. baumannii were grown in deep tracheal aspiration (DTA) cultures were evaluated, retrospectively. Results: A total of forty-three cases diagnosed with VAP caused by A. baumannii were included in the study. Twenty-five (58%) of the cases were male, mean age was 66.8 (19-99) years. The rate of any chronic disease of the patients was 69.8% and the rate of antibiotic use in the previous month was 95.3%. The most susceptible antibiotics were as follows; 81.8% for colistin, 32.4% for levocloxacin and 11.6% for tigecycline, respectively. When the treatment outcome were evaluated; 18 (41.9%) patients were cured, five (11.6%) cases developed recurrence and 20 cases (46.5%) were died. There was no statistically significant difference between the clinical outcome and antibiotic history, PPI use, duration of MV application, leukocyte and CRP levels at the time of diagnosis and gender (p> 0.05). Conclusion: As a conclusion; VAP caused by A. baumannii develops in patients with advanced age and who have chronic diseases, it has been found that the mortality is still high despite the combination antibiotic therapy.

Keywords: Acinetobacter baumannii, Intensive Care Units, Pneumonia, Ventilator-Associated

Makale Dili: T�rk�e

ATIF KOPYALA

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�ZM�R�DE ���NC� BASAMAK B�R HASTANEDE AC�NETOBACTER BAUMANN�ݒYE BA�LI VENT�LAT�R �LE �L��K�L� PN�MON� OLGULARININ DE�ERLEND�R�LMES�

EVALUATION OF CASES WITH VENTILATOR-ASSOCIATED PNEUMONIA CAUSED BY ACINETOBACTER BAUMANII AT A TERTIARY CARE HOSPITAL IN IZMIR

�ZM�R�DE ��NC� BASAMAK B�R HASTANEDE AC�NETOBACTER BAUMANN�ݒYE BA�LI VENT�LAT�R �LE �L��K�L� PN�MON� OLGULARININ DE�ERLEND�R�LMES�