In:
Turkish Journal of Clinics and Laboratory, Turkish Journal of Clinics and Laboratory, Vol. 11, No. 5 ( 2020-12-30), p. 354-358
Abstract:
Aim: The aim of this study is to retrospectively evaluate the rates and infectious factors of healthcare-associated urinary tract infections in patients with Ankara Training and Research Hospital, Anesthesia and Reanimation intensive care unit. Material and Methods: Patients hospitalized in the Anesthesia and Reanimation intensive care unit (ICU) between January 1, 2018 and December 31, 2019 and diagnosed with healthcare-related urinary tract infection were included in the study. Patient data were obtained from the daily visits of infection control nurses and daily consultation records of infectious diseases, while laboratory data were obtained from the Microbiology laboratory. The rate of infection associated with urinary catheter, distribution of infectious agents, and presence of comorbid conditions in patients were recorded. Results: Totaly 1243 patients were followed up for 17,910 patient days in the Anesthesia and Reanimation intensive care unit for two years .The urinary catheter day of the patients was 17470 days. A total of 85 patients were diagnosed with 116 urinary catheter-related urinary tract infections. Forty- seven of the patients (55%) were female, 38 (45%) were male, age median value was 66.During the period of the study, it was found that the rate of urinary catheter use was 0.97, and the rate of catheter-related urinary tract infection (CI-UTI) was 6.63.When the rate of urinary catheter use in the Anesthesia and Reanimation intensive care unit in our hospital is compared with the 2019 Ministry of Health Education and Research Hospitals Anesthesia ICU surveillance data; it was found that the rate of urinary catheter use was consistent with the 25th percentile (0.97), and the rate of CI-UTI was above the 90th percentile (3.8).The most common comorbid diseases in patients were at least one neurological disease (cerebrovascular event, dementia, etc.) in 44 (51.8%) patients, hypertension in 40 (47.1%), diabetes mellitus in 28 (32.9%), chronic obstructive pulmonary diseases in 20 (23.5%) patients and 2.4% of the patients were identified as chronic kidney disease. All patients had urinary catheters. 72 (84.7%) of the patients were intubated and 19 (22.4%) had decubitus ulcers.Distribution of agents causing urinary tract infection; multiple agents in 27 (31.8) patients, Klebsiella species (spp.) in 18 (21.2%) patients, E.coli in 10 (11.8%) patients, Enterococcus spp. in nine (10.6%) patients, Pseudomonas spp in eight (9.4%) patients, Proteus spp. in seven (8.2%) patients, Acinetobacter spp. in four (4.7%) patients, Staphylococcus aureus in one (1.2%) patient, Enterobacter spp. in one (1.2%) patient were determined.In 19 of 85 patients with urinary system infection, the agent was also isolated from the blood culture. The most common factors isolated from blood culture are; 36.8% Klebsiella spp., 31.6% multiple agents, 10.5% E.coli and 10.5% Enterococcus spp. was determined. Conclusion: As a result, it would be an appropriate approach to determine the indications for urinary catheter insertion well and withdraw the catheter when the necessity is eliminated in order to reduce the urinary system infection rates associated with healthcare in the ICU. Determining the factors of nosocomial infection in patients hospitalized in the intensive care unit will contribute to the reduction of mortality and morbidity rates as it will be a guide in empirical treatment.
Type of Medium:
Online Resource
ISSN:
2149-8296
DOI:
10.18663/tjcl.798614
Language:
Unknown
Publisher:
Turkish Journal of Clinics and Laboratory
Publication Date:
2020
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