Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye
Yıl: 2023 Cilt: 17 Sayı: 1 Sayfa Aralığı: 28 - 35 Metin Dili: İngilizce DOI: 10.5578/ced.20239905 İndeks Tarihi: 01-06-2023
Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye
Öz: Objective: Healthcare associated infections are an important health problem that can occur as a complication of modern medical practices and pose a threat to public health. We report an outbreak of pseudo- heparin injectors infected with S. maltophilia. Material and Methods: This retrospective study was conducted at a PICU between November 2021 and February 2022. Results: Two hundred and twenty-five patients were followed up in our pediatric intensive care unit during the study period, and S. maltophilia growth was detected in the control catheter cultures taken immediately after catheterization in 12 (5.33%) of them. Of these patients, 121 jugular and three femoral catheters were inserted. It was determined that the catheter cultures were taken with the same brand (E brand) heparin injectors. Mean age of the 12 patients included in the study was 70.58 ± 81.02 months, seven (58.3%) were male. Of the patients, six were hospitalized due to pneumonia, three postoperatively, two due to non-vehicle traffic accident (NVTA) and one due to chronic renal failure. Six patients had comorbid conditions, of whom five had syndromic conditions and one had chronic renal failure. Mean hospital stay of the patients in the intensive care unit was 27.17 ± 34.41 days. Eleven (91.67%) of the patients were discharged with good recovery. One patient (NVTA) died due to non-sepsis causes. A statistically significant decrease was found in the white blood cell values from the seventh day after the catheterization of the patients (p= 0.014). In addition, mean platelet values did not increase after insertion of the catheter, on the contrary, they showed a constant tendency to decrease (p= 0.272). Procalcitonin values did not increase in the period after the insertion of the catheter, on the contrary, they showed a continuous decrease (p= 0.309). CRP values were shown to decrease statistically significantly in the days after the catheter was inserted (p= 0.027). Conclusion: Considering antibiotic resistance and mortality, it is vital to pay attention to sterilization rules and to control the effectiveness of sterilization in terms of gram-negative bacteria that are resistant even to disinfectants.
Anahtar Kelime: Türkiye’de Bir Çocuk Yoğun Bakım Ünitesinde Stenotrophomonas maltophilia’ya Bağlı Yalancı Salgın
Öz: Giriş: Sağlık bakımı ilişkili enfeksiyon, modern tıbbi uygulamaların bir komplikasyonu olarak meydana gelebilen ve halk sağlığı için tehdit oluşturabilen önemli bir sağlık sorunudur. Biz S. maltophilia ile enfekte olmuş heparinli enjektörlere bağlı bir yalancı salgını rapor ediyoruz. Gereç ve Yöntemler: Bu retrospektif çalışma, Kasım 2021 ile Şubat 2022 tarihleri arasında çocuk yoğun bakım ünitesinde yürütülmüştür. Bulgular: Çalışma sürecinde çocuk yoğun bakım ünitesine (ÇYBÜ) 225 hasta yatışı olmuş ve 124 hastaya kateter takılmıştır. Bu 124 hastanın 12 (%5.33)’sinde kateter takıldıktan sonra kateterden alınan kan kültürlerinde S. maltophilia üremesi saptandı. Bu hastaların 121’ine juguler ve üçüne femoral kateter takıldı. Kataterden alınan kan kültürleri, aynı marka (E marka) heparin enjektörleri ile alındı. Çalışmaya alınan 12 hastanın yaş ortalaması 70.58 ± 81.02 aydı, yedisi (%58.3) erkek idi. Hastaların altısı pnömoni, üçü postoperatif, ikisi araç dışı trafik kazası (ADTK) ve biri kronik böbrek yetmezliği tanısı ile yatırıldı. Altı hastada komorbid durum mevcut olup bunların beşinde sendromik durumlar ve bir hastada kronik böbrek yetmezliği olduğu saptandı. Hastaların yoğun bakım ortalama yatış süresi 27.17 ± 34.41 gün olarak saptandı. Hastaların 11’i şifa ile taburcu edildi. Bir hasta (ADTK) sepsis-dışı nedenlerden dolayı kaybedildi. Hastaların kateter takılmasından yedinci güne kadar geçen süre içerisinde beyaz küre değerlerinde istatistiksel olarak anlamlı bir azalma saptanmıştır (p= 0.014). Ayrıca ortalama trombosit değerleri kateter takıldıktan sonra yükselme göstermemiş, aksine sürekli azalma eğilimi göstermiştir (p= 0.272). Prokalsitonin değerleri de kateter takıldıktan sonraki süreçte artış göstermemiş, aksine sürekli azalma eğilimi göstermiştir (p= 0.309). CRP değerleri, kateter takıldıktan sonraki günlerde istatistiksel olarak anlamlı düzeyde düştüğü gösterildi (p= 0.027). Sonuç: Antibiyotik dirençleri ve mortalite göz önüne alındığında, dezenfektanlara bile dirençli olan gram-negatif bakteriler açısından sterilizasyon kurallarına dikkat etmek ve sterilizasyonun etkinliğini kontrol etmek hayati önem taşımaktadır.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | botan e, boyraz m, ulu botan e, Akış F, Karakuş Epçaçan Z, Yuce S (2023). Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye. , 28 - 35. 10.5578/ced.20239905 |
| Chicago | botan edin,boyraz merve,ulu botan emine,Akış Feride,Karakuş Epçaçan Zerrin,Yuce Servet Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye. (2023): 28 - 35. 10.5578/ced.20239905 |
| MLA | botan edin,boyraz merve,ulu botan emine,Akış Feride,Karakuş Epçaçan Zerrin,Yuce Servet Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye. , 2023, ss.28 - 35. 10.5578/ced.20239905 |
| AMA | botan e,boyraz m,ulu botan e,Akış F,Karakuş Epçaçan Z,Yuce S Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye. . 2023; 28 - 35. 10.5578/ced.20239905 |
| Vancouver | botan e,boyraz m,ulu botan e,Akış F,Karakuş Epçaçan Z,Yuce S Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye. . 2023; 28 - 35. 10.5578/ced.20239905 |
| IEEE | botan e,boyraz m,ulu botan e,Akış F,Karakuş Epçaçan Z,Yuce S "Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye." , ss.28 - 35, 2023. 10.5578/ced.20239905 |
| ISNAD | botan, edin vd. "Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye". (2023), 28-35. https://doi.org/10.5578/ced.20239905 |
| APA | botan e, boyraz m, ulu botan e, Akış F, Karakuş Epçaçan Z, Yuce S (2023). Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye. Çocuk Enfeksiyon Dergisi, 17(1), 28 - 35. 10.5578/ced.20239905 |
| Chicago | botan edin,boyraz merve,ulu botan emine,Akış Feride,Karakuş Epçaçan Zerrin,Yuce Servet Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye. Çocuk Enfeksiyon Dergisi 17, no.1 (2023): 28 - 35. 10.5578/ced.20239905 |
| MLA | botan edin,boyraz merve,ulu botan emine,Akış Feride,Karakuş Epçaçan Zerrin,Yuce Servet Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye. Çocuk Enfeksiyon Dergisi, vol.17, no.1, 2023, ss.28 - 35. 10.5578/ced.20239905 |
| AMA | botan e,boyraz m,ulu botan e,Akış F,Karakuş Epçaçan Z,Yuce S Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye. Çocuk Enfeksiyon Dergisi. 2023; 17(1): 28 - 35. 10.5578/ced.20239905 |
| Vancouver | botan e,boyraz m,ulu botan e,Akış F,Karakuş Epçaçan Z,Yuce S Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye. Çocuk Enfeksiyon Dergisi. 2023; 17(1): 28 - 35. 10.5578/ced.20239905 |
| IEEE | botan e,boyraz m,ulu botan e,Akış F,Karakuş Epçaçan Z,Yuce S "Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye." Çocuk Enfeksiyon Dergisi, 17, ss.28 - 35, 2023. 10.5578/ced.20239905 |
| ISNAD | botan, edin vd. "Pseudo-Outbreaks of Stenotrophomonas maltophilia on a Pediatric Intensive Care Unit in Türkiye". Çocuk Enfeksiyon Dergisi 17/1 (2023), 28-35. https://doi.org/10.5578/ced.20239905 |
