Prevalence of Infectious Diseases and the Assessment of Antibiotic Use in the Anesthesia Intensive Care Unit

Gökçe Kızılkale Kayıkcı; Murat Aksun; Atilla Şencan; Mensure Çakırgöz; Senem Girgin; Esin Çetingöz

Makale detayları

Prevalence of Infectious Diseases and the Assessment of Antibiotic Use in the Anesthesia Intensive Care Unit

Yazarlar:

Gökçe Kızılkale Kayıkcı | Murat Aksun | Atilla Şencan | Mensure Çakırgöz | Senem Girgin | Esin Çetingöz

Yayıncı:

Bursa Uludağ University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.51 Issue 2, pp.311-318

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001350304

pISSN:

1300-414X

Anahtar kelimeler:

Özet:

 Infections remain a major cause of morbidity and mortality in intensive care units. In this retrospective study, conducted to determine the prevalence of infections and resistance patterns in intensive care patients and to highlight the prognostic value of biomarkers and disease severity scores, 195 patients with suspected or confirmed infections admitted to the Anesthesia ICU of XXXXX Hospital between March 2020 and March 2021 were evaluated. Demographic data, infection foci, microbiological findings, biomarkers WBC, CRP, PCT, and disease severity scores APACHE II, SAPS II, SOFA were analyzed. The infection prevalence was 60.6, and ICU mortality was 49.7. The median age was 67 years IQR: 5677, and 61 were male. Age, sex, and BMI were not associated with mortality. Non-survivors had significantly higher severity scores APACHE II: 28.6 vs. 18.1; SAPS II: 63.2 vs. 41.2; SOFA: 10.8 vs. 6.4; all p0.001. Common comorbidities included cardiovascular disease 69.2, diabetes 21.0, and chronic respiratory disease 19.5. Respiratory 36.0, intra-abdominal 18.0, and bloodstream infections 17.4 were most common. Tracheal aspirates were the most frequent culture-positive samples 35.3. K. pneumoniae, A. baumannii, and E. coli were the predominant pathogens. Antimicrobial resistance was found in 56.0 of culture-positive cases, without a significant mortality association p0.118. Empirical antimicrobial therapy was initiated in 87.7 of patients. By the 72nd hour of treatment, significant reductions were observed in PCT 1.40.9 ngmL, p0.001 and WBC 15.312.410³μL, p0.001 levels, while the change in CRP was not statistically significant p0.181. In the mortality group, initial CRP 111.0 vs. 78.5 mgL, p0.032 and PCT 2.4 vs. 1.0 ngmL, p0.034 levels were higher, whereas WBC did not differ significantly p0.787. Our findings suggest that severity scores and biomarker changes have prognostic value in infected critically ill patients, and integrating host response with microbiological data may aid clinical management.

 Infections remain a major cause of morbidity and mortality in intensive care units. In this retrospective study, conducted to determine the prevalence of infections and resistance patterns in intensive care patients and to highlight the prognostic value of biomarkers and disease severity scores, 195 patients with suspected or confirmed infections admitted to the Anesthesia ICU of XXXXX Hospital between March 2020 and March 2021 were evaluated. Demographic data, infection foci, microbiological findings, biomarkers WBC, CRP, PCT, and disease severity scores APACHE II, SAPS II, SOFA were analyzed. The infection prevalence was 60.6, and ICU mortality was 49.7. The median age was 67 years IQR: 5677, and 61 were male. Age, sex, and BMI were not associated with mortality. Non-survivors had significantly higher severity scores APACHE II: 28.6 vs. 18.1; SAPS II: 63.2 vs. 41.2; SOFA: 10.8 vs. 6.4; all p0.001. Common comorbidities included cardiovascular disease 69.2, diabetes 21.0, and chronic respiratory disease 19.5. Respiratory 36.0, intra-abdominal 18.0, and bloodstream infections 17.4 were most common. Tracheal aspirates were the most frequent culture-positive samples 35.3. K. pneumoniae, A. baumannii, and E. coli were the predominant pathogens. Antimicrobial resistance was found in 56.0 of culture-positive cases, without a significant mortality association p0.118. Empirical antimicrobial therapy was initiated in 87.7 of patients. By the 72nd hour of treatment, significant reductions were observed in PCT 1.40.9 ngmL, p0.001 and WBC 15.312.410³μL, p0.001 levels, while the change in CRP was not statistically significant p0.181. In the mortality group, initial CRP 111.0 vs. 78.5 mgL, p0.032 and PCT 2.4 vs. 1.0 ngmL, p0.034 levels were higher, whereas WBC did not differ significantly p0.787. Our findings suggest that severity scores and biomarker changes have prognostic value in infected critically ill patients, and integrating host response with microbiological data may aid clinical management.

 Infections remain a major cause of morbidity and mortality in intensive care units. In this retrospective study, conducted to determine the prevalence of infections and resistance patterns in intensive care patients and to highlight the prognostic value of biomarkers and disease severity scores, 195 patients with suspected or confirmed infections admitted to the Anesthesia ICU of XXXXX Hospital between March 2020 and March 2021 were evaluated. Demographic data, infection foci, microbiological findings, biomarkers WBC, CRP, PCT, and disease severity scores APACHE II, SAPS II, SOFA were analyzed. The infection prevalence was 60.6, and ICU mortality was 49.7. The median age was 67 years IQR: 5677, and 61 were male. Age, sex, and BMI were not associated with mortality. Non-survivors had significantly higher severity scores APACHE II: 28.6 vs. 18.1; SAPS II: 63.2 vs. 41.2; SOFA: 10.8 vs. 6.4; all p0.001. Common comorbidities included cardiovascular disease 69.2, diabetes 21.0, and chronic respiratory disease 19.5. Respiratory 36.0, intra-abdominal 18.0, and bloodstream infections 17.4 were most common. Tracheal aspirates were the most frequent culture-positive samples 35.3. K. pneumoniae, A. baumannii, and E. coli were the predominant pathogens. Antimicrobial resistance was found in 56.0 of culture-positive cases, without a significant mortality association p0.118. Empirical antimicrobial therapy was initiated in 87.7 of patients. By the 72nd hour of treatment, significant reductions were observed in PCT 1.40.9 ngmL, p0.001 and WBC 15.312.410³μL, p0.001 levels, while the change in CRP was not statistically significant p0.181. In the mortality group, initial CRP 111.0 vs. 78.5 mgL, p0.032 and PCT 2.4 vs. 1.0 ngmL, p0.034 levels were higher, whereas WBC did not differ significantly p0.787. Our findings suggest that severity scores and biomarker changes have prognostic value in infected critically ill patients, and integrating host response with microbiological data may aid clinical management.

 Enfeksiyonlar, yoğun bakım unitelerinde morbidite ve mortalitenin başlıca nedenlerindendir. Yoğun bakım hastalarında enfeksiyonların yaygınlığını ve direnç paternlerini ortaya çıkararak, biyobelirteçler ile hastalık şiddeti skorlarının prognozdaki önemini vurgulamayı amaçladığımız bu retrospektif çalışmada; Mart 2020Mart 2021 tarihleri arasında XXXXX Hastanesi Anestezi YBÜnde şupheli veya doğrulanmış enfeksiyon tanısı ile izlenen 195 hasta değerlendirildi. Demografik veriler, enfeksiyon odakları, mikrobiyolojik bulgular, biyobelirteçler WBC, CRP, PCT ve hastalık şiddeti skorları APACHE II, SAPS II, SOFA analiz edildi. Enfeksiyon prevalansı 60,6; mortalite oranı 49,7 olarak bulundu. Medyan yaş 67,0 yıl IQR: 56,0-77,0 olup hastaların 61,0ı erkekti. Yaş, cinsiyet ve vucut kitle indeksi mortalite ile ilişkili bulunmadı. Mortalite grubunda APACHE II 28,6 vs. 18,1, SAPS II 63,2 vs. 41,2 ve SOFA 10,8 vs. 6,4 skorları anlamlı olarak daha yuksekti tum skorlar için p 0,001. Kardiyovaskuler hastalıklar 69,2, diyabet 21,0 ve kronik solunum yolu hastalıkları 19,5 en yaygın komorbiditelerdi. En yaygın enfeksiyon odakları solunum sistemi 36,0, intraabdominal 18,0 ve kan dolaşım sistemi 17,4 olarak belirlendi. Toplam 133 kultur pozitif örnek arasında en sık ureme, n47, 35,3 trakeal aspirat kulturlerinde saptandı. İzole edilen patojenler arasında en sık K. pneumoniae, A. baumannii ve E. coli göruldu. Kultur pozitif vakaların 56,0sında antimikrobiyal direnç mevcut olup, mortaliteyle istatistiksel olarak ilişkilendirilmedi p0,118. Hastaların 87,7sine ampirik antimikrobiyal tedavi başlandı. Antimikrobiyal tedavinin 72. saatinde PCT 1,40.9 ngmL, p0,001 ve WBC 15,312,4 10³μL, p0,001 duzeylerinde anlamlı duşuş izlenirken, CRP değişimi anlamlı değildi p0,181. Mortalite grubunda başlangıç CRP 111,0 vs. 78,5 mgL, p0,032 ve PCT 2,4 vs. 1,0 ngmL p0,034 duzeyleri daha yuksekken, WBC de anlamlı fark saptanmadı p0,787. Bulgularımız, enfeksiyonu olan kritik hastalarda hastalık şiddeti skorları ve biyobelirteç değişimlerinin prognostik değerini ortaya koymakta; konak yanıtı ile mikrobiyolojik verilerin birlikte değerlendirilmesi, hasta yönetimini kolaylaştırabilir.

Makale detayları

Prevalence of Infectious Diseases and the Assessment of Antibiotic Use in the Anesthesia Intensive Care Unit

Yazarlar:

Gökçe Kızılkale Kayıkcı | Murat Aksun | Atilla Şencan | Mensure Çakırgöz | Senem Girgin | Esin Çetingöz

Yayıncı:

Bursa Uludağ University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.51 Issue 2, pp.311-318

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001350304

pISSN:

1300-414X

ICU infections

antimicrobial resistance

biomarkers

empirical antibiotics

mortalityYoğun bakım enfeksiyonları

antimikrobiyal direnç

biyomarkerler

ampirik antibiyotikler

mortalite

Sayı

Makale detayları

Yazarlar: Gökçe Kızılkale Kayıkcı | Murat Aksun | Atilla Şencan | Mensure Çakırgöz | Senem Girgin | Esin Çetingöz

Yayıncı: Bursa Uludağ University

Ana Başlıklar: Anesteziyoloji

Dergi: Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.51 Issue 2, pp.311-318

Belge Tipi: Makale

Yayın Tarihi: 8/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001350304

pISSN: 1300-414X

Sayı

Yazarlar:

Gökçe Kızılkale Kayıkcı | Murat Aksun | Atilla Şencan | Mensure Çakırgöz | Senem Girgin | Esin Çetingöz

Yayıncı:

Bursa Uludağ University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.51 Issue 2, pp.311-318

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001350304

pISSN:

1300-414X