{"id":13685,"date":"2021-01-05T01:21:25","date_gmt":"2021-01-04T22:21:25","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/\/2021\/01\/05\/fatal-seyirli-bakteriyemik-olgularin-kan-kulturu-pozitifliginin-geriye-donuk-olarak-arastirilmasi\/"},"modified":"2021-01-05T01:21:25","modified_gmt":"2021-01-04T22:21:25","slug":"fatal-seyirli-bakteriyemik-olgularin-kan-kulturu-pozitifliginin-geriye-donuk-olarak-arastirilmasi","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2021\/01\/05\/fatal-seyirli-bakteriyemik-olgularin-kan-kulturu-pozitifliginin-geriye-donuk-olarak-arastirilmasi\/","title":{"rendered":"Fatal Seyirli Bakteriyemik Olgular\u0131n Kan K\u00fclt\u00fcr\u00fc Pozitifli\u011finin Geriye D\u00f6n\u00fck Olarak Ara\u015ft\u0131r\u0131lmas\u0131"},"content":{"rendered":"<p><strong>Ama\u00e7<\/strong>: Kan dola\u015f\u0131m\u0131 infeksiyonu b\u00fct\u00fcn d\u00fcnyada sepsisle ili\u015fkili \u00f6nemli morbidite ve mortalitenin ba\u015fl\u0131ca nedenlerinden biridir. Bu geriye d\u00f6n\u00fck \u00e7al\u0131\u015fmada fatal seyirli eri\u015fkin hastalardaki kan k\u00fclt\u00fcr\u00fc pozitifli\u011finin ara\u015ft\u0131r\u0131lmas\u0131; kan k\u00fclt\u00fcr\u00fc sonu\u00e7lar\u0131n\u0131n, bakteriyemi etyolojisinin ve hastalar\u0131n uygun antimikrobiyal tedaviyi al\u0131p almad\u0131klar\u0131n\u0131n de\u011ferlendirilmesi ama\u00e7lanm\u0131\u015ft\u0131r.<\/p>\n<p><strong>Y\u00f6ntemler<\/strong>: Temmuz-Kas\u0131m 2018 tarihleri aras\u0131nda fatal seyreden eri\u015fkin hastalar\u0131n verilerine hastane otomasyon sisteminden ula\u015f\u0131ld\u0131. Hastalarda \u00f6lmeden \u00f6nce bakteriyemi varl\u0131\u011f\u0131 (son 7 g\u00fcn i\u00e7indeki kan k\u00fclt\u00fcr\u00fc pozitifli\u011fi) ve etken mikroorganizmalar ara\u015ft\u0131r\u0131ld\u0131. Demografik veriler olu\u015fturulan formlara kaydedildi.<\/p>\n<p><strong>Bulgular<\/strong>: Fatal seyirli 279 hastan\u0131n \u00f6lmeden \u00f6nce al\u0131nan kan k\u00fclt\u00fcrleri incelendi. Bunlardan 7 g\u00fcn \u00f6ncesine kadar kan k\u00fclt\u00fcr\u00fc al\u0131nan 100 (%36) hasta de\u011ferlendirilmeye al\u0131nd\u0131. Kan k\u00fclt\u00fcr\u00fc al\u0131nan 100 hastan\u0131n 39 (%39)\u2019unda kan k\u00fclt\u00fcr\u00fcnde \u00fcreme tespit edildi. Hastalar\u0131n 55\u2019i erkek ve ya\u015f ortancas\u0131 65 (19-96 aras\u0131) idi. Hastalar\u0131n 41 (%41)\u2019inde en az bir kronik hastal\u0131k vard\u0131. En s\u0131k hipertansiyon (%39) ve ikinci s\u0131kl\u0131kta diabetes mellitus (%29) g\u00f6r\u00fclmekteydi. Hastalar\u0131n %43\u2019\u00fcnde malignite tan\u0131s\u0131 vard\u0131. Charlson komorbite indeksi skoru ortancas\u0131 7.62\u00b14.3 (0-18 aras\u0131) idi. Hastalar\u0131n 94\u2019\u00fc bir yo\u011fun bak\u0131m \u00fcnitesinde takip ediliyordu. 81 hastada sekonder bir infeksiyon vard\u0131. En s\u0131k 43 (%53.8) hastada pn\u00f6moniye ve 14 (%17.5) hastada intraabdominal infeksiyona rastland\u0131. Kan k\u00fclt\u00fcr\u00fc pozitifli\u011fi saptanan 39 hastada en s\u0131k etken Acinetobacter baumannii (%33.3) olarak bulundu. Bu etkenlerin 21 (%53.8)\u2019i periferik kan k\u00fclt\u00fcr\u00fcnde, 7 (%17.9)\u2019si kateter k\u00fclt\u00fcr\u00fcnde ve 11 (%28.2)\u2019i hem periferik kan hem kateter k\u00fclt\u00fcr\u00fcnde saptand\u0131. D\u00f6rt Escherichia coli su\u015fundan 2\u2019si geni\u015flemi\u015f spektrumlu \u03b2-laktamaz-pozitif ve biri karbapeneme diren\u00e7liydi. Yedi Klebsiella pneumoniae su\u015fundan ise 4\u2019\u00fc karbapeneme diren\u00e7liydi. Kan k\u00fclt\u00fcr\u00fcnde \u00fcreme olan 39 hastadan 35\u2019ine ampirik antibiyotik ba\u015flanm\u0131\u015ft\u0131 ve 16 (%41) hastada tedavi uygun de\u011fildi.<\/p>\n<p><strong>Sonu\u00e7lar<\/strong>: Gram-negatif diren\u00e7li patojenlerin artmas\u0131na paralel olarak bakteriyemiye ba\u011fl\u0131 mortalite oranlar\u0131 her ge\u00e7en g\u00fcn artmaktad\u0131r. \u00d6zellikle yo\u011fun bak\u0131m \u00fcnitesinde takip edilen hastalarda bu oranlar daha y\u00fcksektir. Bu hastalara erken d\u00f6nemde ampirik antibiyoterapiye ba\u015flamak hayat kurtar\u0131c\u0131 olabilir.<\/p>\n<p>Klimik Dergisi 2020; 33(3): 281-5.<\/p>\n<p><strong>Cite this article as<\/strong>: Kal\u0131n-\u00dcn\u00fcvar G, \u00c7etinkaya F, T\u00fcre-Y\u00fcce Z, Ulu-K\u0131l\u0131\u00e7 A. [Retrospective evaluation of positive blood culture of bacteremic cases with fatal outcome]. Klimik Derg. 2020; 33(3): 281-5. Turkish.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ama\u00e7: Kan dola\u015f\u0131m\u0131 infeksiyonu b\u00fct\u00fcn d\u00fcnyada sepsisle ili\u015fkili \u00f6nemli morbidite ve mortalitenin ba\u015fl\u0131ca nedenlerinden biridir. Bu geriye d\u00f6n\u00fck \u00e7al\u0131\u015fmada fatal seyirli eri\u015fkin hastalardaki kan k\u00fclt\u00fcr\u00fc pozitifli\u011finin ara\u015ft\u0131r\u0131lmas\u0131; kan k\u00fclt\u00fcr\u00fc sonu\u00e7lar\u0131n\u0131n, bakteriyemi etyolojisinin ve hastalar\u0131n uygun antimikrobiyal tedaviyi al\u0131p almad\u0131klar\u0131n\u0131n de\u011ferlendirilmesi ama\u00e7lanm\u0131\u015ft\u0131r. Y\u00f6ntemler: Temmuz-Kas\u0131m 2018 tarihleri aras\u0131nda fatal seyreden eri\u015fkin hastalar\u0131n verilerine hastane otomasyon sisteminden ula\u015f\u0131ld\u0131. [&hellip;]<\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[2652,3368],"class_list":["post-13685","post","type-post","status-publish","format-standard","hentry","category-ozgun-arastirma","tag-ampirik-tedavi","tag-kan-kulturu"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/13685","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=13685"}],"version-history":[{"count":0,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/13685\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=13685"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=13685"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=13685"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}