Toplum kökenli pnömoni tanısıyla yatırılmış hastaların balgam kültür sonuçlarının değerlendirilmesi ve üreyen etkenlerin yatış süresi ile ilişkisi
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Toplum kökenli pnömoni (TKP), yeni antibiyotikler ile tedavi ve immünizasyon yöntemlerindeki gelişmelere rağmen tüm dünyada en önemli mortalite ve morbidite nedenlerinden biri olmaya devam etmektedir. Ülkemizde TKP olgularını kapsayan çalışmalara bakıldığında, etiyolojik ajan saptama oranlarının %21-62.8 arasında değiştiği görülmektedir. Bu çalışmada bir üniversite hastanesinde TKP tanısı ile yatırılmış hastalarda balgam kültür sonuçlarının değerlendirilmesi ve etkenlerinin yatış süresi ile ilişkisini araştırmak amaçlanmıştır. Gereç ve yöntem: Ekim 2022- Kasım 2023 tarihleri arasında Düzce Üniversitesi Tıp Fakültesi Hastanesi Göğüs Hastalıkları Kliniği'nde TKP tanısı ile yatarak tedavi gören hastaların verileri prospektif olarak değerlendirildi. İstatistiksel değerlendirmeler için SPSS 22 ve R version 4.1.1 programları kullanıldı. Bulgular: Yaş ortalaması 71.3±14.1 olan 298 hastanın %67.1'i erkekti. Hastaların %73.8'i balgam kültür örneği verebilmişti. Kültür örneği verenlerin %45.5' inin sonucu pozitifti. Kültür üremesi olan 100 hastada en sık etkenler sırası ile Pseudomonas Aeruginosa (%21), Klebsiella Pneumoniae (%17), Escherichia Coli (%6), ve Stafilokokus Aureus (%6) idi. Kültür üremesi görülen grupta yatış süresi üreme görülmeyen gruba göre anlamlı düzeyde daha yüksekti (p<0.05). Kültür sonucu pozitif olan ve olmayan grupta akut faz reaktanları (CRP, WBC) bakımından anlamlı düzeyde fark yoktu (p>0.05). Kültür sonucu pozitif olan hastalarda pnömoni ağırlık indeksi (pneumonia severity index-PSI) risk skorunun yüksek olmasının yanı sıra PSI risk skoru 5 olanların (%26) ve CURB-65 risk skoru 4 olanların (%8) oranları anlamlı olarak daha yüksekti (p<0.05). Kardiyovasküler hastalık ve malignite varlığında yatış süreleri anlamlı olarak uzamaktaydı (p<0.05). Hastalarda görülen her bir semptom varlığına göre yatış sürelerinde anlamlı bir fark yoktu. Çoklu bakteri üreyenlerde yatış süresi anlamlı düzeyde daha yüksek (p<0.05) iken sadece Pseudomonas Aeruginosa, Klebsiella Pneumoniae, Escherichia Coli, Stafilokokus Aureus üreme durumlarına göre yatış sürelerinde anlamlı bir fark bulunmadı (p>0.05). Sonuç: Çalışmamızda yatış gerektiren TKP tanılı hastalarının balgam kültürlerinde etken üremesi %45.5 oranında saptanmıştır. Çoklu etken saptanan hastalarda yatış süresinin tek etken saptananlara göre daha uzun olduğu gösterilmiştir. Anahtar Kelimeler; Toplum kökenli pnömoni, balgam kültürü, mikrobiyoloji, etken patojen, yatış süresi
Introduction: Community-acquired pneumonia (CAP) continues to be one of the most important causes of mortality and morbidity worldwide despite advances in new antibiotics, treatment and immunization methods. In our country, the rate of detection of etiologic agent varies between 21-62.8 % in studies involving cases of CAP. The aim of this study was to evaluate the sputum culture results of patients hospitalized with the diagnosis of CAP in a university hospital and to investigate the relationship between the etiologic agents and the length of hospitalization. Materials and methods: Between October 2022 and November 2023, the data of patients who were hospitalized with the diagnosis of CAP in the Chest Diseases Clinic of Düzce University Medical Faculty Hospital were prospectively evaluated. SPSS 22 and R version 4.1.1 programs were used for statistical evaluations. Results: Of the 298 patients with a mean age of 71.3±14.1 years, 67.1% were male. 73.8% of the patients were able to provide sputum culture samples. Of those who provided culture samples, 45.5% had positive results. The most common agents in the 100 patients with culture growth were Pseudomonas Aeruginosa (21%), Klebsiella Pneumoniae (17%), Escherichia Coli (6%), and Staphylococcus Aureus (6%). The length of hospitalization was significantly higher in the group with culture growth compared to the group without culture growth (p<0.05). There was no significant difference in acute phase reactants (CRP, WBC) in the group with and without positive culture results (p>0.05). In addition to the higher PSI risk score in patients with positive culture results, the rates of PSI risk score 5 (26%) and CURB-65 risk score 4 (8%) were significantly higher (p<0.05). The duration of hospitalization was significantly longer in the presence of cardiovascular disease and malignancy (p<0.05). There was no significant difference in the length of hospitalization according to the presence of each symptom. While the length of hospitalization was significantly higher in patients with multiple bacteria growth (p<0.05), there was no significant difference in the length of hospitalization according to the growth of Pseudomonas Aeruginosa, Klebsiella Pneumoniae, Escherichia Coli and Staphylococcus Aureus ( p>0.05). Conclusion: In our study, growth of causative agents in sputum cultures of patients with CAP requiring hospitalization was found in 45.5% of patients. It has been shown that the length of hospitalization was longer in patients with multiple causative agents than in patients with single causative agents. Keywords; Community-acquired pneumonia, sputum culture, microbiology, causative pathogen, hospitalization duration
Introduction: Community-acquired pneumonia (CAP) continues to be one of the most important causes of mortality and morbidity worldwide despite advances in new antibiotics, treatment and immunization methods. In our country, the rate of detection of etiologic agent varies between 21-62.8 % in studies involving cases of CAP. The aim of this study was to evaluate the sputum culture results of patients hospitalized with the diagnosis of CAP in a university hospital and to investigate the relationship between the etiologic agents and the length of hospitalization. Materials and methods: Between October 2022 and November 2023, the data of patients who were hospitalized with the diagnosis of CAP in the Chest Diseases Clinic of Düzce University Medical Faculty Hospital were prospectively evaluated. SPSS 22 and R version 4.1.1 programs were used for statistical evaluations. Results: Of the 298 patients with a mean age of 71.3±14.1 years, 67.1% were male. 73.8% of the patients were able to provide sputum culture samples. Of those who provided culture samples, 45.5% had positive results. The most common agents in the 100 patients with culture growth were Pseudomonas Aeruginosa (21%), Klebsiella Pneumoniae (17%), Escherichia Coli (6%), and Staphylococcus Aureus (6%). The length of hospitalization was significantly higher in the group with culture growth compared to the group without culture growth (p<0.05). There was no significant difference in acute phase reactants (CRP, WBC) in the group with and without positive culture results (p>0.05). In addition to the higher PSI risk score in patients with positive culture results, the rates of PSI risk score 5 (26%) and CURB-65 risk score 4 (8%) were significantly higher (p<0.05). The duration of hospitalization was significantly longer in the presence of cardiovascular disease and malignancy (p<0.05). There was no significant difference in the length of hospitalization according to the presence of each symptom. While the length of hospitalization was significantly higher in patients with multiple bacteria growth (p<0.05), there was no significant difference in the length of hospitalization according to the growth of Pseudomonas Aeruginosa, Klebsiella Pneumoniae, Escherichia Coli and Staphylococcus Aureus ( p>0.05). Conclusion: In our study, growth of causative agents in sputum cultures of patients with CAP requiring hospitalization was found in 45.5% of patients. It has been shown that the length of hospitalization was longer in patients with multiple causative agents than in patients with single causative agents. Keywords; Community-acquired pneumonia, sputum culture, microbiology, causative pathogen, hospitalization duration
Açıklama
Anahtar Kelimeler
Göğüs Hastalıkları, Chest Diseases
