Kandidürili hastalarda risk faktörlerinin olgu konrol çalışması ile araştırılması
Küçük Resim Yok
Tarih
2005
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kandidüriye yol açan risk faktörlerini araştırmak üzere bu çalışmayı planladık MATERYAL - METOP; Selçuk Üniversitesi Meram Tıp Fakültesi Klinik bakteriyoloji ve İnfeksiyon Hastalıkları Laboratuvarına ve Merkez Mikrobiyoloji Laboratuvarına çeşitli kliniklerden gönderilen idrar kültürleri sonuçlan değerlendirildi. Yatıştan 72 saat sonra alınan idrar kültüründe 100.000 cfiı/ml kandida üremesi tespit edilen olgular değerlendirmeye alındı. Bunların arasından idrar kültüründe herhangi bir bakteriyel etkenin saptanmadığı, 38° C üzerinde ateşi olan ve piyürisi pozitif olan, 17 yaş üzeri 51 kandidüri olgusu çalışmaya dahil edildi. Kontrol grubunun seçiminde olgunun tespit edildiği klinikte en az 72 saattir yatan idrar kültüründe üremesi olmayan olguları alındı. Olgu ve kontrol grubu için sorgulama formları dolduruldu. Her bir olguya karşılık yaş, yatış süresi, yattığı servis ve cinsiyet benzeştirilerek 3 adet kontrol olacak şekilde 153 tane kontrol olgususeçildi. İstatikse! değerlendirme için Student -t test, kikare testleri kullanıldı, BULGULAR: Her iki gruptada hastaların yaş ortalaması, yatış süresi, yattığı servis benzerdi. Araştırılan risk faktörleri arasında abdominal cerrahi uygulanması kandidüri riskini 4 kat arttırdığı (p:0,001 OR:4,020), malignitenin ise kandidüri riskini 0,2 oranında arttırdığı tespit edildi (P:0,003, OR: 0,218 ). Steroid ve immünsupresif ilaç kullanımının kandidüri riskini 1,4 kat arttırdığı (P:0.335,OR: 1.478), üriner kateter varlığının kandidüri riskini 12 kat arttırdığı bulundu (P:0.000,OR.T2.408). Antibiyotik kullanımı kontrol grubu ile karşılaştırıldığında kandidüri riskini 6 kat daha fazla arttırdığı bulundu (OR: 6,00, P:0,000). Diabetli olgularda ise kandidüri gelişme riski kontrol grubuna göre 2 kat daha fazla artmış bulundu (OR:2002, P:0,044). Kandidürili hastalarda izole edilen kandida türleri ise C. albicans % 68.62, C. glabrata %11.76, C. kefry % 9.8, C.famata % 3.92, C. sake % 3.92, C. intermedia % 1.96 olarak bulundu. SONUÇ: Kandida türleri içinde en fazla görülen etken C. albicans' dır. DM, geniş spektrumlu antibiyotik kullanımı, üriner kateter varlığı, steroid ve immüno supressif ilaç kullanımı, malignite ve abdominal cerrahi uygulanmasının kandidüri olma riskini arttırdığı bulundu. Sonuç olarak hastanede yatan hastalarda üriner kateter kullanım süresinin kısaltılması, gereksiz kateter kulammımn azaltılması, endikasyonsuz geniş spekturumlu antibiyotik kullanımından kaçınılması gerekmektedir.
We planned this study to investigate the risk factors that cause candiduria in the hospitalized patients. MATERIAL AND METHODS: The cultures that were sent from various clinics to the laboratory of the clinic of infectious Diseases, Meram Faculty of Medicine, Selçuk Universty and to the laboratory of Central Microbiology were evalueted. The cases that showed 100.000 cfu/ml Candida in urine cultures that were taken after 72 hours of hospitalization were estimated. From these patients who were above 17 years of age, and there was no bacterial agent obtained in the urine cultures, who have fever above 38°C and have pyuriae were take to this study. The number of the cases that were taken to this study was 51. The patients that were take to the control group showed negative urine cultures that were taken 72 hours after hospitalization. The same forms were filled for the control and the case group. The special features of the case and control group were similar. For 5 1 case group 153 control group was taken to the study. For statistical analyse student's t test and ki-kare test was used. RESULTS: The average age of the patients, the hospitalization period, and clinics were resemble each other in the two groups. Between the risk factors that were invastigated the abdominal surgery was incresed the risk of candiduria for 4 folds (p:0,001 OR:4,020), malignity was incresed the risk for candiduria for 0,2 folds (P:0,003, OR: 0,218 ), steroid and immunosupressive therapy was incresed the risk for candiduria for 1,4 folds (P:0.335,OR: 1.478), and urinary catheter was incresed the risk for candiduria for 12 folds (P:0.000, OR: 12.408). Antibiotic usage was increased the candiduria risk 6 folds than the control group (OR: 6,00, P:0,000). In the cases with Diabetes Mellitus the risk of candiduria was 2 folds increased than the control group (OR:2002, P:0,044). The species that were isolated in the patients with candiduria were C. albicans 68.62 %, C. glabrata 1 1.76 %, C. kefiy 9.8 %, C.famata 3.92 %, C. sake 3.92 %, C. intermedia 1.96%. CONCLUSION: In the candiduric patients C.a/bicans was the most seen agent. DM, the usage of wide spectrum antibiotic, urinary catheter, steroid and immunospresive therapy and malignity and abdominal surgery increased the risk for candiduria. As a result, in the hospitalized patients we must decrease the usage of urinary catheter, the time of catheterization and we must be avoid of unnecessary antibiotic usage.
We planned this study to investigate the risk factors that cause candiduria in the hospitalized patients. MATERIAL AND METHODS: The cultures that were sent from various clinics to the laboratory of the clinic of infectious Diseases, Meram Faculty of Medicine, Selçuk Universty and to the laboratory of Central Microbiology were evalueted. The cases that showed 100.000 cfu/ml Candida in urine cultures that were taken after 72 hours of hospitalization were estimated. From these patients who were above 17 years of age, and there was no bacterial agent obtained in the urine cultures, who have fever above 38°C and have pyuriae were take to this study. The number of the cases that were taken to this study was 51. The patients that were take to the control group showed negative urine cultures that were taken 72 hours after hospitalization. The same forms were filled for the control and the case group. The special features of the case and control group were similar. For 5 1 case group 153 control group was taken to the study. For statistical analyse student's t test and ki-kare test was used. RESULTS: The average age of the patients, the hospitalization period, and clinics were resemble each other in the two groups. Between the risk factors that were invastigated the abdominal surgery was incresed the risk of candiduria for 4 folds (p:0,001 OR:4,020), malignity was incresed the risk for candiduria for 0,2 folds (P:0,003, OR: 0,218 ), steroid and immunosupressive therapy was incresed the risk for candiduria for 1,4 folds (P:0.335,OR: 1.478), and urinary catheter was incresed the risk for candiduria for 12 folds (P:0.000, OR: 12.408). Antibiotic usage was increased the candiduria risk 6 folds than the control group (OR: 6,00, P:0,000). In the cases with Diabetes Mellitus the risk of candiduria was 2 folds increased than the control group (OR:2002, P:0,044). The species that were isolated in the patients with candiduria were C. albicans 68.62 %, C. glabrata 1 1.76 %, C. kefiy 9.8 %, C.famata 3.92 %, C. sake 3.92 %, C. intermedia 1.96%. CONCLUSION: In the candiduric patients C.a/bicans was the most seen agent. DM, the usage of wide spectrum antibiotic, urinary catheter, steroid and immunospresive therapy and malignity and abdominal surgery increased the risk for candiduria. As a result, in the hospitalized patients we must decrease the usage of urinary catheter, the time of catheterization and we must be avoid of unnecessary antibiotic usage.
Açıklama
Anahtar Kelimeler
Kandidürili, Candiduria, risk faktör, risk factor
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Güler, S. (2005). Kandidürili hastalarda risk faktörlerinin olgu konrol çalışması ile araştırılması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Enfeksiyon Hastalıkları Anabilim Dalı, Konya.
