Infections in Hematopoietic StemCel Transplantation Patients Admitted to Hematology Intensive Care Unit in Gazi University Hospital


Barlas T., Aygencel Bıkmaz Ş. G., Türkoğlu M., Can F., Aydın Kaynar L., Özkurt Z. N., ...Daha Fazla

16. Ulusal Dahili ve Cerrahi Bilimler Yoğun Bakım Kongresi, 8. Avrasya Yoğun Bakım Toplantısı, Antalya, Türkiye, 13 - 16 Kasım 2019, cilt.10, ss.66-67

  • Yayın Türü: Bildiri / Tam Metin Bildiri
  • Cilt numarası: 10
  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.66-67
  • Gazi Üniversitesi Adresli: Evet

Özet

  • Abstract: Objective: Hematopoietic stem cell transplantation (HSCT) patients may have many complications during their follow-up periods and require admission to intensive care units (ICUs). Early or late infections are one of these complications and they may lead to prolonged hospital stay, significant increase in costs and mortality. The aim of this study was to investigate local data of HSCT patients who were admitted to our hematology ICU due to infections or infectious complications. Materials-Methods: HSCT patients who were admitted to hematology ICU between January 01, 2014 and September 01, 2017 were analyzed retrospectively Results: 62 HSCT patients were included in this study. Sixty-one percent (38) of the patients were male, median age was 55.5 (IQR 34.25-62) years and 58% (36) of the patients were allogeneic HSCT patients. The most common reasons for ICU admission were sepsis/septic shock (61.3%) and acute respiratory failure (54.8%). Having neutropenia and central catheters, requiring vasopressors and invasive mechanical ventilation, having high APACHE II and SOFA scores were related with ICU mortality in univariate analysis (Table 1). The prognostic factors affecting ICU mortality in univariate analysis were also reevaluated with logistic regression analysis and the statistical significance of the APACHE II score was maintained. Urinary tract infections and Gram-positive bacteria and / or fungal isolations from any sites of infection were related with ICU mortality. At the same time, there was an increased rate of ICU mortality with the development of new infections in the ICU. Prolonged stay in hospital before ICU admission and septic shock as a reason for ICU admission were the risk factors for the development of new infections in ICU. There was seen that 38 (61.3%) patients had new infections during ICU stay. The most common infections which developed in ICU were ventilator associated pneumonia, the most frequently isolated bacteria were Acinetobacter baumannii, Pseudomonas and Klebsiella spp. CNS was the most common cause of catheter infection, Klebsiella spp. and E. coli were the most common causes of urinary tract infections. Overall ICU mortality rate was 45.2% (28). Conclusion: Larger population studies are needed to investigate the infections and the factors affecting infections and mortality in hematopoietic stem cell transplant patients.