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Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study
Critical Care 2018 Cilt 22 Sayı 93
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112
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22
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Özet
Background: The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey. Methods: A total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included. The presence of systemic inflammatory response syndrome (SIRS), severe sepsis, and septic shock were assessed and documented based on the consensus criteria of the American College of Chest Physicians and Society of Critical Care Medicine (SEPSIS-I) in infected patients. Patients with septic shock were also assessed using the SEPSIS-III definitions. Data regarding demographics, illness severity, comorbidities, microbiology, therapies, length of stay, and outcomes (dead/alive during 30 days) were recorded. Results: Of the 1499 patients included in the analysis, 237 (15.8%) had infection without SIRS, 163 (10.8%) had infection with SIRS, 260 (17.3%) had severe sepsis without shock, and 203 (13.5%) had septic shock. The mortality rates were higher in patients with severe sepsis (55.7%) and septic shock (70.4%) than those with infection alone (24.8%) and infection + SIRS (31.2%) (p < 0.001). According to SEPSIS-III, 104 (6.9%) patients had septic shock (mortality rate, 75.9%). The respiratory system (71.6%) was the most common site of infection, and Acinetobacter spp. (33.7%) were the most common isolated pathogen. Approximately, 74.9%, 39.1%, and 26.5% of Acinetobacter, Klebsiella, and Pseudomonas spp. isolates, respectively, were carbapenem-resistant, which was not associated with a higher mortality risk. Age, acute physiology and chronic health evaluation II score at ICU admission, sequential organ failure assessment score on study day, solid organ malignancy, presence of severe sepsis or shock, Candida spp. infection, renal replacement treatment, and a nurse-to-patient ratio of 1:4 (compared with a nurse-to-patient ratio of 1:2) were independent predictors of mortality in infected patients. Conclusions: A high prevalence of sepsis and an unacceptably high mortality rate were observed in Turkish ICUs. Although the prevalence of carbapenem resistance was high in Turkish ICUs, it was not associated with a higher risk for mortality.

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Makale Bilgileri

Dergi Critical Care
ISSN 1466-609X
Yıl 2018 / 4. ay
Cilt / Sayı 22 / 93
Sayfalar 1 – 14
Makale Türü Özgün Makale
Hakemlik Hakemli
Endeks SCI
Teşvik Puanı 0,64 · YÖKSİS Akademik Teşvik
Yayın Dili İngilizce
Kapsam Uluslararası
Toplam Yazar 28 kişi
Erişim Türü Elektronik
Alan Sağlık Bilimleri Temel Alanı- Anesteziyoloji ve Reanimasyon

YÖKSİS Yazar Kaydı

Yazar Adı BAYKARA ZEHRA NUR,AKALIN EMİN HALİS,ARSLANTAŞ MUSTAFA KEMAL,HANCI VOLKAN,ÇAĞLAYAN ÇİĞDEM,KAHVECİ FERDA ŞÖHRET,DEMİRAĞ KUBİLAY,BAYDEMİR CANAN,GROUP SEPSİS STUDY,ÖZDEMİR PINAR,ULUSOY HÜLYA,MEMİŞ DİLEK,ARAR MAKBULE CAVİDAN,YILMAZ ELİF,GÜRA ÇELİK MELEK,CİNEL İSMAİL HAKKI,TEMUR SİBEL,YAŞAR MEHMET AKİF,TUTAN ÇULHA HAMDİYE,BALCI CANAN,SAN SULTAN,SALBES ASENA,ÖZKAN ELÇİN,PALABIYIK ONUR,ÇELİK JALE BENGİ,YOSUNKAYA ALPER,ÇİÇEKCİ FARUK,GROUP SEPSİS STUDY
YÖKSİS ID 3106874

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Scopus Atıf 112
Havuz Atıfları 0
Teşvik Puanı 0,64
Yazar Sayısı 28