Fırat Üniversitesi Hastanesi Yoğun Bakım Ünitelerinde Gelişen Nozokomiyal Sepsiste Mortalite İçin Risk Faktörleri

Objective: Several problems are present nosocomial sepsis which still remains an important health problem in Turkish intensive care units (ICUs). The aim of the study is to decrease the mortality rate of nosocomial sepsis in ICUs. This study sought to find mortality – related risk factors in ICUs. Material and Methods: The prospective study was performed with following of one year in the ICUs of Firat University Hospital. The patients who were followed in the ICUs for at least 48 hours were enrolled in the study. Nosocomial infections were defined according to the Center for Disease Control and Prevention (CDC) criteria and were categorised by specific infection site. Results: Among the 470 patients, 81 had ICU- acquired sepsis episodes. In- ICUs nosocomial was sepsis rate 17.2% (81/470) and mortality rate 63% (51/81). Needs for mechanical ventilation, entubation, nasogastric catheter, urinary catheters episodes of sepsis were significantly associated with fatalities. Respiratory failure, used of H2 receptor antagonist was associated with a fatal outcome. The most frequent primary sources of nosocomial sepsis were lungs 38.3%, urinary 29.7% and intra-abdominal 12.4%. Cultures were positive of the patients with common microorganisms were Pseudomonas spp. 22.3% (14.5% P.aeruginosa), E.coli 17.1%, S.aureus 17% (including 9% methicillin-resistant), Acinetobacter spp. 13.1%. Conclusion: The most important risk factors of mortality were observed older age, high APACHE II score, mechanical ventilation, intubation, nasogastric catheterization, urinary catheterization, respiratory failure and used H2 receptor antagonist.