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2023年土耳其东南部地震后入住重症监护病房的成年人感染情况:一项多中心观察性研究。

Infections among adults hospitalized in intensive care after the 2023 earthquake in the southeastern part of Türkiye: a multi-center observational study.

作者信息

Kaya Esat Kivanc, Halacli Burcin, Guven Goksel, Yildirim Mehmet, Seven Asir Eren, Gemcioglu Emin, Simsek Meltem, Erdemir Sullu Begum, Yuksel Recep Civan, Kaynar Ahmet Safa, Esmaoglu Aliye, Kilicaslan Banu, Akinci Seda Banu, Gundogan Kursat, Ortac Ersoy Ebru, Rello Jordi, Topeli Arzu

机构信息

Department of Internal Medicine, Division of Intensive Care Medicine, Hacettepe University Faculty of Medicine, Ankara, Türkiye.

Department of Internal Medicine, Ministry of Health, Etlik City Hospital, Ankara, Türkiye.

出版信息

BMC Infect Dis. 2025 Jan 7;25(1):35. doi: 10.1186/s12879-024-10416-x.

Abstract

BACKGROUND

Scarce evidence is available on the epidemiology of microbiologically proven clinical infections in patients admitted to the intensive care unit (ICU) after a great earthquake. The main aim of this study was to assess clinical infections and microbiological features in patients admitted to the ICU following the 2023 earthquake in the southeastern region of Türkiye with a focus on the timing of culture positivity during their ICU stay. The secondary objectives included determining antibiotic susceptibility patterns, identifying the types of antibiotics administered upon ICU admission, evaluating the appropriateness of antibiotic usage, assessing patient outcomes, and identifying factors that influence microbiologically confirmed clinical infections.

METHODS

A retrospective, multicenter, observational study was conducted on adult earthquake victims admitted to the ICU after the 2023 earthquake in southeastern Türkiye. Patients were categorized into four groups on the basis of culture positivity timing at the 72-hour breakpoint and clinical characteristics were compared among these groups. Factors influencing microbiologically proven clinical infections were also analysed.

RESULTS

A total of 107 earthquake-affected adults (58 females and 49 males, median [IQR] age: 37 [27-57] years) were analysed. Infection was present in 50.5% of the patients, predominantly with multidrug-resistant pathogens. Amputation (OR 5.30) and intermittent hemodialysis (OR 2.98) before ICU admission were independent predictors of infection.

CONCLUSIONS

This study demonstrated that half of the patients admitted to the ICU with earthquake-related injuries had microbiologically proven clinical infections, highlighting the early presence of multidrug-resistant pathogens.

摘要

背景

关于大地震后入住重症监护病房(ICU)患者经微生物学证实的临床感染流行病学的证据稀缺。本研究的主要目的是评估2023年土耳其东南部地震后入住ICU患者的临床感染和微生物学特征,重点关注其在ICU住院期间培养阳性的时间。次要目标包括确定抗生素敏感性模式、确定入住ICU时使用的抗生素类型、评估抗生素使用的合理性、评估患者结局以及确定影响微生物学确诊临床感染的因素。

方法

对2023年土耳其东南部地震后入住ICU的成年地震受害者进行了一项回顾性、多中心观察性研究。根据72小时断点处的培养阳性时间将患者分为四组,并比较这些组之间的临床特征。还分析了影响微生物学确诊临床感染的因素。

结果

共分析了107名受地震影响的成年人(58名女性和49名男性,年龄中位数[四分位间距]:37[27 - 57]岁)。50.5%的患者存在感染,主要为多重耐药病原体。入住ICU前截肢(比值比5.30)和间歇性血液透析(比值比2.98)是感染的独立预测因素。

结论

本研究表明,因地震相关损伤入住ICU的患者中有一半经微生物学证实存在临床感染,凸显了多重耐药病原体的早期存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8e7/11706041/28f9762151b5/12879_2024_10416_Fig1_HTML.jpg

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