Yoğun bakımda bakteriyemisi olan hastalardaprokalsitonin, prokalsitonin
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Dosyalar
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bakteriyemili hastalarda tedavinin başında ve takibinde, Prokalsitonin (PCT), Prokalsitonın/Albümin oranı(PCT/ALB oranı), Nötrofil/Lenfosit oranı (NLO) ve C-reaktif protein (CRP) arasındaki ilişkiyi ortaya koymak ve tedavi sürecinde bu belirteçlerin değişimlerini incelemektir. Yöntem: Prospektif çalışmanın örneklemi, erişkin yoğun bakım ünitesindeki 96 hastadan oluştu. Hastaların kan kültürlerinde üreyen etken mikroorganizmalar incelendi. Hastalara 0.gün, 1.gün, 3.gün ve 7-10.gün tetkiklerinden, PCT, CRP, ALB, hemogram değerleri kaydedildi. HbA1c düzeyleri kaydedildi. PCT/ALB oranı, NLO değerleri hesaplandı. Elde edilen veriler istatistiksel olarak değerlendirildi. Bulgular: Çalışmamızda 96 hastanın 45'inde (%46.9) gram pozitif, 51'inde (%53.1) ise gram negatif üreme görüldü. Kan kültürlerinde en sık üreyen mikroorganizma %27.0 ile Acinetobacter baumanniiidi. Çalışmamızda PCT, CRP değerlerinin ve PCT/ALB oranlarının tedaviyle beraber azaldığı saptanmıştır. PCT düzeyi 1.günde %28.9, 3.günde %68.4 ve 7-10.günde %79.5 oranında azalmıştır. CRP düzeyi 1.günde %15.1, 3.günde %35.5 ve 7-10.günde %50.6 oranında azalmıştır. PCT/ALB oranı 1.günde %31.0, 3.günde %68.9 ve 7-10.günde %81.0 oranında azalmıştır. Gram negatif bakteriyemisi olanlarda PCT düzeyi, gram pozitif bakteriyemisi olanlara oranla anlamlı yüksek saptanmıştır. Gram negatif üremesi olan hastalarda 3.gün NLO, gram pozitif üremesi olanlara kıyasla daha yüksek saptanmıştır. Gram negatif üremesi olanlarda 1.gün CRP düzeyleri, gram pozitif üremesi olanlara kıyasla daha yüksek saptanmıştır. Gram negatif üremesi olanlarda 0.gün, 1.gün, 3.gün ve 10.gün PCT/ALB oranları, gram pozitif üremesi olanlara kıyasla daha yüksek saptanmıştır. Sonuçlar: PCT, CRP ve PCT/ALB düzeylerinin tedavi ile azaldığı saptanmıştır. Gram negatif bakteriyemisi olanlar değerlendirilirken kan kültürü sonucu beklenmeksizin, PCT, CRP ve PCT/ALB düzeylerinin anlamlı yüksek olması ampirik tedavinin başlanması için yol gösterebilir.
Objective: The aim of study is to reveal the relationship between Procalcitonin (PCT), Procalcitonin/Albumin ratio, Neutrophil/Lymphocyte ratio (NLR) and C-reactive protein (CRP) at the beginning and follow-up of treatment in patients with bacteremia and to examine the changes in these markers during the treatment follow-up period. Material and Methods: The sample of the prospective study consisted of 96 patients hospitalized in the adult intensive care unit with various diagnoses. The causative microorganisms observed in the blood cultures of the patients were examined. PCT, CRP, ALB and hemogram values on day 0, day 1, day 3 and day 7-10 obtained from laboratory examinations were recorded. In addition, HbA1c levels were recorded. PCT/ALB ratio and NLR values were calculated. Obtained data were evaluated statistically. Results: Gram-positive bacteria were detected in 45 (46.9%) of 96 patients included in the study, and gram-negative bacteria were detected in 51 (53.1%) patients. Acinetobacter baumannii was the most common grown microorganism in blood cultures with a rate of 27.0%.In our study, it was determined that the PCT, CRP and PCT/ALB ratios decreased gradually from the 0th day of starting the treatment. PCT level decreased by 28.9% on day 1, 68.4% on day 3 and 79.5% on day 7-10.CRP level decreased by 15.1% on day 1, 35.5% on day 3 and 50.6% on day 7-10.PCT/ALB ratio decreased by 31.0% on day 1, 68.9% on day 3 and 81.0% on day 7-10.The PCT level was found to be significantly higher in those with gram-negative bacteremia than in those with gram-positive bacteremia. The mean NLR on the 3rd day in gram negative patients was found to be higher than those with gram positive growth. The CRP levels on day 1 in gram-negative patients was found to be higher than those with gram-positive growth.PCT/ALB ratios on day 0, day 1, day 3, and day 7-10 in gram-negative patientswas found to be higher than those with gram-positive growth. Conclusion: It was determined that PCT, CRP and PCT/ALB levels decreased with the treatment. A significantly higher level PCT, CRP and PCT/ALB without waiting for the blood culture results when evaluating patients can be used to guide empirical treatment in the early stages of gram-negative bacteremia. Key words: Bacteremia, Sepsis, Procalcitonin, C-reactive protein, Neutrophil/Lymphocyte Ratio, Procalcitonin/Alumin Ratio
Objective: The aim of study is to reveal the relationship between Procalcitonin (PCT), Procalcitonin/Albumin ratio, Neutrophil/Lymphocyte ratio (NLR) and C-reactive protein (CRP) at the beginning and follow-up of treatment in patients with bacteremia and to examine the changes in these markers during the treatment follow-up period. Material and Methods: The sample of the prospective study consisted of 96 patients hospitalized in the adult intensive care unit with various diagnoses. The causative microorganisms observed in the blood cultures of the patients were examined. PCT, CRP, ALB and hemogram values on day 0, day 1, day 3 and day 7-10 obtained from laboratory examinations were recorded. In addition, HbA1c levels were recorded. PCT/ALB ratio and NLR values were calculated. Obtained data were evaluated statistically. Results: Gram-positive bacteria were detected in 45 (46.9%) of 96 patients included in the study, and gram-negative bacteria were detected in 51 (53.1%) patients. Acinetobacter baumannii was the most common grown microorganism in blood cultures with a rate of 27.0%.In our study, it was determined that the PCT, CRP and PCT/ALB ratios decreased gradually from the 0th day of starting the treatment. PCT level decreased by 28.9% on day 1, 68.4% on day 3 and 79.5% on day 7-10.CRP level decreased by 15.1% on day 1, 35.5% on day 3 and 50.6% on day 7-10.PCT/ALB ratio decreased by 31.0% on day 1, 68.9% on day 3 and 81.0% on day 7-10.The PCT level was found to be significantly higher in those with gram-negative bacteremia than in those with gram-positive bacteremia. The mean NLR on the 3rd day in gram negative patients was found to be higher than those with gram positive growth. The CRP levels on day 1 in gram-negative patients was found to be higher than those with gram-positive growth.PCT/ALB ratios on day 0, day 1, day 3, and day 7-10 in gram-negative patientswas found to be higher than those with gram-positive growth. Conclusion: It was determined that PCT, CRP and PCT/ALB levels decreased with the treatment. A significantly higher level PCT, CRP and PCT/ALB without waiting for the blood culture results when evaluating patients can be used to guide empirical treatment in the early stages of gram-negative bacteremia. Key words: Bacteremia, Sepsis, Procalcitonin, C-reactive protein, Neutrophil/Lymphocyte Ratio, Procalcitonin/Alumin Ratio
Açıklama
Anahtar Kelimeler
Klinik Bakteriyoloji ve Enfeksiyon Hastalıkları, Clinical Microbiology and Infectious Diseases, Bakteriyemi, Prokalsitonin, C-reaktif protein, Nötrofil/Lenfosit Oranı, Prokalsitonin/Albumin Oranı
