Prevalence of Infectious Diseases and the Assessment of Antibiotic Use in the Anesthesia Intensive Care Unit

Authors : Gökçe Kızılkale Kayıkcı, Murat Aksun, Atilla Şencan, Mensure Çakırgöz, Senem Girgin, Esin Çetingöz

Pages : 311-318

Doi:10.32708/uutfd.1655566

View : 55 | Download : 58

Publication Date : 2025-08-28

Article Type : Research Paper

Abstract :Infections remain a major cause of morbidity and mortality in intensive care units. In this retrospective study, conducted to determine the prevalence of infections and resistance patterns in intensive care patients and to highlight the prognostic value of biomarkers and disease severity scores, 195 patients with suspected or confirmed infections admitted to the Anesthesia ICU of XXXXX Hospital between March 2020 and March 2021 were evaluated. Demographic data, infection foci, microbiological findings, biomarkers (WBC, CRP, PCT), and disease severity scores (APACHE II, SAPS II, SOFA) were analyzed. The infection prevalence was 60.6%, and ICU mortality was 49.7%. The median age was 67 years (IQR: 56–77), and 61% were male. Age, sex, and BMI were not associated with mortality. Non-survivors had significantly higher severity scores (APACHE II: 28.6 vs. 18.1; SAPS II: 63.2 vs. 41.2; SOFA: 10.8 vs. 6.4; all p<0.001). Common comorbidities included cardiovascular disease (69.2%), diabetes (21.0%), and chronic respiratory disease (19.5%). Respiratory (36.0%), intra-abdominal (18.0%), and bloodstream infections (17.4%) were most common. Tracheal aspirates were the most frequent culture-positive samples (35.3%). K. pneumoniae, A. baumannii, and E. coli were the predominant pathogens. Antimicrobial resistance was found in 56.0% of culture-positive cases, without a significant mortality association (p=0.118). Empirical antimicrobial therapy was initiated in 87.7% of patients. By the 72nd hour of treatment, significant reductions were observed in PCT (1.4→0.9 ng/mL, p<0.001) and WBC (15.3→12.4×10³/μL, p<0.001) levels, while the change in CRP was not statistically significant (p=0.181). In the mortality group, initial CRP (111.0 vs. 78.5 mg/L, p=0.032) and PCT (2.4 vs. 1.0 ng/mL, p=0.034) levels were higher, whereas WBC did not differ significantly (p=0.787). Our findings suggest that severity scores and biomarker changes have prognostic value in infected critically ill patients, and integrating host response with microbiological data may aid clinical management.
Keywords : Yoğun bakım enfeksiyonları, antimikrobiyal direnç, biyomarkerler, ampirik antibiyotikler, mortalite

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