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    Candidemia in adult intensive care units: Analysis of a 4 year process in a tertiary hospital in Turkey
    (2020) Erdogan, Esra; Erdogan, Mehmet Mustafa; Acun Delen, Leman
    Aim: Candidemia are one of the most important causes of mortality and morbidity in inpatients, and their importance is increasing with the increasing number of immunosuppressive patients and the widespread use of invasive procedures and broad spectrum antibiotics in recent years. In our study, we aimed to identify Candida species isolated from blood cultures and to determine the antifungal susceptibility rates of adult patients who were hospitalized in Malatya Education and Research Hospital Intensive Care Units between July 2015 and July 2019, and had Candida growth in at least one of their blood cultures.Materials and Methods: The blood cultures isolated from adult intensive care units patients and sent to the Microbiology Laboratory of our hospital over the four years, were examined retrospectively. Species distribution and antifungal susceptibility were determined using VITEK 2 Compact System (BioMerieux, France).Results: Of the 123 clinical samples, 59 (48%) were C. albicans, 21 (17.1%) were C. parapsilosis, 18 (14.6%) were C. tropicalis, 12 (9.8%) were C. glabrata, 5 (4.1%) were C. kefyr, 2 (1.6%) were C. krusei, 2 (1.6%) were C. lipoliytica, 2 (1.6%) were C. lusitaniae, 1 (0.8%) was C. dubliniensis and 1 (0.8%) was C. pelliculosa. 96.5% of C. glabrata strains were found to be susceptible to amphotericin-B, 93.1% to fluconazole, 98.3% to voriconazole, 93.5% to caspofungin, 91.4% to micafungin and 96.7% to flucytosine. 98.1% of nonalbicans Candida (NAC) strains were found to be susceptible to amphotericin-B, 74.6% to fluconazole, 90.7% to voriconazole, 78.4% to caspofungin, 80% to micafungin and 100% to flucytosine.Conclusion: The highest resistance to antifungals was found in C. glabrata and the highest susceptibility was observed in C. tropicalis. In order to develop effective and accurate infection control strategies and reduce mortality and morbidity, it is important to know the distribution and susceptibility of infectious agents, especially in critical patients in intensive care units.
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    An evaluation of cost analysis of palliative care centers
    (2022) Korkmaz Dişli, Zeliha; Öterkuş, Mesut; Acun Delen, Leman; Erce, Çiğdem
    Palliative care services were established in order to reduce the work and patient burden of intensive care units (ICU) and to reduce the treatment and care costs of patients. We objectives to make a reference study for the determination and planning of expenditure items by making expense analyzes of these centers. The files of 149 patients hospitalized in the palliative care center of Malatya Training and Research Hospital were reviewed retrospectively. The hospital automation system and files were analyzed and recorded for the data of the patients. Demographic data of patients, diagnoses of hospitalization, length of stay, treatment and care costs, including, antibiotics and other drugs, nutrition, wound care, laboratory and imaging studies, consultations, and daily bed costs were recorded and evaluated. 72 (48%) of the patients were male and the mean age was 75.4±13.0 years. The most common indications for hospitalization were malignancy 35.6% (n: 53) and cerebrovascular disease (CVD) 33.6% (n: 50). The average cost per patient was 7700 Turkish Liras (TL). It was found that the most important expenditure items in the palliative care center were daily cost of bed (6835 TL) per day), non-antibiotic drugs (2395 TL), and nutrition (1087 TL), respectively. Palliative care services are very effective units in reducing the care and treatment expenses of hospitals, which reduces the work and patient burden of intensive care units. In this respect determining and analyzing the costs of expenditure items will play an important role in health planning.