| Sažetak | Ciljevi studije: pretvoriti postojeću bazu podataka u oblik koji je pogodan za uspoređivanje smrtnosti, učestalosti izolacije uzročnika i mjesta uzorkovanja pozitivnih mikrobioloških nalaza u razdobljima prije i tijekom COVID-19 pandemije.
Nacrt studije: Presječna studija.
Bolesnici i metode: Mikrobiološki nalazi boravaka na Jedinici za intenzivno liječenje KBC Osijek promatrani su u razdoblju prije početka COVID-19 pandemije (24. 05. 2016. - 17. 04. 2020.) i tijekom pandemije (18. 04. 2020. - 10. 03. 2022.). Uspoređuju se izolirani patogeni uzročnici, mjesta uzorkovanja pozitivnih nalaza, odjeli s kojih su bolesnici primljeni, smrtni ishodi, duljine hospitalizacija i korištenja respiratora, s obzirom na promjene uzrokovane pandemijom.
Rezultati: Bolesnici s pozitivnim nalazom imaju veću smrtnost, dulju hospitalizaciju i veću potrebu za korištenjem respiratora. U razdoblju prije pandemije uočen je trend povećanja učestalosti izolacije Acinetobacter baumannii i smanjenja učestalosti izolacije Enterococcus faecalis, Escherichia coli i Staphylococcus aureus s obzirom na duljinu boravka. S obzirom na razdoblje prije pandemije, u razdoblju tijekom pandemije manji je broj bolesnika, manji udio pozitivnih bolesnika, manji udio umrlih, veći medijan korištenja respiratora i manji medijan duljine hospitalizacije u pozitivnih bolesnika, manja prosječna duljina hospitalizacije, manji udio primljenih s abdominalne kirurgije, manja učestalost izolacije Acinetobacter baumannii i Enterobacter species, te veća učestalost izolacije Pseudomonas aeruginosa i koagulaza negativnih stafilokoka.
Zaključak: Prilagodba baze podataka omogućila je uvid i analizu u ukupno 13741 mikrobiološka uzorka. COVID-19 pandemija uzrokovala je drastične promjene u načinu rada cijelog zdravstvenog sustava, a te su se promjene drastično odrazile na mikrobiološku situaciju JIL-a. U razdoblju tijekom COVID-19 pandemije manje je umrlih, inficiranih, i manji udio umrlih među pozitivnim bolesnicima. Smanjen protok bolesnika kroz zdravstveni sustav uzrokovao je promjenu u profilu bolesnika i težini bolesti, dok će se prave posljedice odgađanja elektivnih zahvata očitovati u nadolazećim studijama. |
| Sažetak (engleski) | Objectives: to convert the existing database into a form suitable for comparing the mortality, frequency of pathogenic bacteria isolation and sampling sites of positive microbiological findings in the period before and during the COVID-19 pandemic.
Study design: Cross-sectional study.
Patients and methods: Microbiological findings from the intensive care unit of the Osijek Clinical hospital center were observed in the period before the start of the COVID-19 pandemic (May 24th, 2016. - April 17th, 2020.) and during the pandemic (April 18th, 2020. - March 10th, 2022.). Isolated pathogenic bacteria, sampling sites of positive findings, departments from which patients were admitted, mortality, lengths of hospitalization and ventilator use are compared, considering the changes caused by the COVID-19 pandemic.
Results: Patients with a positive microbiological finding have higher mortality, longer hospitalization and a greater need for ventilator use. In the period before the pandemic, the frequency of Acinetobacter baumannii isolation was increased in correlation with length of stay, while the frequency of Enterococcus faecalis, Escherichia coli and Staphylococcus aureus isolation was decreased. Compared to the period before the pandemic, the period during the pandemic had fewer patients, fewer patients with positive findings, lower mortality, higher usage of ventilators, shorter median length of hospitalization for patients with positive findings, shorter average length of hospitalization, fewer patients admitted from abdominal surgery ward, lower frequency of Acinetobacter baumannii and Enterobacter species isolation, and higher frequency of Pseudomonas aeruginosa and coagulase negative Staphylococci isolation.
Conclusion: The adaptation of the database enabled the insight and analysis of a total of 13741 microbiological samples. The COVID-19 pandemic caused drastic changes in the way the entire healthcare system works, which had a noticeable effect on the microbiological situation of the ICU. In the period during the COVID-19 pandemic, there were fewer deaths, infections, and fewer deaths among positive patients. The reduced flow of patients through the healthcare system caused a change in the patient profile and the severity of the disease upon admission, while the consequences of postponing elective procedures will be revealed in future studies. |
