The effects of hospital-acquired infections in the Internal Medicine Intensive Care Unit on the occurrence of acute kidney injury and mortality

Introduction and Purpose: Nosocomial infections are defined as infections that develop 48-72 hours after hospitalisation or that are not in the incubation stage at the time of admission, are exposed to the causative agent during the hospital stay, are discharged, and have symptoms within ten days after discharge. Nosocomial infections are one of the most common complications in patients hospitalised in intensive care units (ICU). Acute kidney injury (AKI) is a common organ failure in ICUs and is associated with increased mortality and morbidity and prolonged ICU and hospitalisation. In this study, it was aimed to determine the nosocomial infection agents in patients hospitalised in Dicle University Faculty of Medicine, Internal Medicine ICU, to identify the patients who developed AKI and to reveal the relationship between the detected infection agents and AKI and mortality. Materials and Methods: Patients who were diagnosed with nosocomial infection in the 3rd step intensive care unit of Internal Medicine at Dicle University Faculty of Medicine Hospital between January 2019 and December 2023 were included in the study. Clinical, demographic and laboratory characteristics of these cases were analysed in terms of mortality and AKI development. Results: A total of 129 patients, 76 (58.9%) females and 53 (41.1%) males, were included in the study. According to survival, 29 (22.4%) patients were included in the living group and 100 (77.6%) patients were included in the deceased group. When compared in terms of the presence and stages of AKI, the absence of AKI was found to be statistically significant in terms of decreasing mortality (p=0.048). Comparison of the causes of nosocomial infections between the groups showed that central catheter-associated bloodstream infections (CCBI-CDE) were more common in the deceased patient group and there was a statistically significant difference between the groups in terms of increasing mortality (p=0,048). A statistically significant difference was found between Gr(-) bacteria A.baummani and K.pnuemoniae in terms of mortality (p=0,043 and p=0,040, respectively). A.baummani and K.pnuemoniae were more common in the group with AKI and a statistically significant difference was found between the groups in terms of AKI development (p=0,047 and p=0,034, respectively). Conclusion: We believe that the rapid identification of hospital-acquired infection agents during ICU monitoring and the initiation of appropriate treatments can significantly reduce both mortality and the incidence of acute kidney injury (AKI). Keywords: Acute Kidney Injury, Hospital Infections, Intensive Care Unit, Mortality.