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1.
Rev. bras. cir. cardiovasc ; 36(6): 743-751, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1351661

ABSTRACT

Abstract Introduction: The evaluation of extracorporeal membrane oxygenation-related nosocomial infection (ECMO-related NI) in a homogeneous cohort remains scarce. This study analyzed ECMO-related NI in adult patients who have undergone cardiac surgery. Methods: From January 2012 to December 2017, 322 adult patients who have received ECMO support after cardiac surgery were divided into the infection group (n=131) and the non-infection group (n=191). ECMO-related NI was evaluated according to demographic data, surgical procedures, and ECMO parameters. Results: The incidence of ECMO-related NI was 85.4 cases per 1000 ECMO days. Acinetobacter baumannii was the most common pathogen causing blood stream infection and respiratory tract infection. Prolonged duration of surgery (P=0.042) and cardiopulmonary bypass assist (P=0.044) increased the risk of ECMO-related NI. Body mass index (odds ratio [OR]: 1.077; 95% confidence interval [CI]: 1.004-1.156; P=0.039) and duration of ECMO support (OR: 1.006; 95% CI: 1.003-1.009; P=0.0001) were the independent risk factors for ECMO-related NI. Duration of ECMO support > 144 hours (OR: 2.460; 95% CI: 1.155-7.238; P<0.0001) and ECMO-related NI (OR: 3.726; 95% CI: 1.274-10.895; P=0.016) increased significantly the risk of in-hospital death. Conclusion: Prolonged duration of ECMO support was an independent risk factor for NI. Surgical correcting latent causes of cardiopulmonary failure and shortening duration of ECMO whenever possible would reduce susceptibility to NI.


Subject(s)
Humans , Adult , Cross Infection/etiology , Cross Infection/epidemiology , Cardiac Surgical Procedures/adverse effects , Cardiopulmonary Bypass/adverse effects , Extracorporeal Membrane Oxygenation/adverse effects , Retrospective Studies , Risk Factors , Hospital Mortality
2.
Arq. ciências saúde UNIPAR ; 25(2): 111-116, maio-ago. 2021.
Article in Portuguese | LILACS | ID: biblio-1252357

ABSTRACT

O ambiente hospitalar é um dos locais com maiores chances de acontecer quadros de infecções, sendo um dos motivos a utilização irrestrita dos aparelhos celulares tanto por pacientes quanto por profissionais da saúde que não se preocupam com as boas práticas de higienização. O objetivo deste estudo foi determinar a prevalência de micro­organismos em aparelhos celulares da equipe de enfermagem da Unidade de Terapia Intensiva (UTI) de um hospital na região noroeste paranaense. Participaram da pesquisa 22 colaboradores da UTI, sendo colhidos swabs umedecidos em caldo Brain Heart Infusion (BHI) dos aparelhos celulares de cada um dos participantes e, posteriormente, as amostras foram incubadas e realizadas as análises microbiológicas. Além disso, aplicou-se um questionário para se conhecer sobre o manuseio do telefone celular por parte dos colaboradores. Na análise microbiológica, observou-se crescimento em todas as amostras de pelo menos um micro­organismo (100% nos meios Ágar Sal Manitol e Ágar Sangue, e 27,3% em Ágar MacConkey). Posteriormente, realizou-se comparação com as respostas do questionário e com o resultado da amostra, sendo que apenas 13,6% dos colaboradores relataram realizar sempre higienização dos aparelhos, porém também houve crescimento de micro­organismos nos aparelhos desses colaboradores. A partir dos dados obtidos, espera-se o envolvimento da Comissão de Controle de Infecção Hospitalar (CCIH) para desenvolver ações que reduzam a prevalência e a gravidade da contaminação no ambiente hospitalar.(AU)


Hospital environments are one of the most likely places for the development of infections, with one of the reasons being the unrestricted use of cell phones by both patients and health professionals, with disregard to good hygiene practices. The purpose of this study is to determine the prevalence of microorganisms on cell phones of the nursing staff at the Intensive Care Unit (ICU) of a hospital in the northwestern region of Paraná. A total of twenty-four ICU employees participated in the research. Swabs were collected from the cell phones of each participant and were then moistened in Brain Heart Infusion (BHI) broth. Subsequently, the samples were incubated, and a microbiological analysis was carried out. In addition, a questionnaire was applied to learn out about the employee's handling of the cell phone. From the microbiological analysis, growth of at least one microorganism (100% in the Agar Salt Mannitol and Blood Agar, and 27.3% in MacConkey Agar) could be observed in all samples. Subsequently, a comparison was made with the answers to the questionnaire and with the sample result, with only 13.6% of employees reporting that they always clean the devices. However, even the devices that were reported as being cleaned presented microorganisms. With the data obtained, the Hospital Infection Control Commission (HICC) is expected to be involved in order to develop actions to reduce prevalence, incidence, and the severity of contamination in hospital environments.(AU)


Subject(s)
Humans , Cross Infection/epidemiology , Microbiological Techniques/instrumentation , Cell Phone , Epidemiology, Descriptive , Prevalence , Intensive Care Units , Nursing, Team
3.
Article in Chinese | WPRIM | ID: wpr-880143

ABSTRACT

OBJECTIVE@#To investigate the clinical characteristics and risk factors of nosocomial infection in patients with non-Hodgkin lymphoma (NHL), in order to guide better clinical prevention and treatment of nosocomial infection.@*METHODS@#The incidence of nosocomial infection, infection site, characteristics of pathogenic bacteria, drug sensitivity test results and infection risk factors of 472 non-Hodgkin lymphoma patients admitted to the Second Affiliated Hospital of Fujian Medical University from January 2015 to September 2020 were retrospectively analyzed.@*RESULTS@#Among the 472 patients, 97 (20.6%) had nosocomial infection, mainly in the lower respiratory tract (41.2%), followed by oral cavity, upper respiratory tract, urogenital tract, and blood. A total of 71 strains of pathogenic bacteria were isolated, including Gram-negative (G@*CONCLUSION@#NHL patients show high nosocomial infection rate and lower respiratory tract infection is common. Hospital day, clinical stage, presence of bone marrow invasion, and neutrophil count in peripheral blood are independent risk factors.


Subject(s)
Cross Infection/epidemiology , Drug Resistance, Bacterial , Humans , Lymphoma, Non-Hodgkin , Methicillin-Resistant Staphylococcus aureus , Retrospective Studies , Risk Factors
4.
Article in Chinese | WPRIM | ID: wpr-878718

ABSTRACT

Objective To verify the relationship between catheter-related urinary tract infection(CAUTI)and stress hyperglycemia during catheter retention in stroke patients. Methods We used nosocomial infection monitoring system to track the status of CAUTI in stroke patients in a hospital.The study cohort was all the patients who received retention catheterization from January 2016 to March 2020.According to the nested case-control design,multivariate logistic regression analysis was performed to explore the relationship between stress hyperglycemia and CAUTI in stroke patients with indwelling catheter. Results A total of 322 cases of CAUTI and 644 cases of non-CAUTI were enrolled in this study.The length of stay in the case group was(20.68 ± 3.73)d,significantly longer than that[(13.00 ± 4.01)d]in the control group(t=29.473,P <0.001).Compared with non-stress hyperglycemia,stress hyperglycemia posed a higher risk of CAUTI in the stroke patients with indwelling catheter(OR=2.020,95% CI=1.447-2.821,P=0.000)and led to the higher incidence of CAUTI in one thousand days(P<0.001). Conclusion Stress hyperglycemia in the stroke patients with indwelling catheter can significantly increase the risk of CAUTI.


Subject(s)
Catheter-Related Infections/epidemiology , Cross Infection/epidemiology , Humans , Hyperglycemia/complications , Stroke/complications , Urinary Catheterization , Urinary Tract Infections/epidemiology
5.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 17-26, jan.-dez. 2021. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1145877

ABSTRACT

Objetivo: verificar a demanda de hemoculturas, aspirados traqueais e uroculturas realizadas no HU-UNIVASF/ EBSERH e a prevalência dos microrganismos identificados no período de janeiro a junho de 2016. Métodos: estudo retrospectivo documental com abordagem quantitativa. Resultados: o setor de microbiologia realizou 488 hemoculturas, 427 uroculturas e 197 aspirados traqueais. A positividade de hemoculturas mostrou-se entre 10,9 à 25,7%, e o percentual de contaminações variou de 6,8 à 14,0%. Os microrganismos mais prevalência nas hemoculturas foram Staphylococcus epidermidis (23,7%), Staphylococcus aureus (19,3%) e Klebisiella pneumoniae (9,6%). Nas uroculturas foram Klebisiella pneumoniae (23,1%), Candida sp. (13,5%) e Escherichia coli (12,5%). Nos aspirados traqueais foram Acinetobacter baumannii (29,2%), Pseudomonas aeruginosa (26,6%) e Staphylococcus aureus (16,2%). Conclusão: a cultura mais solicitada foi hemocultura. A bactéria mais prevalente nas hemoculturas foi Staphylococcus epidermidis, nos aspirados traqueais Acinetobacter baumannii e nas uroculturas Klebisiella pneumoniae


Objective: the study's purpose has been to verify the demand for blood cultures, tracheal aspirates and urine cultures performed at a University Hospital from the Universidade Federal do Vale do São Francisco (HU-UNIVASF/EBSERH), as well as the predominance of microorganisms identified over the period from January to June 2016. Methods: it is a retrospective documentary study with a quantitative approach. Results: the microbiology sector carried out 488 blood cultures, 427 urine cultures and 197 tracheal aspirates. The positivity of blood cultures was between 10.9 and 25.7%, and the percentage of contaminations ranged from 6.8 to 14.0%. The most prevalent microorganisms in blood cultures were Staphylococcus epidermidis (23.7%), Staphylococcus aureus (19.3%) and Klebsiella pneumoniae (9.6%). In urine cultures were Klebsiella pneumoniae (23.1%), Candida sp. (13.5%) and Escherichia coli (12.5%). In tracheal aspirates were Acinetobacter baumannii (29.2%), Pseudomonas aeruginosa (26.6%) and Staphylococcus aureus (16.2%). Conclusion: the most requested culture was blood culture. The most prevalent bacterium in blood cultures was Staphylococcus epidermidis, in tracheal aspirates was Acinetobacter baumannii, and in urine cultures was Klebsiella pneumoniae


Objetivo: el propósito del trabajo es verificar la demanda de hemocultivos, aspirados traqueales y urocultivos realizados en el Hospital Universitário de la Universidade Federal do Vale do São Francisco (HU-UNIVASF/ EBSERH) y la prevalencia de los microorganismos identificados en el período de enero a junio de 2016. Métodos: este trabajo es un estudio retrospectivo documental con abordaje cuantitativo. Resultados: el sector de microbiología realizó 488 hemocultivos, 427 urocultivos y 197 aspirados traqueales. La positividad de hemocultivos se mostró entre el 10,9 al 25,7%, y el porcentaje de contaminaciones varía de 6,8 a 14,0%. Los microorganismos más prevalentes en los hemocultivos fueron Staphylococcus epidermidis (23,7%), Staphylococcus aureus (19,3%) y Klebsiella pneumoniae (9,6%). En los urocultivos fueron Klebisiella pneumoniae (23,1%), Candida sp. (13,5%) y Escherichia coli (12,5%). En los aspirados traqueales fueron Acinetobacter baumannii (29,2%), Pseudomonas aeruginosa (26,6%) y Staphylococcus aureus (16,2%). Conclusión: la cultura más solicitada fue hemocultivo. La bacteria más prevalente en los hemocultivos fue Staphylococcus epidermidis, en los aspirados traqueales, Acinetobacter baumannii y en los urocultivos, Klebisiella pneumoniae


Subject(s)
Urine/microbiology , Cross Infection/microbiology , Cross Infection/epidemiology , Bacteriological Techniques/methods , Blood Culture , Staphylococcus aureus , Staphylococcus epidermidis , Prevalence , Acinetobacter baumannii , Escherichia coli , Hospitals, University , Klebsiella pneumoniae
6.
Rev. chil. infectol ; 37(5): 509-514, nov. 2020. tab
Article in Spanish | LILACS | ID: biblio-1144244

ABSTRACT

Resumen La infección del tracto urinario asociada al catéter urinario permanente (ITU/CUP) es un problema relevante en los centros de salud por su alta frecuencia. Objetivo: Identificar factores de riesgo de ITU en pacientes adultos con CUP. Material y Método: Estudio caso control efectuado entre los años 2010-2016 en el Hospital Militar de Santiago. Se realizó un análisis estadístico univariado y multivariado por medio del modelo de regresión logística binaria, con variables como edad, duración e indicación del dispositivo, algunas comorbilidades y la instalación del dispositivo luego de 15 días hospitalización. Resultado: Se obtuvo un total de 63 casos y 123 controles. Fueron variables predictoras de ITU/CUP la duración del CUP desde el séptimo día en adelante (OR 2,6 IC 1,4-4,9, p = 0,004) y la instalación del CUP con una estadía de hospitalización previa de 15 días y más (OR 7,8 IC 2,920,9 p = 0,000). No se encontró asociación con la edad mayor de 80 años, comorbilidades como diabetes y vejiga neurogénica e indicación de instalación. Conclusiones: Los resultados permiten focalizar las intervenciones, evaluando la necesidad real de indicación de CUP en pacientes con estadía hospitalaria previa de dos semanas y fomentar el retiro de CUP antes del séptimo día de uso.


Abstract Catheter-associated urinary tract infection (CAUTI) is a relevant problem in health centers because of its high frequency. Objective: To identify UTI risk factors in adult patients with urinary catheter. Material and Method: Control case study carried out between the years 2010-2016 at the Military Hospital of Santiago, Chile. Univariate and multivariate statistical analysis were performed using the binary logistic regression model, variables such as age, duration and indication of the device, some comorbidities and the installation of the device after 15 days of hospitalization. Result: A total of 63 cases and 123 controls were obtained. Predictive variables of CAUTI for the duration of the urinary catheter from the 7th day onwards (OR 2.6 IC 1.4-4.9, p = 0.004) and the installation of the urinary catheter with a previous hospital stay of 15 days and more (OR 7.8 CI 2.9-20.9 p = 0.000). No association was found in age over 80 years, comorbidities such as diabetes and neurogenic bladder and indication. Conclusions: The results permitted to focus the interventions, evaluating the real need for indication of CUP in patients with previous hospital statistics of 2 weeks and encouraging the withdrawal of CUP before the 7th day of use.


Subject(s)
Humans , Adult , Aged, 80 and over , Urinary Tract Infections/etiology , Urinary Tract Infections/epidemiology , Catheter-Related Infections/epidemiology , Urinary Catheters/adverse effects , Urinary Catheterization/adverse effects , Chile/epidemiology , Cross Infection/epidemiology , Risk Factors
7.
Rev. chil. infectol ; 37(5): 515-522, nov. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144245

ABSTRACT

Resumen Introducción: Las infecciones del torrente sanguíneo son un problema creciente y actualmente son una amenaza para la salud pública. La bacteriemia representa aproximadamente 15% de todas las infecciones nosocomiales y afecta a 1% de los pacientes hospitalizados. Objetivo: Describir las características clínicas, epidemiológicas y microbiológicas de episodios de bacteriemia nosocomial ocurridos en un hospital colombiano. Pacientes y Métodos: Estudio retrospectivo, observacional, de corte transversal, con inclusión de pacientes adultos, hospitalizados por el Servicio de Medicina Interna en el Hospital Universitario de Santander, Bucaramanga, Colombia, durante los años 2014 a 2016. El protocolo fue aprobado por el Comité de Ética en Investigación de la Universidad Industrial de Santander. Resultados: Se revisaron 450 historias clínicas, con 148 pacientes y 182 aislados microbianos. Los antecedentes más frecuentes fueron: hipertensión arterial (46,6%) e infección por VIH (29,7%). El sistema vascular y urinario ocuparon los sitios anatómicos más frecuentes (37,3 y 38,3%, respectivamente). La letalidad fue de 29%. Los patógenos más frecuentemente aislados fueron: Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa (en suma: 49,8%) y Staphylococcus aureus 12,1%. El análisis multivariado mostró relación de la anemia con mortalidad intrahospitalaria (OR = 17,3; IC95% 2,95-102,0). Conclusiones: La bacteriemia es una infección frecuente durante la atención hospitalaria que presenta gran mortalidad. Es destacable el predominio de aislados de enterobacterias multiresistentes. El antecedente de infección por VIH es uno de los más frecuentes el que amerita ser evaluado como grupo de riesgo.


Abstract Background: Bloodstream infections are an increasing problem and currently represent a threat to public health, overcoming diseases such as HIV. Bacteremia accounts for approximately 15% of all nosocomial infections and affects 1% of all hospitalized patients. Aim: To describe the clinical, epidemiological and microbiological characteristic of episodes of nosocomial bacteremia occurring in a Colombian hospital. Methods: Retrospective, observational, cross-sectional study including adult patients, hospitalized in the internal medicine unit at the University Hospital of Santander, Bucaramanga, Colombia, during years 2014 to 2016, who met the criteria of the CDC for bloodstream infection. The protocol was approved by the Hospital Ethics Committee and by the Research Ethics Committee of the Industrial University of Santander. Results: We reviewed 450 clinical records with 148 patients and 182 microbiological isolates. 53% were male. The most frequent comorbidities were: high blood pressure (46.6%), HIV infection (29.7%). The vascular and urinary systems were the most frequent anatomical sites as the source of the infection (respectively 37.3% and 38.3%). Case fatality rate was 29%. The pathogens most frequently isolated were: Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa (globally: 49.8%) and Staphylococcus aureus 12.1%. The multivariate analysis showed a relationship between anemia and in-hospital mortality (OR = 17.3, 95%CI 2.95-102.0). Conclusions: Bacteremia is a frequent infection during hospital care that presents high mortality. It is noteworthy the predominance of Enterobacteriaceae isolates with broad profiles of resistance. The history of HIV infection is one of the most frequent which deserves to be evaluated as a risk group.


Subject(s)
Humans , Male , Female , Cross Infection/drug therapy , Cross Infection/epidemiology , Bacteremia/drug therapy , Bacteremia/epidemiology , HIV Infections/drug therapy , Retrospective Studies , Colombia/epidemiology , Anti-Bacterial Agents/therapeutic use
8.
Rev. bras. cir. cardiovasc ; 35(5): 614-618, Sept.-Oct. 2020. tab
Article in English | LILACS, SES-SP | ID: biblio-1137351

ABSTRACT

Abstract Objectives: The study aimed to determine the incidence of healthcare-associated infections (HAI) and their sites in a cardiac surgery service, as well as to determine if gender and age were risk factors for infection and to quantify mortality and increase in the hospital length of stay (LOS) due to HAI. Methods: Medical records of patients who underwent cardiac surgery from January 2012 to January 2018 were retrospectively analyzed. Data on age, gender, mortality, occurrence of HAI during hospitalization, and LOS were collected. Continuous variables were analyzed using Student's t-test, while categorical variables were compared using Fisher's exact test or chi-square test. Results: Among the 195 patients available, the HAI rate in our service was 22.6%, with female gender being a risk factor for infections (odds ratio [OR]=2.23; P=0.015). Age was also a significant risk factor for infections, with a difference in the mean age between the group with and without infection (P=0.02). The occurrence of an infectious process increased the LOS in 14 days (P<0.001) and resulted in higher mortality rates (P=0.112). A patient who has HAI was approximately 19 times more likely to remain hospitalized for more than nine days (P<0.001). Conclusion: Age and gender were risk factors for the development of HAI and the occurrence of an infectious process during hospitalization significantly increases the LOS. These findings may guide future actions aimed at reducing the impact of HAI on the health system.


Subject(s)
Humans , Male , Female , Cross Infection/epidemiology , Cardiac Surgical Procedures/adverse effects , Brazil/epidemiology , Retrospective Studies , Delivery of Health Care , Length of Stay
9.
Rev. Soc. Bras. Med. Trop ; 53: e20200248, 2020. tab, graf
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1136841

ABSTRACT

Abstract INTRODUCTION: The increase in the prevalence of multidrug-resistant Acinetobacter baumannii infections in hospital settings has rapidly emerged worldwide as a serious health problem. METHODS: This review synthetizes the epidemiology of multidrug-resistant A. baumannii, highlighting resistance mechanisms. CONCLUSIONS: Understanding the genetic mechanisms of resistance as well as the associated risk factors is critical to develop and implement adequate measures to control and prevent acquisition of nosocomial infections, especially in an intensive care unit setting.


Subject(s)
Humans , Acinetobacter Infections/drug therapy , Acinetobacter Infections/epidemiology , Cross Infection/drug therapy , Cross Infection/epidemiology , Acinetobacter baumannii , Disease Outbreaks , Drug Resistance, Multiple, Bacterial , Delivery of Health Care , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/pharmacology
10.
Rev. pediatr. electrón ; 16(2): 3-7, ago. 2019.
Article in Spanish | LILACS | ID: biblio-1021327

ABSTRACT

Los pacientes inmunocomprometidos presentan un riesgo aumentado de colonización e infecciones por microorganismos multirresistentes (MOR), entre ellos Enterococcus spp resistentes a vancomicina (ERV) y bacterias productoras de betalactamasas de espectro extendido (BLEE), las cuales son causa importante de morbimortalidad. OBJETIVO: Describir la prevalencia de MOR en Servicio de Oncología del Hospital Roberto del Río. MÉTODO: Se realizó un estudio descriptivo retrospectivo de los niños hospitalizados en el servicio de oncología desde enero a diciembre del 2016 a los cuales se les realizó vigilancia de portación de ERV y BLEE. RESULTADOS: De los 97 pacientes hospitalizados, se identificó un 8% de portación de ERV, un 13,7% de BLEE y un 6,8% presentó portación de ambos microorganismos. DISCUSIÓN: Entre enero 2012 a diciembre del 2013 se observó en nuestro centro que un 52% de los pacientes hospitalizados en oncología estaban colonizados por ERV, la disminución significativa de la portación podría deberse a la mejor adherencia de normas de prevención de infecciones asociadas a la atención en salud (IAAS), programa de uso racional de antimicrobianos y a la nueva infraestructura del servicio.


The inmunosupressed patients are at increased risk of colonization and infection with vancomycin resistant Enterococci (VRE) and extended- spectrum b-lactamase producing Enterobacteriaceae (ESBL), which can cause substantial morbidity and mortality. OBJECTIVE: Describe the prevalence of VRE and ESBL in the Oncology Unit of Roberto del Río Hospital. METHODS: Descriptive and retrospective study of hospitalized children since January to December 2016 in the Oncology Unit, that underwent VRE and ESBL colonization surveillance. RESULTS: From the 97 hospitalized patients, there were 8% of VRE colonization, 13.7% of ESBL and 6.8% of colonization from both microorganism. DISCUSSION: Between January 2012 and December 2013, we observed that 52% of hospitalized patients in the Oncology Unit were colonized by VRE. The significant decrease in colonization may be due to better fulfillment of healthcare-associated infections (HAI) normative, antibiotics stewardship and new infraestructure of our unit.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , beta-Lactamases/metabolism , Cross Infection/epidemiology , Gram-Positive Bacterial Infections/epidemiology , Vancomycin-Resistant Enterococci/enzymology , Cross Infection/microbiology , Cross Infection/prevention & control , Prevalence , Retrospective Studies , Oncology Service, Hospital , Infection Control , Gram-Positive Bacterial Infections/microbiology , Gram-Positive Bacterial Infections/prevention & control , Hospitals, Pediatric
11.
Rev. chil. infectol ; 36(3): 274-282, jun. 2019. tab
Article in Spanish | LILACS | ID: biblio-1013784

ABSTRACT

Resumen Introduccion: Las infecciones asociadas a atencion de salud (IAAS) aumentan la morbilidad y mortalidad. Durante 2014, en Hospital Clinico Red de Salud UC Christus (RS-UCCH) se estimo que 15% de las infecciones virales respiratorias fueron adquiridas durante la atencion de salud, siendo mas frecuente el virus influenza. Objetivos: Caracterizacion clinico-epidemiologica de IAAS por influenza en pacientes hospitalizados en unidades de pacientes criticos (UPC) y cuidados especiales. Material y Metodos: Estudio descriptivo. Se incluyeron pacientes en UPC y cuidados especiales con IAAS influenza entre 2014 y 2017 en RS-UCCH. IAAS por influenza se definio como: inicio de sintomas y/o RPC-TR positiva para virus influenza ≥ 48 h de ingreso hospitalario, sin sintomatologia respiratoria o estudio negativo previo. Resultados: Se identificaron 22 pacientes, edad mediana 74 anos. La influenza fue adquirida en promedio al dia 13; el 77% fue por influenza A y el 27% presento coinfeccion respiratoria. Trece (59%) estaban hospitalizados en UPC, dos (15%) por problemas pulmonares. El 86% tenia co-morbilidad y el 50% descompensacion de ella. No estaba vacunado 59%; la letalidad observada fue 18%. Conclusiones: IAAS por influenza ocurrio en pacientes cronicos, de mayor edad y no vacunados. Es primordial educar en prevencion de IAAS y mantener altas coberturas de vacunacion.


Background: Healthcare-associated infections (HAIs) increase morbidity and mortality. During 2014, at the Hospital Clinico Red de Salud UC Christus (RS-UCCH) it was estimated that 15% of respiratory viral infections were acquired during hospitalization and influenza A was more frequent. Aims: Clinical and epidemiological characterization of HAIs due to influenza virus in patients hospitalized in critical care units (CCU) and special care. Methods: Descriptive study. We included patients hospitalized in CCU and special care with hospital acquired influenza during 2014-2017. HAI due to influenza was defined as: symptom onset and/or positive influenza PCR after ≥ 48 hours of hospital admission, without previous respiratory symptoms or previous negative influenza test study. Results: 22 patients were identified, median age was 74 years. Influenza was acquired average on day 13. Influenza A was detected in 77% and 27% had respiratory co-infection. Thirteen (59%) were hospitalized in CCU, only 2 (15%) due to lung problems. Comorbidity was present in 86% and decompensation in 50%. Only 41% received influenza vaccine. The associated lethality was 18%. Conclusions: HAI due to influenza occurred in chronic, older and unvaccinated patients. Education about HAIs and continuous high vaccination coverage must be reinforced.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Cross Infection/epidemiology , Influenza, Human/epidemiology , Intensive Care Units/statistics & numerical data , Influenza Vaccines , Comorbidity , Chile/epidemiology , Cross Infection/diagnosis , Cross Infection/prevention & control , Age Factors , Critical Care , Influenza, Human/diagnosis , Influenza, Human/prevention & control , Hospitalization/statistics & numerical data
12.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 17(1): 59-68, abr. 2019. tab, ilus
Article in Spanish | LILACS, BDNPAR | ID: biblio-1008026

ABSTRACT

Las Infecciones Asociadas a las Atenciones Sanitarias (IAAS), constituyen un serio problema de salud pública. Se describe un brote de IAAS en una Unidad de Cuidados Intensivos Neonatales de Asunción y las medidas de control implementadas. Estudio descriptivo de serie de casos, entre el 26 de marzo y el 18 de abril del 2013. Fueron utilizados datos secundarios como historias clínicas, registros de enfermería, certificados de defunción, resultados de bacteriología, registros de control de IAAS. El universo estuvo constituido por 12 neonatos, en cuatro se aislaron Pseudomona aeruginosa y en tres Klebsiella pneumoniae BLEE. Predomino el sexo masculino (6/7), la media de edad de 2 días (rango:2-45 días), la mayoría prematuros (5/7). Todos con procedimientos invasivos durante la hospitalización. La tasa global de ataque fue 58% (7/12), con una tasa de ataque para P. aeruginosa de 33 % (4/12) y para K. pneumoniae BLEE de 38 % (3/12). La mortalidad global fue 29% (2/12) y la tasa de la letalidad atribuible a la infección por P. aeruginosa fue del 50% (2/4). Las medidas de control del brote fueron el aislamiento de los pacientes infectados, una enfermera por paciente, se intensifico los cuidados de bioseguridad para procedimientos invasivos y lavado de manos; suspensión de pacientes remitidos hasta que se asegurar el corte de transmisión. Se confirmó dos brotes simultáneos con agentes etiológicos diferentes, P. aeruginosa y K. pneumoniae BLEE. Es necesario reforzar las medidas de control de infecciones y lavado correcto de manos, de manera a prevenir brotes de IAAS en la UCIN(AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Pseudomonas aeruginosa , Pseudomonas Infections/epidemiology , Klebsiella Infections/epidemiology , Intensive Care Units, Neonatal , Cross Infection/epidemiology , Klebsiella pneumoniae , Paraguay/epidemiology , Disease Outbreaks
13.
Braz. j. infect. dis ; 23(2): 143-145, Mar.-Apr. 2019. tab
Article in English | LILACS | ID: biblio-1039222

ABSTRACT

ABSTRACT Background: There is little information on herpes zoster from hospital registries in South America. The aim of this study was to describe the epidemiological and clinical aspects of herpes zoster (HZ) in hospitalized patients.' Methods: We searched for hospital-based records during the period from March 2000 to January 2017 in a 700-bed tertiary-care hospital located in southern Brazil. The medical records of all eligible patients were reviewed, and data regarding demographics, medical history, clinical and laboratory characteristics, treatment regimens, and clinical outcomes were collected. Patients were also evaluated for mortality. Results: There were 801 records of herpes zoster according to the proposed criteria. Most patients with HZ presented a cutaneous clinical form of the disease with involvement of a single dermatome (n = 589, 73.5%). Additional clinical characteristics included postherpetic neuralgia (22.1%), ophthalmic HZ (7.6%) and meningoencephalitis (2.7%). Most patients presented immunocompromised conditions (64.9%) including HIV, administration of immunosuppressive agents, and malignant neoplasms. During this period, there were 105 (13.1%) deaths, which were mostly unrelated to HZ. Five deaths were related to HZ meningoencephalitis. Conclusion: The results of this study demonstrate a high burden of HZ disease in a Brazilian tertiary care hospital in the HZ vaccination era. Awareness of the incidence and comorbidity factors associated with HZ in Latin American countries such as Brazil contribute for adoption and implementation of strategies for immunization in this area.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Cross Infection/epidemiology , Tertiary Care Centers/statistics & numerical data , Herpes Zoster/epidemiology , Brazil/epidemiology , Retrospective Studies , Sex Distribution , Age Distribution
14.
Rev. Esc. Enferm. USP ; 53: e03474, 2019. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1013169

ABSTRACT

ABSTRACT Objective: To study the epidemiological profile of Healthcare-associated Infections caused by Enterobacteria which carry the Klebsiella pneumoniae Carbapenemase gene (blaKPC) in the hospital environment. Method: A descriptive study was conducted in a private hospital in Belo Horizonte, MG, Brazil, which included all patients with infections caused by Enterobacteriaceae which carry the Klebsiella pneumoniae Carbapenemase gene. The data were collected by the Automated System of Hospital Infection Control and analyzed by descriptive statistics by the Epi Info 7 program. Results: Eighty-two (82) patients participated in the study. Klebsiella pneumoniae was the most frequent species (68%) isolated in blood (30%), bronchoalveolar lavage (22%) and urine (18%), while catheter-associated bloodstream infection (30%) predominated regarding topography. A case fatality rate of 62% is highlighted in evaluating the outcome. Conclusion: The resistance genes spread rapidly, limiting the antimicrobial options for treating infectious diseases. The epidemiological profile of Healthcare-Associated Infections found in this study can be prevented by prevention and infection control programs.


RESUMEN Objetivo: Inventariar el perfil epidemiológico de las Infecciones relacionadas con la Asistencia Sanitaria causadas por Enterobacterias que transfieren el gen Klebsiella pneumoniae Carbapenemasa (blaKPC) en el entorno hospitalario. Método: Estudio descriptivo, llevado a cabo en un hospital de Belo Horizonte, MG, Brasil, que incluyó a todos los pacientes con infecciones causadas por Enterobacterias que transfieren el gen Klebsiella pneumoniae Carbapenemasa. Los datos fueron recogidos por el Sistema Automatizado de Control de Infección Hospitalaria y analizados por estadística descriptiva por el programa Epi Info 7. Resultados: Participaron en el estudio 82 pacientes. La Klebsiella pneumoniae fue la especie más frecuente (68%) aislada en la sangre (30%), lavado broncoalveolar (22%) y orina (18%). Con relación a la topografía, prevaleció la infección de torrente sanguíneo asociada con catéter (30%). En la evaluación de los resultados, se destacó una tasa de letalidad del 62% de los pacientes. Conclusión: Los gentes de resistencia se diseminan de modo rápido, limitando las opciones antimicrobianas para el tratamiento de los agravamientos infecciosos. El perfil epidemiológico de las Infecciones relacionadas con la Asistencia Sanitaria encontrado en este estudio los puede trabajar de manera preventiva los programas de prevención y control de infección.


RESUMO Objetivo: Levantar o perfil epidemiológico das Infecções relacionadas à Assistência à Saúde causadas por Enterobactérias que carreiam o gene Klebsiella pneumoniae Carbapenemase (blaKPC) no ambiente hospitalar. Método: Estudo descritivo, realizado em um hospital privado de Belo Horizonte, MG, Brasil que incluiu todos os pacientes com infecções causadas por Enterobactérias que carreiam o gene Klebsiella pneumoniae Carbapenemase. Os dados foram coletados pelo Sistema Automatizado de Controle de Infecção Hospitalar e analisados por estatística descritiva pelo programa Epi Info 7. Resultados: Participaram do estudo 82 pacientes. A Klebsiella pneumoniae foi a espécie mais frequente (68%) isolada no sangue (30%), lavado broncoalveolar (22%) e urina (18%). Em relação à topografia, prevaleceu a infecção de corrente sanguínea associada a cateter (30%). Na avaliação do desfecho, destacou-se uma taxa de letalidade de 62% dos pacientes. Conclusão: os genes de resistência se disseminam de forma rápida, limitando as opções antimicrobianas para o tratamento dos agravos infecciosos. O perfil epidemiológico das Infecções relacionadas à Assistência à Saúde encontrado neste estudo pode ser trabalhado de forma preventiva pelos programas de prevenção e controle de infecção.


Subject(s)
Humans , Male , Female , Drug Resistance, Microbial , Cross Infection/epidemiology , Enterobacteriaceae , Infection Control
15.
Revista Digital de Postgrado ; 8(3): e167, 2019. graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1087875

ABSTRACT

La utilización de catéter venoso central produce, en ocasiones, infecciones de tipo local o sistémico, como la bacteriemia no complicada o complicada (bacteriemia persistente, tromboflebitis séptica, endocarditis y otras complicaciones metastásicas). En este estudio se dan a conocer las infecciones ocasionadas por el uso de Catéter Venoso Central (CVC), así como los microorganismos presentes en los pacientes. Métodos: La investigación fue de tipo retrospectivo, descriptivo y de corte transversal, con un diseño de investigación no experimental y tuvo la finalidad de conocer, en forma directa, la realidad de la problemática. Las unidades de observación fueron (188) historias clínicas de los pacientes que ingresaron en el servicio de medicina interna en el hospital Miguel Pérez Carreño en el periodo comprendido entre enero y abril de 2017. Resultados: En 30 de los pacientes se realizó el cultivo de la punta del catéter venoso central. En el 67% no hubo crecimiento de microorganismos, mientras que el 33% crecieron microorganismos a las 24 horas. El 80% de las muestras cultivadas reportan la presencia de Cocos Gram positivos. Un 10% reportaron enterobacterias y un 10% reportan levaduras, finalmente con menor frecuencia pseudomona con un 0%. Conclusiones: Solo 78 pacientes ameritaron la colocación de un catéter venoso central, de los cuales se cultivaron 30 puntas de catéter, encontrándose que solo 10 de las puntas de catéteres dieron positivas para infección con crecimiento bacteriano a las 24 horas, siendo los cocos Gram positivos la principal bacteria aislada en los pacientes con CVC seguidos de enterobacterias(AU)


Intravascular catheterization is used for hemodynamic monitoring, hemodialysis, metabolic and nutritional support, fluid administration, chemotherapy and prolonged antibiotic therapy, blood and derivatives, among others. In this study, infections caused by the use of (CVC) central venous catheter are reported, as well as the microorganisms present in patients. Methods: The research was of a retrospective, descriptive and cross-sectional type, with a non-experimental research design and aimed to know, in a direct way, the reality of the problem. The observation units were (188) clinical records of the patients admitted to the internal medicine service at the Miguel Pérez Carreño Hospital in the period between January and April 2017. Results In 30 of the patients, the culture of the tip of the central venous catheter. In 67% there was no growth of microorganisms, while 33% grew microorganisms at 24 hours. 80% of the cultivated samples report the presence of Gram-positive cocci. 10% reported enterobacteria and 10% reported yeast, finally with less frequency pseudomonas with 0%. Conclusions: Only 78 patients required placement of a central venous catheter, of which 30 catheter tips were cultured, finding that only 10 of the catheter tips were positive for infection with bacterial growth at 24 hours, with Gram-positive cocci. the main bacteria isolated in patients with CVCfollowed by enterobacteria(AU)


Subject(s)
Humans , Adolescent , Adult , Thrombophlebitis/diagnosis , Catheterization, Central Venous/methods , Gram-Positive Cocci , Endocarditis/diagnosis , Catheter-Related Infections/microbiology , Central Venous Catheters/adverse effects , Bacterial Infections , Medical Records/statistics & numerical data , Cross Infection/epidemiology , Retrospective Studies
16.
Rev. cuba. enferm ; 34(4): e1643, oct.-dic. 2018. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126471

ABSTRACT

RESUMEN Introducción: Las infecciones asociadas a la asistencia sanitaria repercuten en la calidad de los servicios de salud, causando prolongación en la estancia hospitalaria, aumento en costos de atención, riesgo para la vida de los pacientes. A pesar de los intentos por mejorar esta situación, la problemática aún persiste. Objetivo: Determinar la carga y tipología microbiana relacionada con las infecciones asociadas a la asistencia sanitaria en servicios clínicos. Métodos: Estudio cuantitativo, descriptivo, correlacional, diseño no experimental, realizado en servicios Quirúrgica y Unidad de Cuidados Intensivos de un Hospital de Santa Marta, Colombia, durante abril a septiembre de 2014. De manera intencional se tomaron muestras de laboratorio a pacientes, trabajadores, espacios físicos y equipos. El análisis de la información se realizó mediante frecuencias absolutas y relativas, así como correlación de Pearson. Resultados: Quirúrgica reportó infección de herida quirúrgica (100 por ciento), aislando Pseudomona aeruginosa en 66,66 por ciento de casos; cinco espacios positivos (60,00 por ciento Staphylococcus albus coagulasa negativo y 40,00 por ciento Streptococcus ssp). Dos equipos resultaron positivos para Staphylococcus albus (coagulasa negativo). Unidad de Cuidados Intensivos reportó infecciones urinarias (40,00 por ciento), neumonía (40,00 por ciento) y de herida quirúrgica (20,00 por ciento), siendo Acinetobacter baumannii (40,00 por ciento) el microorganismo más frecuente. En el 100,00 por ciento espacios positivos se aisló Streptococcus ssp; ningún germen fue aislado en instrumental y equipos. Conclusiones: Quirúrgica tuvo mayor carga microbiana que la Unidad de Cuidados Intensivos. El germen predominante fue Acinetobacter baumanii. La correlación entre germen causal de las Infecciones Asociadas a la Asistencia Sanitaria, espacios físicos y equipos biomédicos resultó débil; entre germen causal e instrumental quirúrgico no existió relación(AU)


ABSTRACT Introduction: Health care-associated infections have an impact on the quality of health care services, thus causing longer stay at hospitals, rise in assistance costs and risks for the patient's life. Despite the attempts at improving this situation, the problem still remains. Objective: To determine the microbial burden and typing related to health care-associated infections in the clinical services. Methods: A quantitative, descriptive, correlative and non-experimental design-type study conducted in the Surgery services and in the Intensive Care Unit of a hospital located in Santa Marta, Colombia, from April to September, 2014. The lab samples were intentionally taken from patients, workers, physical spaces and equipment. The information analysis was based on absolute and relative frequencies as well as Pearson's correlation coefficient. Results: The Surgery Services reported surgical wound infection (100 percent), isolation of Pseudomona aeruginosa in 66.66 percent of cases; five bacteria-positive physical spaces (60 percent to coagulase-negative Staphylococcus albus and 40 percent to Streptococcus spp). Two pieces of equipment were positive to coagulase-negative Staphylococcus albus. The Intensive Care Unit reported urinary infections (40 percent), pneumonia (40 percent) and surgical wound (20 percent), being Acinetobacter baumannii (40 percent) the most frequent. In all the positive physical spaces, Streptococcus spp was isolated, but not a single germ was found in the medical instruments or in the equipment. Conclusions: Surgical Service had higher microbial burden than the Intensive Care Unit. The predominant germ was Acinetobacter baumanni. The correlation among the causative germ of health care-associated infections, the physical spaces and the biomedical equipment was poor whereas the correlation of the causative germ and the surgical instruments was non-existent(AU)


Subject(s)
Humans , Quality of Health Care , Cross Infection/epidemiology , Acinetobacter baumannii/isolation & purification , Intensive Care Units , Surgical Wound Infection , Epidemiology, Descriptive , Equipment and Supplies/microbiology
17.
Braz. j. infect. dis ; 22(5): 424-432, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-974235

ABSTRACT

ABSTRACT Introduction: Nontyphoidal Salmonella serotypes are the main cause of human food-borne infection, including several hospitalization cases in the developing countries. Aim: To detect the main serotypes and to characterize the antibiotic resistance of human non-enteric and enteric nontyphoidal Salmonella from clinical isolates in Brazil. Methods: Salmonella serotypes were identified by microbiological and molecular methods. Susceptibility testing to antibiotics was performed by agar disk diffusion. Real-time PCRs were carried out for the detection of the genus Salmonella as well as serotypes Typhimurium and Enteritidis. Results: A total of 307 nontyphoidal Salmonella were isolated from 289 different patients in a reference laboratory (LACEN-RS) from Southern Brazil in a six-year period (2010-2015). There were 45 isolates from emerging cases and 244 from sporadic cases in hospitalized patients. Non-enteric isolates were detected in 42.6% of the patients from sources such as urine, blood and other clinical fluids. Serological and PCR-specific tests demonstrated that Typhimurium (48.4%) and Enteritidis (18.3%) were the most frequent serotypes. Typhimurium isolates were generally resistant to three or more antibiotic classes, while Enteritidis isolates to one or two classes. Typhimurium was the most frequent serotype in all samples (48.4%), mainly among the hospitalized patients (55.6%), and presented the highest rates of multidrug resistance (59.3% of the isolates of this serotype). Further, the prevalence of this serotype increased along the years of the study in comparison to other nontyphoidal Salmonella serotypes. Conclusion: Greater public health attention should be given to prevent salmonellosis in the community and in hospital settings to reduce the rates of Typhimurium strains with multidrug resistance.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Young Adult , Salmonella Infections/microbiology , Salmonella Infections/epidemiology , Salmonella typhimurium/drug effects , Drug Resistance, Multiple, Bacterial , Hospitalization/statistics & numerical data , Salmonella enteritidis/isolation & purification , Salmonella enteritidis/drug effects , Salmonella typhimurium/isolation & purification , Time Factors , Brazil/epidemiology , Microbial Sensitivity Tests , Serotyping , Cross Infection/microbiology , Cross Infection/epidemiology , Prevalence , Real-Time Polymerase Chain Reaction , Serogroup , Anti-Bacterial Agents/pharmacology
18.
Braz. j. infect. dis ; 22(4): 338-344, July-Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-974224

ABSTRACT

ABSTRACT Introduction Ventilator-associated pneumonia (VAP) is one of the most common healthcare-associated infections (HAI) in neonates admitted in neonatal intensive care units (NICUs). Methods We did a systematic review using PRISMA methodology to identify the main etiological agents in Brazilian NICUs. Eligible studies published without period restriction were identified in PUBMED, SCIELO, LILACS and DOAJ. Studies were included if they were conducted in neonates hospitalized at NICU. Studies done in outpatient care, neonates outside NICU, emergency department, primary care, long-term care facilities or a combination of these were excluded. Results We identified 6384 articles in the initial search and four papers met the inclusion criteria. In all studies included, rates of device-associated infections were described, including VAP rates. The VAP incidence density, in exclusively Brazilian NICU, ranged from 3.2 to 9.2 per 1000 ventilator-days. Pneumonia was described as the main HAI in NICU in one article, as the second type of HAI in two other articles and as the fourth type of HAI in the last one. The main pathogens causing all HAI types were described in three of four articles, but, none of the articles reported which pathogens were related or associated to VAP. Conclusion Etiological agents causing VAP in Brazilian NICUs are, until the present time, not known.


Subject(s)
Humans , Infant, Newborn , Intensive Care Units, Neonatal/statistics & numerical data , Cross Infection/epidemiology , Pneumonia, Ventilator-Associated/epidemiology , Brazil/epidemiology , Randomized Controlled Trials as Topic , Cross Infection/microbiology , Incidence , Publication Bias , Pneumonia, Ventilator-Associated/microbiology
19.
Rev. Assoc. Med. Bras. (1992) ; 64(8): 736-742, Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-976843

ABSTRACT

SUMMARY INTRODUCTION Healthcare associated infections (HAI) are the most frequent complication of hospitalized patients. The aim of this study was to describe the clinical and epidemiological characteristics of critically ill post-surgical patients with a diagnosis of healthcare associated infections, after a pattern of sedoanalgesia of at least 4 days. METHODS All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology where sedation was based as analgesic the opioid remifentanil for at least 96 hours in continuous perfusion. Patients who died during admission to the unit and those with combined analgesia (peripheral or neuroaxial blocks) were excluded. Data analysis was performed using the statistical package Stata version 7.0. RESULTS The patients admitted to the Post-Surgical Critical Care Unit (PCU) during study were 1789 and the population eligible was comprised of 102 patients. 56.86% of patients suffered IACS. The most frequent IACS was pneumonia associated with mechanical ventilation (30.96 per 1000 days of mechanical ventilation), Pseudomonas aeruginosa being the most frequently isolated germ. The germs with the greatest involvement in multiple drug resistance (MDROs) were enterobacteria, mainly Klebsiella pneumoniae resistant to extended-spectrum beta-lactamases (ESBL). CONCLUSIONS Pneumonia associated with mechanical ventilation is the most prevalent HAI and Pseudomonas aeruginosa is the main etiological agent. The groups of antibiotics most frequently used were cephalosporin and aminoglycosides. It is necessary to implement the prevention strategies of the different HAI, since most of them are avoidable.


RESUMO INTRODUCCIÓN Las infecciones asociadas a cuidados de salud (IACS) constituyen la complicación más frecuente de los pacientes hospitalizados. El objetivo de este estudio es describir las características clínicas y epidemiológicas de los pacientes críticos postquirúrgicos con diagnóstico de infección asociada a cuidados de salud, tras una pauta de sedoanalegia de al menos 4 días. MÉTODOS Se seleccionaron de manera consecutiva todos los pacientes mayores de 18 años con un ingreso en la Unidad de Reanimación Postquirúrgica (URP) superior a 4 días. La población de estudio fue aquella afectada por patología quirúrgica de cualquier origen donde la sedación se basó en cualquier hipnótico y como analgésico el opioide remifentanilo durante al menos 96 horas en perfusión continua. Se excluyeron los pacientes que fallecieron durante su ingreso en la unidad y aquellos pacientes con analgesia combinada (bloqueos periféricos o neuroaxiales). El análisis de los datos se realizó con paquete estadístico Stata versión 7.0. RESULTADOS El número de pacientes que ingresaron en la URP durante el periodo de estudio fueron de 1789. Tras aplicar los criterios de inclusión y exclusión, la población elegible quedó constituida por 102 pacientes. Un 56,86% de pacientes padecieron IACS. La IACS más frecuente fue la neumonía asociada a ventilación mecánica (30,96 por 1000 días de ventilación mecánica) siendo Pseudomona aeruginosa el germen más frecuentemente aislado. Los gérmenes con mayor implicación en las multirresistencias (MDROs) fueron las enterobacterias, principalmente Klebsiella pneumoniae resistente a betalactamasas de espectro extendido (BLEE). CONCLUSIONES La neumonía asociada a ventilación mecánica es la IACS más prevalente y Pseudomona aeruginosa es el principal agente etiológico. Los grupos de antibióticos más frecuentemente empleados fueron cefalosporinas y aminoglucósidos. Es necesario implementar las estrategias de prevención de las distintas IACS, ya que la mayoría de ellas son evitables.


Subject(s)
Humans , Male , Female , Aged , Postoperative Complications/epidemiology , Cross Infection/epidemiology , Remifentanil/administration & dosage , Analgesics, Opioid/administration & dosage , Postoperative Complications/microbiology , Pseudomonas aeruginosa/isolation & purification , Spain/epidemiology , Time Factors , Midazolam/administration & dosage , Propofol/administration & dosage , Cross Infection/microbiology , Prospective Studies , Risk Factors , Critical Illness , APACHE , Pneumonia, Ventilator-Associated/microbiology , Pneumonia, Ventilator-Associated/epidemiology , Deep Sedation/adverse effects , Deep Sedation/methods , Hospitalization/statistics & numerical data , Hypnotics and Sedatives/administration & dosage , Anesthesia, Local/adverse effects , Anesthesia, Local/methods , Klebsiella pneumoniae/isolation & purification , Middle Aged
20.
Prensa méd. argent ; 104(5): 252-259, jul2018. tab
Article in English | LILACS, BINACIS | ID: biblio-1049318

ABSTRACT

Hon en día entre el 5-10% de los pacientes que ingresan a un hospital adquiere una infección nosocomial, 20% de estas son reportadas en la Unidad de Cuidados Intensivos. La incidencia es 2 a 5 veces más alta que en otros servicios hospitalarios. Objetivos: Describir la epidemiología de los patógenos intrahospitalarios en la Unidad de Cuidados Intensivos y su resistencia antibiótica. Material y métoos: Estudio transversal. La información se obtuvo de expedientes en la Unidad de Cuidados Intensivos siendo considerados solos los pacientes que desarrollaron una infección nosocomial. Resultados: Un total de 35 muestras fueron analizadas, dos grupos se obtuvieron, 24 gram positivos y 11 gram negativos. La edad media de los pacientes fue de 41.79 (78-18) ± 21.22 años. El principal sitio de infección reportado en ambos grupos, gram-negativos y gram-positivos fue la vía respiratoria baja en un 58,.3% y 81.1% respectivamente. Para el grupo de gram negativos los tres principales organismos aislados en los cultivos fueron: Klebsiella pneumoniae in 29.2% (n=7)., Acinetobacter baumanii en 25% (n=6) y Pseudomonas aeruginosa en 16.7% (n=4) por otra parte para el grupo de gram positivos la principal bacteria aislada fue: Enterococcus facalis in 27.3% (n=3). A su vez, con respecto al tratamiento inicial en el grupo de gram negativos fue en un 79.2% con dos o más antibióticos, 16.7% con ceftriaxona y 4.2% con cefazolina. Aunado a ello el tratamiento inicial para el grupo de gram positivos en ocho casos, dos o más antibióticos fueron usados, en 2 metropenem fue usado y en uno con ceftriaxona. En relación con la resistencia antibiótica para gram negativos el principal fue para ampicilina y ceftriaxona en un 100%, cefazolina y aztreonam en un 95.8%. A su vez par el grupo de gram positivos, los antibióticos asociados a resistencia fueron eritromicina y claritromicina en un 90.9%. Conclusión: De esta investigación, los médicos podrán orientarse en esta unidad, para el tratamiento de las infecciones nosocomiales, las guías nacionales establecen que el tratamiento empírico debe ser realizado con el conocimiento de las resistencias bacterianas a antibióticos


Nowadays, between 5-10% of the general in-patient hospital population gets a nosocomial inflection, 20% of these infections are reported in the Intensive Care Unit. It has been reportd that the incidence of nosocomial infections at the Intensive Care Unit is about 2 to 5 times higher than in other hospital services. Objectives: Describe the epidemiology of intrahospital pathogens in the Intensive Care Unit and their antimicrobial resistance. Material and methods: Cross-sectional study. Information was obtained from medical records of patients at the Intensive Care Unit considering only the ones whom developed a nosocomial infection. Thirty-five samples were considered, from these, two groups, were obtained. The period of time considered for this study was from June to December 2016 at the High Specialty Medical Unit, Hospital of Trauma and Orthopedic of the Instituto Mexicano del Seguro Social (IMSS). Results: A total of 35 samples were analyzed, two groups were obtained, 24 gram positive and 11 gram negative. The mean age of the patients was of 41.79 (78-18) ±21.22 years old. Principal site of infection reported in both groups, gram- negative and gram-positive was the respiratory low tract in a 58.3% and 81.1% respectively. For gram negative group three main organisms were isolated in cultures Klebsiella pneumoniae in 29.2% (n=7). Acinetobacter baumannii in 25% (n=6) and Pseudomonas aeruginosa in a 16.7% (n=4) besides for gram pisitive group the main bactria isolated in cultures was. Enterococcus faecalis in 27.3% (n=3). On the other band, corresponding to initial treatment in gram negative group 79.2% were treated sith two or more antibiotics, 16.7% with ceftriaxone and 4.2% with cefazolin. In addition to initial treatment for gram positive group in 8 cases, 2 or ore antibiotics were used, in 2 meropenem was used and 1 with ceftriaxone. In relation to antibiotic resistance for gram negative group the greatest was for ampicillin and ceftriaxone with a 100% resistance, cefazolin and aztreonam in a 95.8%. As well, for gram positive group, antibiotics associated with resistance were erythomycin and clarithromycin 980.9%. Conclusion: From this investigation, medical practitiioners could be oriented for the treatment of nosocomial infections in this unit, as a matter of fact national guidelines establish that empirical treatmente should be assed with the knowledge of the microorganism's resistences


Subject(s)
Adult , Middle Aged , Aged , R Factors , Cross Infection/epidemiology , Cross-Sectional Studies , Gram-Positive Bacterial Infections , Gram-Negative Bacterial Infections , Drug Resistance, Bacterial
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