RESUMO
Background: The surgical wound infections (SWI) are common in hospitals, depending on the type of surgery and the presence of risk factors, cancer patients have a higher prevalence of infection, (immune-compromised state in which it is located). A low rate of infection is one parameter to measure the quality of surgical services. The aim of the present work was to determine the epidemiological characteristics of SWI in cancer patients in the Jaliscience institute of cancerology. Study Design: A descriptive, retrospective study. Methodology: 46 patients were studied with SWI. Centers of disease control and prevention criteria for surgical wound infection were considered. Information was obtained from the Jaliscience Institute of Cancerology epidemiological department, using the hospital network for epidemiological surveillance (HNES) format record´s, included microbiological results and clinical data. The statistical analysis were performed with the SPSS-20 program. Results: There were 2637 major surgeries from April 2008 thru December 2010. 46 had SWI. Frequency of service per 100 infected surgeries was: Gastroenterology 58.6%, Gynecology 32.6%, Urology 4.4, Head and Neck 2.2% and Traumatology 2.2%. Incidence by gender: men (1.1), women (0.83), with no significant difference. Average age of 51 years. The surgical-wound infected (SWI) were detected between 7.4±4.2 days. Average days stay 19 days. The results of microbiology cultures exhibited: Escherichia coli 53.3%, Pseudomonas aeruginosa 11.9%, Morganella morganii 4.8%, Enterococcus faecium 11.9%, Enterococcus faecalis 23.8%, Staphylococcus-coagulase-negative 7.1%, Streptococcus ß-hemolytic 4.8%. Conclusion: Surgical wound infection rates were similar to that reported in other countries and below the rates reported in oncology hospitals in México. It is important to note that a proper preventive approach and epidemiological surveillance are critical to avoid mortality of patients.
RESUMO
Introducción: las intervenciones durante el tratamiento en el paciente oncológico, aumentan los riesgos para sufrir una infección nosocomial. En el Instituto Jalisciense de Cancerología, la prevención, identificación y seguimiento de las infecciones nosocomiales se realiza a través del programa de epidemiologia y por el Comité de Vigilancia Epidemiológica. Objetivos: determinar la incidencia de infecciones nosocomiales en pacientes oncológicos atendidos en el citado instituto. Métodos: se trata de un estudio descriptivo retrospectivo. Se tomaron en cuenta 5 056 egresos de abril de 2008 a diciembre de 2010, de los cuales 140 pacientes presentaron 178 infecciones nosocomiales. Resultados: la tasa global de infecciones por 100 egresos, fue variable (2008: 5,8; en 2009: 3,5 y en 2010: 2,2). La infección de herida quirúrgica se mantuvo con las tasas más altas (2,9; 1,5; 1,1). El germen más frecuentemente aislado fue Escherichia coli (55 %, 34 %, 20 %), el hongo más frecuente fue la Candida albicans (6 %, 7 %, 6 %). El promedio días estancia en el momento de la captación de la infección, fue de 3,3 días y en el momento del egreso fue de 17 días. La tasa de letalidad, fue de 19 por cada 100 casos, y la tasa de mortalidad 27 por cada 100 casos. Conclusiones: se observa una disminución en la tasa de infección nosocomial en los últimos años. La intervención del Servicio de Epidemiología con sus acciones dirigidas de manera específica, al manejo de las heridas quirúrgicas, es fundamental.
Background: the treatments in cancer patients increase the risk of catching nosocomial infection. In the Instituto Jalisciense de Cancerología, the prevention, identification and monitoring of nosocomial infections is carried out by the Epidemiological Surveillance Committee through an epidemiological program. Objectives: To determine the incidence of nosocomial infections in cancer patients seen at the Instituto Jalisciense de Cancerología Methods: A retrospective and descriptive study, which included 5056 patients discharged from April 2008 to December 2010, of whom 140 had nosocomial infections. Results: The overall rate of infections per 100 discharges was variable (5.8 in 2008; 3.5 in 2009 and 2.2 in 2010). The surgical wound infection kept the highest rates (2.9, 1.5, 1.1 respectively). The most common isolated bacteria was Escherichia coli (55 %, 34 %, 20 %); the most frequent fungus was Candida albicans (6 %, 7 %, 6 %). The average length of stay at the time of catching the infection was 3.3 days, and at the time of hospital discharge was 17 days. The fatality rate was 19 per 100 cases whereas the mortality rate was 27 per 100 cases. Conclusions: a decrease in the rate of nosocomial infection was observed in recent years; where the epidemiology service was the key to implementing epidemiological actions, in particular the management of surgical wounds.