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Hispanofila ; 193:33-48, 2021.
Article in Spanish | Web of Science | ID: covidwho-1917005
Hispanofila ; 193:33-48, 2021.
Article in Spanish | Scopus | ID: covidwho-1910456
Open Forum Infectious Diseases ; 8(SUPPL 1):S296, 2021.
Article in English | EMBASE | ID: covidwho-1746606


Background. Patients with severe SARS-CoV-2 infection are at high risk of complications due to the intensive care unit stay. Hospital-acquired infections (HAI) are one of the most common complication and cause of death in this group of patients, it is important to know the epidemiology and microbiology of this hospital-acquired infections in order to begin to the patients a proper empirical treatment. We describe the epidemiologic and microbiologic characteristics of HAI in patients with COVID-19 hospitalized at intensive care unit (ICU) in a tertiary level private hospital in Mexico City. Methods. From April to December 2020, data from all HAIs in patients with severe pneumonia due to SARS-CoV-2 infection with mechanical ventilation at ICU were obtained. The type of infection, microorganisms and antimicrobial susceptibility patterns were determined. Results. A total of 61 episodes of HAIs were obtained, the most common was ventilator associated pneumonia (VAP) in 52.4% (n=32) followed by urinary tract infection (UTI) 34.4%(n=21) and bloodstream infection (BSI) 9.84% (n=6). Only two episodes corresponded to C. difficile associated diarrhea. We identified 82 different microorganisms, the most frequent cause of VAP was P. aeruginosa 22% (10/45) followed by K. pneumoniae 20% (9/45);for UTI, E. coli 28.5% (6/21), and S. marcescens 19% (4/21);for BSI the most frequent microorganism was S. aureus 28.5 (2/7). Regarding the antimicrobial susceptibility patters the most common were Extended Spectrum Beta-Lactamase (ESBL) Gram-negative rods followed by Methicillinresistant Staphylococcus aureus. Conclusion. In patients with severe COVID-19 hospitalized in the ICU the most frequent HAIs were VAP and UTI caused by P. aeruginosa and E. coli respectively. ESBL enterobacteriaceae was the most common resistant pattern identifed in the bacterial isolations in our series.

Clin Invest Ginecol Obstet ; 49(3): 100752, 2022.
Article in Spanish | MEDLINE | ID: covidwho-1699059


The COVID-19 pandemic caused a sudden change in the usual care practice of our urogynaecology unit. Therefore, we designed a new healthcare model to adapt our practice to the epidemiological situation. The central axis of the new model was reduced hospital attendance, offering the same healthcare quality through the introduction of telemedicine.To achieve this aim, we made the following changes: a first telematic medical visit was the first step, telematic monitoring visits for conservative and pharmacological treatments and pack visit. We created the following packs: LUTS, postpartum and post-discharge pack. All packs included visits and diagnostic tests performed on the same day.The LUTS pack is indicated in patients with lower urinary tract symptoms, associated or not with pelvic organ prolapse. It includes two visits (nursing and medical) and two tests (urodynamics and pelvic floor ultrasound).The postpartum pack is indicated in women with symptoms of urinary incontinence, anal incontinence, pelvic organ prolapse and sexual disfunctions after delivery, as well as asymptomatic patients with a history of obstetric perineal trauma. It includes a medical visit, a pelvic floor ultrasound and a visit with the physiotherapist.The post-discharge pack is scheduled a month after the surgery and includes two tests (pelvic floor ultrasound and uroflowmetry) and a medical visit.Some face-to-face visits were maintained, as were physiotherapy treatments and other visits following medical criteria.

Clinica e investigacion en ginecologia y obstetricia ; 2022.
Article in Spanish | EuropePMC | ID: covidwho-1678593


La pandemia COVID-19 generó un cambio de forma brusca en la práctica asistencial habitual de nuestra Unidad de Uroginecología, y a raíz de esta situación se ideó un nuevo modelo asistencial para adaptarnos a la nueva etapa epidemiológica. Se acordó, como eje central del nuevo modelo, la disminución de la presencialidad hospitalaria, ofreciendo la misma calidad asistencial mediante la introducción de la telemedicina.Para conseguir tal fin, se elaboró un modelo con tres tipos de visitas nuevas: primera visita médica telemática, visitas de seguimiento de tratamientos conservadores y farmacológicos telemáticas, y creación de visita pack (pack STUI, el pack postparto y el pack post-alta) que incluye visitas y pruebas diagnósticas uroginecológicas que se realizan todas el mismo día. El pack STUI va dirigido a todas las pacientes con síntomas del tracto urinario inferior (STUI), asociados o no a prolapso de órganos pélvicos. Consta de dos visitas (enfermería y médica), y dos pruebas diagnósticas avanzadas (urodinamia y ecografía de suelo pélvico).El pack postparto va dirigido a mujeres con síntomas de incontinencia urinaria, incontinencia anal, prolapso y/o alteraciones de la sexualidad tras el parto. También incluye mujeres asintomáticas con antecedente de trauma perineal obstétrico. Consta de una visita médica, una ecografía de suelo pélvico y una visita por la fisioterapeuta.El pack post-alta se realiza al mes de la cirugía e incluye dos pruebas (ecografía de suelo pélvico y flujometría) y una visita médica.Los tratamientos de fisioterapia y otras visitas que por motivos médicos lo requirieran, han mantenido su presencialidad.