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1.
Open Forum Infectious Diseases ; 8(SUPPL 1):S274, 2021.
Article in English | EMBASE | ID: covidwho-1746655

ABSTRACT

Background. According to the Institute of Global Health Science (IGHS), mortality for Covid-19 patients treated in public hospitals in Mexico ranges between 30-50%, decreasing to 20% in private health care facilities. Our objective was to describe the mortality rate in a teaching private hospital in Mexico City. Methods. We included all patients that were admitted to hospital Medica Sur, in the south part of Mexico City during year 2020. We analyzed the total mortality presented in all our patients with a follow up of two months, and relay that to age and gender. Results. During year 2020, we admitted in our hospital 1,075 patients with confirmed diagnosis of COVID-19 through nasopharyngeal molecular test;772 were male (71.8%) with more than 50% between 40 and 59 years, while females were more frequent between 40 and 69 years' age. Seventy-four patients (6.88%) died during hospitalization;59 (79.7%) males and 15 females. Mortality rate was clearly related to age (figure 1) with 30% mortality for males between 80-89 years and 19% for females. Mortality rate by gender and age Conclusion. Mortality in private hospitals was clearly lower than in public hospitals. In our hospital, mortality was lower than 10%, mostly related to their availability of unlimited intensive care without ECMO and despite the lack of some drugs like Remdesivir. As described, space limitations for intensive care as well as the lack of trained personal impacted significantly the mortality in public hospitals.

2.
Open Forum Infectious Diseases ; 8(SUPPL 1):S296, 2021.
Article in English | EMBASE | ID: covidwho-1746606

ABSTRACT

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.

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