ABSTRACT
Objetivo: El objetivo del estudio fue describir los factores de riesgo de los pacientes adultos con infección de vías urinarias (IVU) por enterobacterias productoras de betalactamasas de espectro extendido (BLEE) en la población usuaria del Hospital Militar Central (HMC) los años 2012 y 2014. Se analizaron factores de riesgo como hospitalización previa, residente en unidad de cuidado crónico, uso previo de antibióticos, uso previo de esteroides, instrumentación del tracto urinario y usuario de sonda vesical. Materiales y métodos: Se realizó un estudio de casos y controles, retrospectivo, la fuente de información fueron las historias clínicas de los pacientes adultos mayores de 18 años de edad, que consultaron al servicio de urgencias del HMC, con diagnostico de IVU por una enterobacteria productora de BLEE. Se establecieron las características de la muestra y se determinó cuales fueron los factores de riesgo asociados al desarrollo de la infección por gérmenes productores de BLEE en la muestra seleccionada. Resultados: De los 1986 aislamientos que cumplían los criterios de selección, 14% correspondían a microorganismos productores de BLEE. De los seis factores de riesgo estudiados, tres presentaron una diferencia estadísticamente significativa: la hospitalización previa, el uso previo de antibióticos y la instrumentación del tracto urinario. De los factores de riesgo identificados, se realizó un análisis multivariado donde se mantuvieron como factores de riesgo significativos el uso previo de antibióticos y la instrumentación del tracto urinario que aumentan el riesgo de IVU por gérmenes productores de BLEE en 1,9 y 3,18 veces respectivamente. Conclusiones: Si bien los otros factores de riesgo descritos no alcanzaron una diferencia estadísticamente significativa, se deben realizar estudios prospectivos para poder evaluar su asociación con el desarrollo de infecciones por gérmenes resistentes y así desarrollar una escala de riesgo que permita al personal de urgencias administrar antibioticoterapia dirigida para este subgrupo poblacional.
Objectives: The objective of the study was to describe the risk factors of adult patients with urinary tract infection (UTI) with extended spectrum beta-lactamase producing bacteria (ESBL) in the population of the Hospital Militar Central (HMC) in 2012 and 2014. Risk factors such as previous hospitalization, chronic care unit resident, previous use of antibiotics, previous use of steroids, urinary tract instrumentation and bladder catheter were analyzed. Material and methods: We conducted a retrospective case-control study, the source of information were the medical records of adult patients older than 18 years of age, who consulted the emergency department of the HMC, diagnosed with UTI by a bacterium carrying ESBL. The characteristics of the sample were established and the risk factors associated with the development of infection by ESBL-producing bacteria in the selected sample were determined. Results: Of the 1986 isolates that fulfilled the selection criteria, 14% reported microorganisms producing ESBL. Of the six risk factors studied, three presented a statistically significant difference: previous hospitalization, previous use of antibiotics and urinary tract instrumentation. Of the risk factors identified, a multivariate analysis was performed in which the previous use of antibiotics and urinary tract instrumentation were maintained as significant risk factors that increase the risk of UTI by ESBL-producing bacterias in 1,9 and 3,18 times respectively. Conclusions: Although the other risk factors described did not reach a statistically significant difference, prospective studies should be performed to assess their association with the development of resistant germ infections and to develop a risk scale that allows emergency personnel to administer targeted antibiotic therapy to this population subgroup.
Subject(s)
Humans , Male , Adult , Middle Aged , Urinary Tract Infections , beta-Lactamases , Risk Factors , Emergency Service, Hospital , Bacteria , Urinary Bladder , Enterobacteriaceae , Catheters , Hospitals, MilitaryABSTRACT
BACKGROUND: The establishment of scientific collaborations with researchers abroad can be considered a good practice to make appropriate use of their knowledge and to increase the possibilities of them returning to their country. This paper analyses the collaboration between Spanish researchers abroad devoted to health sciences and national science institutions. METHODS: We used the Fontes' approach to perform a study on this collaboration with Spanish researchers abroad. We measured the level of national and international cooperation, the opportunity provided by the host country to collaborate, the promotion of collaboration by national science institutions, and the types of collaboration. A total of 88 biomedical researchers out of the 268 Spanish scientists who filled up the survey participated in the study. Different data analyses were performed to study the variables selected to measure the scientific collaboration and profile of Spanish researchers abroad. RESULTS: There is a high level of cooperation between Spanish health science researchers abroad and international institutions, which contrasts with the small-scale collaboration with national institutions. Host countries facilitate this collaboration with national and international scientific institutions to a larger extent than the level of collaboration promotion carried out by Spanish institutions. CONCLUSIONS: The national collaboration with Spanish researchers abroad in the health sciences is limited. Thus, the practice of making appropriate use of the potential of their expertise should be promoted and the opportunities for Spanish health science researchers to return home should be improved.
Subject(s)
Biomedical Research , Cooperative Behavior , International Cooperation , Research Personnel , Humans , Spain , Surveys and QuestionnairesABSTRACT
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