ABSTRACT
INTRODUCTION: Increased antimicrobial use during the COVID-19 pandemic has raised concerns about the spread of resistant bacteria. This study analyzed the frequency of device-associated infections (DAI) caused by resistant bacteria, the predictors of these infections, and 30-day all-cause mortality in patients with and without COVID-19. METHODS: A retrospective cohort study was conducted on DAI patients admitted to the ICU (intensive care unit) in 20 hospitals in Medellin, Colombia (2020-2021). The exposure assessed was the COVID-19 diagnosis, and outcomes analyzed were resistant bacterial infections and 30-day mortality. Clinical and microbiological information was collected from surveillance databases. Statistical analysis included generalized linear mixed-effects models. RESULTS: Of the 1521 patients included, 1033 (67.9%) were COVID-19-positive and 1665 DAI were presented. Carbapenem-resistant Enterobacteriaceae (CRE) infections predominated during the study (n = 98; 9.9%). The patients with COVID-19 had a higher frequency of metallo-beta-lactamase-producing CRE infections (n = 15; 33.3%) compared to patients without the disease (n = 3; 13.0%). Long-stay in the ICU (RR: 2.09; 95% CI: 1.39-3.16), diabetes (RR: 1.73; 95% CI: 1.21-2.49), and mechanical ventilation (RR: 2.13; 95% CI: 1.01-4.51) were CRE infection predictors in COVID-19 patients, with a mortality rate of 60.3%. CONCLUSION: CRE infections were predominant in COVID-19 patients. In pandemic situations, the strategies to control DAI should be maintained to avoid infections caused by resistant bacteria, such as length of stay in the ICU and duration of mechanical ventilation.
ABSTRACT
La corrupción es definida como el abuso del poder para obtener una ganancia privada. A excepción de Chile, Uruguay y la Guayana Francesa, el territorio centro y sudamericano muestran altos índices de corrupción. Esta investigación buscó evidenciar las creencias de los ciudadanos comunes sobre la corrupción y la relación existente entre sus narraciones y el partido político con el que simpatizan. Para desarrollar el estudio se contó con la participación de 325 personas, 166 mujeres con edades entre los 18 y 69 años (M=35.88, DE=13.44) y 159 hombres con edades entre los 19 y 74 años (M=36.09, DE=13.02), con un nivel de escolaridad de primaria, secundaria, técnica o tecnóloga, universitaria, posgrado y sin ningún nivel de estudios, quienes respondieron a una breve entrevista de 30 minutos aproximadamente. Las narraciones se analizaron con métodos unidimensionales y multidimensionales utilizando el software SPAD. Las variables que se emplearon para el análisis fueron (textuales): significado de la corrupción, casos de corrupción y gravedad de la corrupción, y (categóricas): sexo, nivel educativo, nivel socioeconómico y partido político de preferencia. Los principales resultados mostraron que los significados y definiciones de corrupción parten de los verbos beneficiar, poder, obtener, aprovecharse, robar, sobornar y amenazar. También se observó la mención a actos de corrupción divulgados en los medios de comunicación y en los que se implicaron personas del Gobierno y grandes sumas de dinero. Un tercer resultado fue la evidencia de que las variables sociodemográficas como el sexo y nivel de estudios están estrechamente relacionadas con las percepciones de lo que puede o no ser corrupto. De igual manera, la simpatía con un grupo político influencia el juicio sobre los actos corruptos del grupo oponente y del mismo al que se sigue. En la discusión se desarrollaron, en primer lugar, las diferencias entre hombres y mujeres sobre los hechos y los significados de la corrupción; en segundo lugar, que los hechos de corrupción (grandes y pequeños) son percibidos como graves o no en relación con los niveles de educación de los ciudadanos, y finalmente, que las actitudes y los juicios que se emiten con respecto a un acto ilegal son considerados más o menos corruptos dependiendo del grupo social o político con el que los ciudadanos se identifiquen
Corruption is defined as the abuse of power in order to obtain personal benefit. Central and South America, with the exception of Chile, Uruguay and the French Guiana, show high rates of corruption. This study sought to find the meanings that ordinary people attach to corruption as well as the relationship between their narratives and sociodemographic characteristics, such as sex and educational level, and political standpoints, such as their political party affiliation. A total of 325 people participated, 166 females aged 18-69 (M=35.58, SD=13.44) and 159 males aged 19-74 (M=36.09, SD=13.02). All education levels (primary, secondary, technical, university, postgraduate and none) were represented in the sample. Narratives were analysed via uni- and multidimensional methods and using the SPAD software programme. Variables used for the analysis were: meaning of corruption, corruption cases, seriousness of corruption (textual), and sex, educational level, socioeconomic level, political party affiliation (categorical). The primary results suggested that the meanings and definitions of corruption frequently feature the following verbs: to benefit, power, to obtain, to take advantage of, to steal, to bribe, and to threaten. Participants also mentioned acts of corruption that they learned about via mass media, and that involved the participation of government agents and large amounts of money. A third result was evidence that sociodemographic characteristics such as sex and education level are closely related with perceptions of what is and is not corrupt. Likewise, identification with a political party influences the judgments made on acts of corruption by both the opposing group and the group to which participants belong. We first discuss the gender difference in terms of the facts and meanings of corruption, and then we discuss how the facts of corruption (big and small) are perceived as serious or not depending on the education level of the citizens. Finally, we discuss how the attitudes and judgements expressed regarding an illegal act are considered more or less corrupt depending on the social or political group with which the citizens identify
