ABSTRACT
Background: Infections associated with health care, previously known as nosocomial infections, constitute one of the main causes of morbidity and mortality in hospital. The aim of this study is to estimate the lethality of HAI, as well as the risk of dying from HAI versus mortality by other causes. Methods: We analyzed the historical cohort of IAAS of the Epidemiology service of a tertiary-level hospital, from 2012 to 2017. The incidence analysis and the probability of death of IAAS were made against other causes, as well as the analysis of age, period-cohort of lethality of IAAS. Results: The incidence of IAAS ranged from 27.9 to 31.5 IAAS/1000 person-days between 2012 and 2017, the probability of having an IAAS in ICU is 3.51 (CI95%: 2.93-4.20), p < 0.01, NAVM lethality against any other causes of death had a relative risk (RR) of 6.06 (CI95%: 2.91-12.6) in 2016, RR was 4.01 (CI95%: 1.59-10.09) in ITUAC in 2015, no effect of age, cohort or period in the case of IAAS was identified. Conclusions: IAAS remain to be an important public health problem in our country, without excluding our medical unit, it is important to redirect efforts to reduce them in the medium term.
Introducción: Las infecciones asociadas a la atención a la salud, anteriormente conocidas como nosocomiales, constituyen una de las principales causas de morbimortalidad hospitalaria. El objetivo de este trabajo fue estimar el riesgo de fallecer de aquellos pacientes hospitalizados en una Unidad Médica de Alta Especialidad (UMAE) cuando se asocian a infecciones asociadas a la atención en salud (IAAS) más frecuente en nuestro medio. Métodos: Se realizó un análisis de una cohorte histórica de IAAS por la División de Epidemiología de la UMAE, del 2012 al 2017. Se estimó la incidencia y la probabilidad de muerte por IAAS y se comparó con otras causas, analizando las variables de edad, cohorte y periodo de la letalidad. Resultados: La incidencia de IAAS entre 2012 y 2017 fue de 27.9 a 31.5 IAAS/1000 días estancia, la probabilidad de tener una IAAS al estar en la Unidad de Cuidados Intensivos fue de 3.51 (IC95%: 2.93-4.20) p < 0.01, la letalidad por neumonía asociada a ventilación mecánica frente a otras causas en 2016 tuvo un riesgo relativo (RR) de 6.06 (IC95%: 2.91-12.6), y para infección del tracto urinario asociado a cateter el RR fue de 4.01 (IC95%: 1.59-10.09). Conclusiones: Las IAAS siguen siendo un importante problema de salud pública en nuestro medio; es importante redirigir los esfuerzos para abatir las IAAS en el mediano y corto plazo
Subject(s)
Cross Infection/mortality , Hospital Mortality , Tertiary Care Centers , Humans , Incidence , Mexico/epidemiology , Risk FactorsABSTRACT
BACKGROUND: Burkholderia cepacia (B. cepacia) has been the causal agent of infectious hospital outbreaks. METHODS: a case-controls study was conducted to describe an outbreak of urinary tract infection associated to lubricant-gel contaminated with B. cepacia. Patients who developed UTIsc were included in this study. Their clinical data, urine cultures, antiobiograms and the molecular bacterial analysis were analyzed. RESULTS: the urine culture was positive in 101 (55.8 %); the bacterial strains isolated were: B. cepacia 30.7 %, Escherichia coli 22.7 %, Enterococcus faecalis 9.9 %, Enterococcus spp. 8.9 %. They were 31 patients with B. cepacia isolation that was taken as the cases group and 63 with UTIsc due to another organism as control group. The Charlson comorbidity index was 5.3 ± 1.8 for cases and 4.5 ± 1.2 for controls. The factors associated with death were: heart disease, diabetes, pneumonia, bacteremia and UTIsc B. cepacia. CONCLUSIONS: the lubricant gel used for urinary catheter placement originated the outbreak. Heart disease, pneumonia, bacteremia and UTIsc B. cepacia were related to patients' death.
Subject(s)
Burkholderia Infections/epidemiology , Burkholderia cepacia/isolation & purification , Cross Infection/epidemiology , Disease Outbreaks , Drug Contamination , Urinary Tract Infections/epidemiology , Case-Control Studies , Female , Gels , Humans , Lubricants , MaleABSTRACT
INTRODUCTION: Respiratory infections increased in Mexico in 2009 due to an epidemic of influenza. METHODS: To compare symptoms and infectivity of influenza A(H1N1) and seasonal influenza we evaluated epidemiological data and microbiological sampling of health workers (HW) and patients who probably had influenza. RESULTS: From April to November 2009 we studied 83 HW (29 with influenza A(H1N1) and 8 with seasonal influenza) and 71 patients (26 and 11, respectively). The subtypes of influenza had similar clinical data. CONCLUSIONS: Fifteen patients with immunosuppression or chronic diseases developed fatal pneumonia; the infectivity was greater for influenza A(H1N1).
Subject(s)
Disease Outbreaks , Hospitals, Urban/statistics & numerical data , Influenza A Virus, H1N1 Subtype/pathogenicity , Influenza, Human/epidemiology , Inpatients/statistics & numerical data , Personnel, Hospital/statistics & numerical data , Adult , Aged , Antiviral Agents/therapeutic use , Comorbidity , Contact Tracing , Cross Infection/epidemiology , Cross Infection/transmission , Cross Infection/virology , Female , Hospital Mortality , Humans , Immunocompromised Host , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Infectious Disease Transmission, Professional-to-Patient/statistics & numerical data , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/drug therapy , Influenza, Human/prevention & control , Influenza, Human/transmission , Influenza, Human/virology , Male , Mexico/epidemiology , Middle Aged , Neoplasms/epidemiology , Occupational Diseases/drug therapy , Occupational Diseases/epidemiology , Occupational Diseases/virology , Oseltamivir/therapeutic use , Virulence , Zanamivir/therapeutic useABSTRACT
Introducción: En 2009 se incrementaron las infecciones respiratorias en México por una epidemia de influenza. Métodos: Para comparar sintomatología y contagiosidad de influenza A(H1N1) e influenza estacional recogimos, entre abril y noviembre de 2009, datos clínico-epidemiológicos y muestras microbiológicas de Trabajadores sanitarios (TS) y pacientes con probable influenza. Resultados: De 83 TS, 29 tuvieron influenza A(H1N1) y 8 estacional; de 71 pacientes 26 y 11 respectivamente. Observamos cuadro clínico similar en ambos subtipos de influenza. Conclusiones: Quince pacientes con inmuno supresión y con enfermedades crónicas desarrollaron neumonía fatal; la contagiosidad fue mayor para influenza A(H1N1) (AU)
Introduction: Respiratory infections increased in Mexico in 2009 due to an epidemic of influenza. Methods: To compare symptoms and infectivity of influenza A(H1N1) and seasonal influenza we evaluated epidemiological data and microbiological sampling of health workers (HW) and patients who probably had influenza. Results: From April to November 2009 we studied 83HW(29 with influenza A(H1N1) and 8 with seasonal influenza) and 71 patients (26 and 11, respectively). The subtypes of influenza had similar clinical data. Conclusions: Fifteen patients with immuno suppression or chronic diseases developed fatal pneumonia; the infectivity was greater for influenza A(H1N1) (AU)
