ABSTRACT
INTRODUCTION: Invasive aspergillosis (IA) is a serious opportunistic infection in immunocompromised patients. Transplant recipients and patients with cancer represent the highest risk group. The antifungal treatment involves prolonged hospitalization and high economic resources. OBJECTIVE: to estimate costs represented by IA as an intercurrent complication of oncologic treatment. PATIENTS AND METHOD: Retrospective case-control study. Estimation of the cost of treatment in pediatric oncologic patients with IA in the Hospital Luis Calvo Mackenna during the years 2007-2008 was done. A control for each case of IA paired by sex, age, number of diagnosis and clinical department was selected. RESULTS: There were 13 patients during the observation period. The attributable cost of treatment of aspergillosis was US $23,600 and the cost for each indicator was: hospital days US $16,500; antifungal therapy US $7,000; and serum galactomannan US $100. DISCUSSION: In this study, the cost of treating IA is mainly due to hospitalization and antifungal medications. Three patients acquired IA in spite of staying in a protected environment.
Subject(s)
Antifungal Agents/economics , Antigens, Fungal/economics , Aspergillosis/economics , Health Care Costs/statistics & numerical data , Neoplasms/complications , Opportunistic Infections/economics , Adolescent , Antifungal Agents/therapeutic use , Antigens, Fungal/therapeutic use , Aspergillosis/complications , Aspergillosis/drug therapy , Case-Control Studies , Child , Chile , Cross Infection/economics , Female , Galactose/analogs & derivatives , Humans , Immunocompromised Host , Male , Mannans/blood , Mannans/economics , Opportunistic Infections/complications , Opportunistic Infections/drug therapy , Retrospective StudiesABSTRACT
INTRODUCTION: The gram-negative bacillus Hafnia alvei is the only species of the genus Hafnia, family Enterobacteriaceae. It occasionally behaves as an opportunistic pathogen in humans, causing intestinal and respiratory infection and sepsis. It rarely causes bacteremia, usually of unknown focus. OBJECTIVE: To describe a nosocomial outbreak of four pediatric patients with bacteremia by Hafnia alvei. METHODS: Descriptive study using clinical records of pediatric patients diagnosed with Hafnia alvei bacteremia in a pediatric cardio surgical unit, in October 2008. RESULTS: The attack rate was 4/8 (50%), lethality rate 2/4 (50%) and mortality 2/8 (25%). The microbiological study and pulsed-field gel electrophoresis confirmed the same clonal bacterial strain. DISCUSSION: The source of bacteremia was identified only in two patients and was associated with central venous catheters. The other two cases had no known infectious source. Epidemiological surveillance of emerging agents must be maintained.
Subject(s)
Bacteremia/microbiology , Cross Infection/microbiology , Enterobacteriaceae Infections/microbiology , Hafnia alvei/isolation & purification , Bacteremia/diagnosis , Cross Infection/diagnosis , Enterobacteriaceae Infections/diagnosis , Fatal Outcome , Female , Humans , Infant , Infant, Newborn , Male , Retrospective StudiesABSTRACT
El Hospital Luis Calvo Mackenna, inserto en un proceso de cambios relacionados con la búsqueda de la satisfacción del usuario y con la mejoría de la calidad de los servicios, construyó participativamente una misión y un plan. En éste último, uno de los objetivos estratégicos es la calidad. El hospital ha constituido un consejo de calidad multidisciplinario, quien ha explicitado sus valores-. compromiso con la vida y el ser humano. Y, a la calidad, la ha señalado como instrumento principal para el logro de la eficiencia social que nos impone ese compromiso valórico, lo que implica un cambio cultural profundo, que supone un proceso largo y paciente para consolidar una transformación de las costumbres y una modificación de los comportamientos, con el objetivo de responder a nuestros requerimientos éticos y asegurar la vialidad futura de] sistema público. Como ejemplo de lo anterior se señalan, entre otros, algunos avances en materia de calidad y satisfacción-usuario en áreas tales como participación usuaria, mejoría de la accesibilidad y de la calidad técnica de los servicios
