RESUMEN
Objetivo: Determinar la prevalencia puntual de infecciones hospitalarias (IH) en un hospital peruano de Nivel IV, en el año 2008. Material y métodos: Estudio descriptivo de corte transversal. Infecciones hospitalarias fueron identificadas empleando los criterios del Centers for Disease Control and Prevention (CDC) de 1999. Resultados: En total se evaluaron 1578 pacientes: 685 varones y 893 mujeres. La prevalencia de infecciones hospitalarias por 100 pacientes hospitalizados fue de 7,54 (7,05, 6,77, 7,31, 4,55, 0,75 y 26,85, en los servicios de Medicina, Cirugía, Pediatría, GinecologíaûObstetricia, Emergencia y Unidad de Cuidados Intensivos respectivamente). El número de pacientes con infecciones hospitalarias fue 119, 62 varones y 57 mujeres. La mediana de hospitalización en los pacientes con infecciones hospitalarias fue de 22 días y 6 días en los pacientes que no presentaron IH. 127 infecciones hospitalarias diagnosticadas en los 119 pacientes: 113 con una infección hospitalaria, cuatro pacientes con dos y dos pacientes con tres. La IH más común fue neumonía (25,2 por ciento), seguida por infecciones de tracto urinario (24,4 por ciento), infección de herida quirúrgica profunda (11 por ciento) y bacteriemia (6,3 por ciento). De 32 pacientes con neumonía nosocomial, 10 tenían ventilación mecánica. 61,3 por ciento de los pacientes con infección de tracto urinario hospitalario contaba con catéter urinario. Los agentes infecciosos más comunes fueron Pseudomona aeruginosa 16,1 por ciento y Staphylococcus aureus 9,7 por ciento. Conclusiones: La prevalencia de infecciones intrahospitalarias hallada se encuentra en el rango esperado para hospitales de similar complejidad.
Objective: To determine the point prevalence of hospital infections in a peruvian Level IV hospital, in 2008. Material and methods: Descriptive cross-sectional study. Hospital infections were identified using 1999 Centers for Disease Control and Prevention (CDC) criteria. Results: In total, 1578 patients were surveyed: 685 male and 893 female patients. The prevalence of hospital infections per hundred patients was 7.54 (7.05, 6.77, 7.31, 4.55, 0.75 and 26.85 in the areas of Medicine, Surgery, Pediatrics, Ginecology-Obstetrics, Emergency Medicine and Intensive Care Units respectively). The number of patients with hospital infections was 119, 62 were male and 57 were female. The median duration of hospitalization in patients with the diagnosis of hospital infection was 22 days and 6 days in patients without hospital infections. 127 hospital infections were diagnosed in 119 patients: 113 had one hospital infection, four patients had two and two patients had three. The most common hospital infection was pneumonia (25.2 percent), followed by urinary tract infection (24.4 percent), deep surgical site infection (11 percent) and bloodstream infection (6.3 percent), four hospital infections were not classified. From 32 patients with nosocomial pneumonia ten had mechanical ventilation. 61.3 percent of patients with urinary tract infection had a urinary catheter. The most common pathogens were Pseudomona aeruginosa 16,1 percent and Staphylococcus aureus 9.7 percent. Conclusions: The prevalence of hospital infections found was on the expected range for hospitals of similar complexity.
Asunto(s)
Humanos , Masculino , Femenino , Infección Hospitalaria/diagnóstico , Prevalencia , Epidemiología Descriptiva , Estudios Transversales , PerúRESUMEN
BACKGROUND: We describe the temporal variation in viral agents detected in influenza like illness (ILI) patients before and after the appearance of the ongoing pandemic influenza A (H1N1) (pH1N1) in Peru between 4-January and 13-July 2009. METHODS: At the health centers, one oropharyngeal swab was obtained for viral isolation. From epidemiological week (EW) 1 to 18, at the US Naval Medical Research Center Detachment (NMRCD) in Lima, the specimens were inoculated into four cell lines for virus isolation. In addition, from EW 19 to 28, the specimens were also analyzed by real time-polymerase-chain-reaction (rRT-PCR). RESULTS: We enrolled 2,872 patients: 1,422 cases before the appearance of the pH1N1 virus, and 1,450 during the pandemic. Non-pH1N1 influenza A virus was the predominant viral strain circulating in Peru through (EW) 18, representing 57.8% of the confirmed cases; however, this predominance shifted to pH1N1 (51.5%) from EW 19-28. During this study period, most of pH1N1 cases were diagnosed in the capital city (Lima) followed by other cities including Cusco and Trujillo. In contrast, novel influenza cases were essentially absent in the tropical rain forest (jungle) cities during our study period. The city of Iquitos (Jungle) had the highest number of influenza B cases and only one pH1N1 case. CONCLUSIONS: The viral distribution in Peru changed upon the introduction of the pH1N1 virus compared to previous months. Although influenza A viruses continue to be the predominant viral pathogen, the pH1N1 virus predominated over the other influenza A viruses.