Efectividad de las medidas aplicadas para la prevención de las infecciones asociadas a la asistencia sanitaria en la terapia
Keywords:
Communicable Diseases, Cross Infection, Intensive Care Units.Abstract
Introduction: at the dawn of the 21st century, infectious diseases constitute one of the first causes of death and the first of years of healthy life lost due to disability in the world.
Objective: to evaluate the effect of the measures applied on infections associated with healthcare in the Intensive Care Unit of the “Dr. León Cuervo Rubio”.
Method: an observational, analytical, lon- gitudinal and prospective study was carried out that included 285 patients admitted to the intensive care unit of the Hospital “León Cuervo Rubio” in the period from September 2018 to November 2019.
Results: no differences were found with relations- hip to sex. In 2018, 81 % of the ventilated patients had ventilator-associated pneumonia, and in 2019 17 % (x2 = 44.01; p = 0.00), bacteremia: 15% and 5.6 % (x2 = 4, 33; p = 0.03), urinary tract infections: 28.4 % and 7.9 % in 2018 and 2019 (x2 = 19.13; p = 0.00001) respectively in each case. Enterobacter was isolated in 33% of pneumonias associated with early-onset ventilation, E. coli in 77 % of urinary infections and in 37% of bacteremia, showing a resistance above 50 % to cephalosporins of third and fourth generation.
Conclusions: there was a significant decrease in the infections associated with health care evaluated with the application of the measures.
References
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2. Sánchez García M. Bacteriemia primaria y bacteriemia relacionada con catéter por estafilococoscoagulasa-negativos. ¿Una complicación sin importancia? Med Intensiva [Internet]. 2018 [citado el 18/11/ 2020]; 35(4): [aprox. 2 p.]. Disponible en: http://scielo.sld.cu/scielo.php.
3. Grupo de Trabajo de Enfermedades Infecciosas. Estudio Nacional de Vigilancia de Infección Nosocomial en Servicios de Medicina Intensiva [Internet]. España: Sociedad Española de Medicina Intensiva Critica y Unidades Coronarias; [Internet]. 2018 [citado el 18/11/2020]. Disponible en: http://hws.vhebron.net/envin-helics/.
4. Mandell LA, Wunderink RG, Anzueto A. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis [Internet]. 2017 [citado el 18/11/2020]; 44(2): [aprox. 6 p.]. Disponible en: http://cid.oxfordjournals.org/content/44/Supplement_2/S27.full.pdf+html
5. D Hunter J. Neumonía asociada a la ventilación mecánica. Estrategias para su prevención. Arch Bronconeumol [Internet]. 2017 [citado 22/02/2020]; 20(4): [aprox. 7 p.]. Disponible en: http://www.intramed.net/.
6. Álvarez Lerma F, Torres Martí A, Rodríguez de Castro F. Recomendaciones para el diagnóstico de la neumonía asociada a ventilación mecánica. Arch Bronconeumol [Internet]. 2016 [citado el 18/11/2020]; 37(8): [aprox. 10 p.]. Disponible en: http://www.sciencedirect.com/science/article/pii/S0210569101797021.
7. Moossa AR, Hart ME, Easter DW. Complicaciones Quirúrgicas. En: Sabinton DC. Tratado de patología quirúrgica. 18 ed. 2008, T-1. La Habana: Editorial Científico –Técnico; 2008. p. 367- 86.
8. Rocha Alamazán M, Sánchez Aguilar M, Belmares Taboada J, Esmer Sánchez D, Tapia Pérez JH, Gordillo Moscoso A. Infección del sitio operatorio en cirugía abdominal no traumática. Cir Ciruj [Internet]. 2018 [citado el 22/02/2020]; 76:(2) [aprox. 9 p.]. Disponible en: http://www.medigraphic.com/pdfs/circir/cc-2008/cc082e.pdf
9. Donahoe L, Mc Donald E, kho ME, Maclennan M, Stratford PW, Cook DJ. Increasing Reliability of APACHE II Scores in a Medical-Surgical Intensive Care Unit: A Quality Improvement Study. Am J CritCare [Internet]. 2017 [citado el 22/02/2020]; 18(1):[aprox. 5 p.]. Disponible en: http://ajcc.aacnjournals.org/content/18/1/58.short
10. Pineda LA, Saliba RG, EL Solh AA. Efectt of oral decontamination with clorhexidine in the incidence of nosocomial pneumonia: a metanalysis. CritCare [Internet]. 2018 [citado el 22/02/2020]; 10(2): [aprox. 11 p.]. Disponible en: http://ccforum.com/content/10/1/R35
11. Chlebicki MP, Safdar N. Tropical clorhexidine for prevention of ventilator-associated pneumonia: a meta-analysis. CritCare Med [Internet]. 2017 [citado el 22/02/2020]; 35(2):[aprox. 7 p.]. Disponible en:http://journals.lww.com/ccmjournal/Abstract/2007/02000/Topical_chlorhexidine_for_prevention_of.37.aspx
12. Rello J, Diaz E. Pneumonia in the Intensive Care Unit. CritCare Med [Internet]. 2016 [citado el 04/03/2020]; 31(10):[aprox. 9 p.]. Disponible en: http://journals.lww.com/ccmjournal/Abstract/2003/10000/Pneumonia_in_the_intensive_care_unit.21.aspx
13. Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S. An intervention to decrease catheter-related blood stream infections in the ICU.N Engl J Med [Internet]. 2016 [citado el 06/03/2020]; 355(1):[aprox. 8 p.]. Disponible en: http://www.nejm.org/doi/full/10.1056/nejmoa061115
14. Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD. International study of the prevalence and infection in intensive care units. JAMA [Internet]. 2017 [citado el 07/052020]; 302(21):[aprox. 7 p.].Disponible en: http://jama.jamanetwork.com/article.aspx?articleid=184963
15. Cook DJ, Walter SD, Cook RJ, Griffith LE, Guyatt GH, Leasa D. Incidence and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med [Internet]. 2018 [citado el 22/06/2020]; 129(6):[aprox. 7 p.]. Disponible en: http://annals.org/article.aspx?articleid=711674
16. Olaechea PM, Insausti J, Blanco A, Luque P. Epidemiología e Impacto de las infecciones nosocomiales. Med Intensiva [Internet]. 2016 [citado el citado el 18/11/2020]; 34(4):256-267. Disponible en: http://www.sciencedirect.com/science/article/pii/S0210569109001673
17. Leone M, Garnier F, Avidan M, Martin C. Catheter associated urinary tract infections in intensive care units. Microbes Infect [Internet]. 2019 [citado el 13/06/2020]; 6 (11): [aprox. 7 p.]. Disponible en: http://www.sciencedirect.com/science/article/pii/S1286457904002060
18. National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, datasummary from January 2010 through June 2012, issued October 2012. Am J Infect Control [Internet]. 2017 [citado el 22/02/2020]; 32:[aprox. 5 p.]. Disponible en: http://www.jstor.org/stable/10.1086/657140
19. Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA.Guideline for prevention of catheter-associated urinarytract infections 2009. Infect Control Hosp Epidemiol [Internet]. 2016 [22/06/2020]; 31:[aprox. 5 p.]. Disponible en: http://www.jstor.org/stable/10.1086/651091
20. Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE,Rice JC. Diagnosis, prevention, and treatment ofcatheter-associated urinary tract infection in adults: 2009International Clinical Practice Guidelines from the InfectiousDiseases Society of America. ClinInfectDis [Internet]. 2016 [citado el 22/06/2020]; 50(5):[aprox. 6 p.]. Disponible en: http://cid.oxfordjournals.org/content/50/5/625.short
21. Espinosa F. Patógenos multirresistentes emergentes. Rev Acta Médica [Internet]. 2018 [citado el 22/02/2020]; 13(1) [aprox. 9 p.]. Disponible en: http://new.medigraphic.com/cgi-bin/resumenMain.cgi?IDARTICULO=49345
22. Martínez Martínez L, Calvo J. The growing problem of antibiotic resistance in clinically relevant Gram-negative bacteria: Current situation. EnfermInfeccMicrobiolClin[Internet]. 2018 [citado el20/06/2020]; 28 (S2): [aprox. 6 p.]. Disponible en: http://europepmc.org/abstract/MED/21130927
23. Woodford N, Turton JF, Livermore DM. Multiresistant Gram-negative bacteria: The role of high-risk clones in the dissemination of antibiotic resistance. RevMicrobiol [Internet]. 2016 [15/06/2020]; 35 (5):[aprox. 3 p.]. Disponible en:http://onlinelibrary.wiley.com/doi/10.1111/j.1574-6976.2011.00268.x/full
24. Canton R, Valverde A, Novais A, Baquero F, Coque T. Evolución y panorama actual de las BLEE. Enferm Infecc Microbiol [Internet]. 2017 [citado el 22/06/2020]; 25(2):[aprox. 8 p.]. Disponible en: http://www.elsevier.es/sites/default/files/elsevier/pdf/28/28v25nSupl.2a13112082pdf001.pdf
25. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect [Internet]. 2019 [citado el 22/02/2020]; 18 (3):[aprox. 7 p.]. Disponible en: http://onlinelibrary.wiley.com/doi/10.1111/j.1469-0691.2011.03570.x/full
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2021-12-16
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Cecilia-Paredes EE, Echevarría-Cruz A, Cecilia-Paredes E, García-Peña EA, Soto-Alvarez EM, Santaya-Labrador JM. Efectividad de las medidas aplicadas para la prevención de las infecciones asociadas a la asistencia sanitaria en la terapia. Rev 16 de abril [Internet]. 2021 Dec. 16 [cited 2025 Jan. 12];60(282):e1447. Available from: https://rev16deabril.sld.cu/index.php/16_04/article/view/1447
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