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Mortalidad de pacientes con infección por bacilos gram Negativos sensibles versus resistentes en la unidad de cuidado intensivo medico de la Fundación Cardioinfantil.

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dc.contributor.advisorVarón Vega, Fabio Andrés
dc.creatorMartinez Caballero, Azucena
dc.creator.degreeEspecialista en Medicina Interna
dc.date.accessioned2017-08-01T12:12:40Z
dc.date.available2017-08-01T12:12:40Z
dc.date.created2017-02-24
dc.date.issued2017
dc.descriptionIntroducción: Las infecciones por bacilos gram negativos resistentes son frecuentes, más en cuidado intensivo; están asociadas a mayor morbilidad, mortalidad y costos en salud. Nuestro objetivo fue determinar diferencias en mortalidad en pacientes con infecciones por gérmenes gram negativos resistentes versus sensibles, y que factores están asociados. Metodología: Estudio de cohorte retrospectiva, de pacientes adultos con sepsis y choque séptico hospitalizados en la Unidad de Cuidado Intensivo Médico de FCI - FNC entre el año 2012 y 2014, con aislamiento de bacilos gram negativos. Se realizó estadística descriptiva e inferencial de todas las variables y un análisis multivariado para buscar asociaciones con mortalidad. Resultados: Se recolectaron 230 pacientes, 145 (63%) tuvieron aislamiento de bacilos gram negativos resistentes. La tabla 1 muestra las características generales de ambos grupos encontrando que los pacientes con gram negativos resistentes tenían menor edad, sin diferencias en comorbilidad, score de severidad y origen de infección. Los gram negativos resistentes fueron más frecuentes en caso de infección nosocomial (49 Vs 30%, p < 0.001). No se encontraron diferencias en el aislamiento microbiológico, excepto para E. coli sensible (28 Vs 59%, p < 0.001), Grafica 1. En pacientes con gram negativos resistentes fue mayor el tiempo en cuidado intensivo, así como la necesidad de ventilación mecánica; siendo ésta último factor asociado a mortalidad (OR 11.2 IC95% 2.5 – 49.8, p 0.002). Conclusiones: La infección por gérmenes gram negativos resistentes es frecuente, sin diferencias demográficas, ni clínicas con el grupo de infección por gérmenes sensibles. Se asoció con mayor estancia en cuidado intensivo y tiempo de ventilación mecánica, siendo esta última el único factor de riesgo asociado a mortalidad.spa
dc.description.abstractIntroduction: Resistant gram negative bacilli infections are frequent, more in intensive care; They are associated with a mayor of morbidity, mortality, and health costs. Our objective was to determine differences in mortality in patients with resistant and susceptible gram negative bacterial infections, and which factors are associated. Methodology: Retrospective cohort study of adult patients with sepsis and septic patients hospitalized in the FCI - FNC Medical Intensive Care Unit between 2012 and 2014, with isolation of gram negative bacilli. We performed descriptive and inferential statistics of all variables and multivariate analysis to find associations with mortality. Results: 230 patients were collected, 145 (63%) had isolation of resistant gram negative bacilli. Table 1 shows the general characteristics of both groups found with patients with resistant negative grams with lower age, with no differences in comorbidity, severity score and origin of infection. Resistant gram negative was more frequent in case of nosocomial infection (49 Vs 30%, p &lt; 0. 001). There were no differences in microbiological isolation, except for sensitive E. coli (28 Vs 59%, p &lt; 0. 001), Graph 1. In patients with resistant gram negative the time in intensive care was longer, as was the need for ventilation mechanics; Being the last factor associated with mortality (OR 11. 2 IC95% 2. 5 - 49. 8, p 0. 002). Conclusions: Infection with resistant gram negative bacteria is frequent, with no demographic or clinical differences with the group of infection by sensitive germs. It was associated with longer stay in intensive care and time of mechanical ventilation, the latter being the only risk factor associated with mortality.eng
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dc.identifier.doihttps://doi.org/10.48713/10336_13595
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/13595
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de Medicinaspa
dc.publisher.programEspecialización en Medicina Internaspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectBacilos gram negativosspa
dc.subjectMortalidadspa
dc.subjectMultirresistenciaspa
dc.subjectCuidado críticospa
dc.subject.ddcIncidencia & prevención de la enfermedad
dc.subject.decsBacterias Gramnegativasspa
dc.subject.decsInfecciones Bacterianasspa
dc.subject.decsCuidados Críticosspa
dc.subject.keywordGram negative bacillieng
dc.subject.keywordMortality Multiresistanceeng
dc.subject.keywordcritical care.eng
dc.titleMortalidad de pacientes con infección por bacilos gram Negativos sensibles versus resistentes en la unidad de cuidado intensivo medico de la Fundación Cardioinfantil.spa
dc.typemasterThesiseng
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
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