Factores de riesgo para criptococosis en pacientes con HIV en el Hospital Dr. Teodoro Maldonado Carbo en el período de 1 de junio del 2013 al 31 de mayo del 2014
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2015
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
Resumen
Antecedentes: El critoccocus neoformans es el principal hongo patógeno en el ser humano, que ha adquirido una relevancia fundamental en los últimos años como agente patógeno en pacientes con VIH/SIDA debido a la alta morbimortalidad que causa en este grupo. Si bien su tratamiento ha reducido de manera importante la mortalidad por esta patología, no es menos cierto que la terapéutica expone al paciente a riesgo que también pueden poner en peligro su vida, por lo que sería mejor que se pudiera contar con información que permitiera anticipar su desarrollo. Metodología:.Con el objetivo de determinar los factores de riesgo más importantes para contraer una infección por criptoccocosis entre pacientes con VIH/SIDA atendidos en el hospital Teodoro Maldonado Carbo – Guayaquil, se realizó un estudio de tipo observacional analítico longitudinal retrospectivo no experimental en el que se incluyeron pacientes procedentes del Departamento de control de infecciones, atendidos entre el 2013 a 2014, con una historia completa y exámenes elaborados en la institución y se excluyeron pacientes incompletos o inexistentes. Resultados: Los estudios mostraron que un tiempo de duración de la enfermedad de VIH más allá de los 39 años, se asoció a un riesgo incrementado de desarrollo de infección por critoccoco (57,1% vs 26,7% OR. 6,66 IC95%: 1,342 – 33,126; P 0.003) (P 0.003). Lo mismo se asoció con contajes de CD4 menores de 200 que se asociaron a un incremento del riesgo (71,4% vs 12,2% OR. 17,91 IC95%: 3,12 – 102,851) (P 0.003) Conclusión: Un tiempo de desarrollo de la enfermedad de 40 años o más y un conteo de CD4 menos de 200 son los factores de riesgo más importante para infección por Criptoccoco neoformans entre pacientes con VIH/SIDA atendidos
Critoccocus neoformans is the main fungal pathogen in humans, which has acquired a fundametal relevance in recent years as a pathogen in patients with HIV / AIDS due to the high morbidity and mortality causes in this group. While treatment has significantly reduced mortality from this disease, it is equally true that the therapeutic exposes patients to risks that can also endanger your life, so it would be best that could have information that would anticipate development. Methodology: In order to determine the most important risk factors for contracting an infection criptoccocosis among patients with HIV / AIDS treated at the Teodoro Maldonado Hospital - Guayaquil, a study of non-experimental longitudinal observational analytical retrospective in which was conducted including patients from infection control department, served between 2013-2014, with a complete history and tests developed in the institution and incomplete or non-existent patients were excluded. Results: The study showed that duration of HIV disease beyond 39 years was associated with an increased risk of developing infection critoccoco (57.1% vs 26.7% OR 6.66 CI95 risk. %: 1.342 to 33.126; P 0.003) (P 0.003). The same was associated with CD4 counts less than 200 that were associated with an increased risk (71.4% vs 12.2% 17.91 OR 95% CI. 3.12 to 102.851) (P 0.003) Conclusion: A time course of the disease 40 years or more and a CD4 count less than 200 are the most important risk factors for Criptoccoco neoformans infection in patients with HIV / AIDS cared for.
Critoccocus neoformans is the main fungal pathogen in humans, which has acquired a fundametal relevance in recent years as a pathogen in patients with HIV / AIDS due to the high morbidity and mortality causes in this group. While treatment has significantly reduced mortality from this disease, it is equally true that the therapeutic exposes patients to risks that can also endanger your life, so it would be best that could have information that would anticipate development. Methodology: In order to determine the most important risk factors for contracting an infection criptoccocosis among patients with HIV / AIDS treated at the Teodoro Maldonado Hospital - Guayaquil, a study of non-experimental longitudinal observational analytical retrospective in which was conducted including patients from infection control department, served between 2013-2014, with a complete history and tests developed in the institution and incomplete or non-existent patients were excluded. Results: The study showed that duration of HIV disease beyond 39 years was associated with an increased risk of developing infection critoccoco (57.1% vs 26.7% OR 6.66 CI95 risk. %: 1.342 to 33.126; P 0.003) (P 0.003). The same was associated with CD4 counts less than 200 that were associated with an increased risk (71.4% vs 12.2% 17.91 OR 95% CI. 3.12 to 102.851) (P 0.003) Conclusion: A time course of the disease 40 years or more and a CD4 count less than 200 are the most important risk factors for Criptoccoco neoformans infection in patients with HIV / AIDS cared for.
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Criptococosis, Virus, Síndrome de inmunodeficiencia adquirida, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador