Eficacia terapéutica según los microorganismos más frecuentes aislados en peritonitis en pacientes en diálisis peritoneal del Hospital del Niño Dr. Francisco de Icaza Bustamante 2014-2016
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La peritonitis es la principal complicación, vinculada al tratamiento, de los pacientes pediátricos en diálisis peritoneal (DP). La incidencia ha disminuido, sin embargo, las complicaciones derivadas de episodios de peritonitis son una de las principales causas de abandono de la técnica dialítica y de mortalidad en este grupo de pacientes.
Cerca del 50% de las complicaciones y errores en la diálisis peritoneal son los procesos infecciosos. El tratamiento precoz y adecuado de los episodios de peritonitis es la piedra angular del éxito del mismo, por lo que conocer la prevalencia de los distintos gérmenes y su sensibilidad antibiótica tiene fundamental importancia en el grupo de pacientes pediátricos con diálisis peritoneal. El objetivo de este estudio fue Determinar la eficacia terapéutica según los microorganismos más frecuentes aislados en peritonitis en pacientes en diálisis peritoneal atendidos en el Hospital del Niño “Dr. Francisco de Icaza Bustamante” 2014-2016. Fue realizado en el servicio de nefrología con una muestra de 53 pacientes en edad pediátrica atendidos por diálisis peritoneal en el período de enero de 2014 a diciembre del 2016. Se realizó un estudio observacional, descriptivo, retrospectivo y longitudinal. Existió un ligero predominio del sexo femenino (50,9%) y el 71,7% de los pacientes estaban en edades entre 11 y 15 años. El 54,7% llevaba entre 1 y 3 años con ERC, casi la totalidad con diálisis peritoneal automatizada. El germen aislado de mayor frecuencia fue el Stafilococo aureus. La mayor sensibilidad microbiana la tuvieron ante la Gentamicina y la mayor resistencia, ante la Oxacilina y el Trimetoprim/Sulfametoxazol. El 75,5% de los casos necesitaron más de 21 días de ingreso y la hipertensión arterial fue la complicación que más se observó. En la mayoría de los pacientes funcionó el tratamiento empírico, teniendo una buena eficacia terapéutica.
Peritonitis is the main treatment-related complication of pediatric patients on peritoneal dialysis (PD). The incidence has decreased, however, the complications derived from peritonitis episodes are one of the main causes of abandonment of dialysis technique and mortality in this group of patients. About 50% of complications and errors in peritoneal dialysis are infectious processes. The early and adequate treatment of peritonitis episodes is a cornerstone of its success, so knowing the prevalence of different germs and their antibiotic sensitivity is of fundamental importance in the pediatric group with peritoneal dialysis. The objective of this study was to determinate e the therapeutic efficacy according to the most frequent microorganisms isolated in peritonitis in pediatric patients on peritoneal dialysis treated at the Child Hospital "Dr. Francisco de Icaza Bustamante" in the period 2014-2016. The present study was conducted in the nephrology department with a sample of 53 pediatric patients attended by peritoneal dialysis in the period from January 2014 to December 2016. An observational, descriptive, retrospective and longitudinal study was conducted. There was a slight predominance of females (50.9%) and 71.7% of patients were between 11 and 15 years of age. 54.7% had between 1 and 3 years with CKD, almost all with automated peritoneal dialysis. The most frequent isolated germ was Staphylococcus aureus. The highest microbial sensitivity was to Gentamicin and the highest resistance to Oxacillin and Trimethoprim / Sulfamethoxazole. 75.5% of the cases required more than 21 days of hospitalization and arterial hypertension was the most observed complication. In the majority of the patients the empirical treatment worked, having a good therapeutic efficacy.
Peritonitis is the main treatment-related complication of pediatric patients on peritoneal dialysis (PD). The incidence has decreased, however, the complications derived from peritonitis episodes are one of the main causes of abandonment of dialysis technique and mortality in this group of patients. About 50% of complications and errors in peritoneal dialysis are infectious processes. The early and adequate treatment of peritonitis episodes is a cornerstone of its success, so knowing the prevalence of different germs and their antibiotic sensitivity is of fundamental importance in the pediatric group with peritoneal dialysis. The objective of this study was to determinate e the therapeutic efficacy according to the most frequent microorganisms isolated in peritonitis in pediatric patients on peritoneal dialysis treated at the Child Hospital "Dr. Francisco de Icaza Bustamante" in the period 2014-2016. The present study was conducted in the nephrology department with a sample of 53 pediatric patients attended by peritoneal dialysis in the period from January 2014 to December 2016. An observational, descriptive, retrospective and longitudinal study was conducted. There was a slight predominance of females (50.9%) and 71.7% of patients were between 11 and 15 years of age. 54.7% had between 1 and 3 years with CKD, almost all with automated peritoneal dialysis. The most frequent isolated germ was Staphylococcus aureus. The highest microbial sensitivity was to Gentamicin and the highest resistance to Oxacillin and Trimethoprim / Sulfamethoxazole. 75.5% of the cases required more than 21 days of hospitalization and arterial hypertension was the most observed complication. In the majority of the patients the empirical treatment worked, having a good therapeutic efficacy.
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Peritonitis, Diálisis peritoneal, Eficacia terapéutica, Estudios retrospectivos, Hospital del Niño Francisco de Icaza Bustamante, Cantón Guayaquil, Ecuador