Correlación de la neumonía adquirida en la comunidad y hospitalaria, elaboración de un protocolo
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La neumonía adquirida en la comunidad ( NAC ) tiene menor mortalidad que la
neumonía adquirida en el hospital ( NAH), el impacto está determinado por los agentes
infecciosos y la elección adecuada del antibiótico empírico debido a la alta resistencia
de los gérmenes hospitalarios. El objetivo del presente estudio es correlacionar la NAC
con la NAH. Se realizó un estudio retrospectivo, descriptivo, cuantitativo, analítico,
transversal, con un enfoque positivista, con los casos de los pacientes del Hospital
Nacional de Especialidades Guayaquil “Dr. Abel Gilbert Pontón” de enero a diciembre
del 2015. Los resultados encontrados fueron 129 pacientes con diagnóstico de
neumonía, de los cuales para n= 90 para NAC y n=39 para NAH, el agente etiológico
más frecuentes fue la Klebsiella pneumoniae tanto para NAC ( 43% ) y para NAH (
46% ); la mortalidad fue mayor para NAH con un OR: 3,7698 y p: 0,001. Entre las
conclusiones tenemos que la estancia hospitalaria fue mayor en los pacientes con NAH
en comparación a la NAC, generando mayor morbi-mortalidad, el principal agente
etiológico fue la Klebsiella pneumoniae multidrogrresistente con sensibilidad variable
a carbapenems y colistina, la hipertensión arterial, diabetes mellitus, insuficiencia
renal crónica con tratamiento sustitutivo, enfermedad cerebro vascular además de la
enfermedad cardíaca crónica fueron los factores de riesgo más importantes.
The community-acquired pneumonia (CAP) have lower mortality than hospital acquired pneumonia (HAP), the impact is determined by infectious agents and appropriate empiric due to the high resistance of hospital germs. The aim of this study is to correlate the CAP with the HAP. A retrospective, descriptive, quantitative, analytical, cross-sectional study was conducted with a positivist approach, with cases of patients in the National Specialty Hospital Guayaquil "Dr. Abel Gilbert Ponton "from January to December 2015. The results were 129 patients diagnosed with pneumonia, which for n = 90 for CAP and n = 39 for to HAP, the most common etiologic agent was Klebsiella pneumoniae both CAP ( 43%) and HAP (46%); mortality was higher for HAP with an OR: 3.7698 and p: 0.001. Among the conclusions we have to stay in hospital was higher in patients with HAP compared to the CAP, generating increased morbidity and mortality, the major etiologic agent was Klebsiella pneumoniae multidrogrresistente variable to carbapenems and colistin sensitivity, hypertension, diabetes mellitus , chronic renal failure with replacement therapy, vascular brain disease in addition to chronic heart disease were the most important risk factors.
The community-acquired pneumonia (CAP) have lower mortality than hospital acquired pneumonia (HAP), the impact is determined by infectious agents and appropriate empiric due to the high resistance of hospital germs. The aim of this study is to correlate the CAP with the HAP. A retrospective, descriptive, quantitative, analytical, cross-sectional study was conducted with a positivist approach, with cases of patients in the National Specialty Hospital Guayaquil "Dr. Abel Gilbert Ponton "from January to December 2015. The results were 129 patients diagnosed with pneumonia, which for n = 90 for CAP and n = 39 for to HAP, the most common etiologic agent was Klebsiella pneumoniae both CAP ( 43%) and HAP (46%); mortality was higher for HAP with an OR: 3.7698 and p: 0.001. Among the conclusions we have to stay in hospital was higher in patients with HAP compared to the CAP, generating increased morbidity and mortality, the major etiologic agent was Klebsiella pneumoniae multidrogrresistente variable to carbapenems and colistin sensitivity, hypertension, diabetes mellitus , chronic renal failure with replacement therapy, vascular brain disease in addition to chronic heart disease were the most important risk factors.
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Palabras clave
Neumonía, Infección hospitalaria, Salud comunitaria, Protocolos, Epidemiología descriptiva, Estudios retrospectivos, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador