Factores de riesgo hospitalarios que influyen en la colonización por klebsiella productora de carbapenemasas trabajo a realizarse en el Hospital de Infectología José Rodríguez Maridueña en el período 2018 a 2020
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2020
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
La frecuencia y desimanación incontrolada de entero bacterias productoras de carbapenemasas, es uno de los principales problemas de salud pública en todo el mundo debido a la facilidad de trasmisión, la dificultad del tratamiento y su impacto en la economía de la salud y social. Objetivo: Determinar los factores de riesgo hospitalarios que influyen en la colonización por Klebsiella productora de carbapenemasas.. Metodología: Estudio descriptivo, observacional, retrospectivo, transversal. Universo: 174 pacientes; muestra 120. Resultados: La sala de UCI presenta un alto porcentaje de pacientes colonizados 50% e infectado 50%, UCI contingencia 70% y 30% Los antibioticos para Klebsiella pneumoniae se utilizó cotrimoxazol 40%, Meropenem en 20 pacientes 22%, doxiciclina en 24 pacientes 26%, y en menor proporción la clindamicina 8%. Por otra parte en los diagnósticos de Klebsiella pneumoniae, por hisopado rectal con un promedio de 79 pacientes 75%, Klebsiella oxitoca 16%, E coli 4% y Enterobacter cloacae complex 3%; como factores de riesgos los procedimientos invasivos utilizados es el catéter urinario de uso hasta los 7 días con un rango de 75 pacientes 100% y se enmarca como factor para producción de KPC. Conclusiones: Los diagnósticos de Klebsiella pneumoniae, mayormente se presentaron en muestras por hisopado rectal en las salas de UCI, UCI contingencia, los antibioticos usados como abordaje de tratamiento fue cotrimoxazol, Meropenem, doxiciclina y clindamicina. Los procedimientos invasivos utilizados, con mayor relevancia se presentan el uso de catéter urinario de uso hasta los 7 días con un rango de 75 pacientes 100%
The frequency and uncontrolled de-magnetization of enterocarbapenemaseproducing bacteria is one of the main public health problems worldwide due to the ease of transmission, the difficulty of treatment, and its impact on the health and social economy. Objective: Determine the hospital risk factors that influence colonization by carbapenemase-producing Klebsiella. Methodology: Descriptive, observational, retrospective, cross-sectional study. Universe: 174 patients; sample 120. Results: The ICU ward shows a high percentage of 50% colonized and 50% infected patients, contingency ICU 70% and 30%. Antibiotics for Klebsiella pneumoniae were used cotrimoxazole 40%, Meropenem in 20 patients 22%, doxycycline in 24 patients 26%, and to a lesser extent clindamycin 8%. On the other hand, in the diagnoses of Klebsiella pneumoniae, by rectal swab with an average of 79 patients 75%, Klebsiella oxytoca 16%, E coli 4% and Enterobacter cloacae complex 3%; As risk factors, the invasive procedures used is the urinary catheter for use up to 7 days with a 100% range of 75 patients and it is framed as a factor for KPC production. Conclusions: Klebsiella pneumoniae diagnoses were mostly presented in rectal swab samples in the ICU and contingency ICU wards. The antibiotics used as a treatment approach were cotrimoxazole, Meropenem, doxycycline and clindamycin. The invasive procedures used, with the greatest relevance, are the use of a urinary catheter for use up to 7 days with a 100% range of 75 patients
The frequency and uncontrolled de-magnetization of enterocarbapenemaseproducing bacteria is one of the main public health problems worldwide due to the ease of transmission, the difficulty of treatment, and its impact on the health and social economy. Objective: Determine the hospital risk factors that influence colonization by carbapenemase-producing Klebsiella. Methodology: Descriptive, observational, retrospective, cross-sectional study. Universe: 174 patients; sample 120. Results: The ICU ward shows a high percentage of 50% colonized and 50% infected patients, contingency ICU 70% and 30%. Antibiotics for Klebsiella pneumoniae were used cotrimoxazole 40%, Meropenem in 20 patients 22%, doxycycline in 24 patients 26%, and to a lesser extent clindamycin 8%. On the other hand, in the diagnoses of Klebsiella pneumoniae, by rectal swab with an average of 79 patients 75%, Klebsiella oxytoca 16%, E coli 4% and Enterobacter cloacae complex 3%; As risk factors, the invasive procedures used is the urinary catheter for use up to 7 days with a 100% range of 75 patients and it is framed as a factor for KPC production. Conclusions: Klebsiella pneumoniae diagnoses were mostly presented in rectal swab samples in the ICU and contingency ICU wards. The antibiotics used as a treatment approach were cotrimoxazole, Meropenem, doxycycline and clindamycin. The invasive procedures used, with the greatest relevance, are the use of a urinary catheter for use up to 7 days with a 100% range of 75 patients
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Klebsiella pneumoniae, Factores de riesgo, Infección hospitalaria, Unidades de Cuidados Intensivos, Epidemiología descriptiva, Estudios retrospectivos, Enterobacteriaceae resistentes a los carbapenémicos, Hospital de Infectología Dr. José Daniel Rodríguez Maridueña, Cantón Guayaquil, Ecuador