Manifestaciones clínicas y de laboratorio en neumonía nosocomial de acuerdo con el germen causal en el Hospital General Guasmo Sur 2017 - 2019
Fecha
2020
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
La neumonía nosocomial es una patología que se desarrolla en el parénquima pulmonar caracterizada por la colonización e infección de microorganismos que se encuentran en el ambiente hospitalario y su diagnóstico debe estar relacionado con una estancia de hospitalización mayor a 48 horas.
Su definición clínica es una colección de manifestaciones clínicas de fiebre, escalofríos, tos, dolor pleurítico, esputo, taquipnea, crepitaciones, que se acompañan de infiltrados en la radiografía de tórax.
Esta investigación tiene como finalidad identificar las diferencias en la presentación clínica y resultados de pruebas complementarias en pacientes con neumonía nosocomial, de acuerdo con el germen causal identificado; trabajo ejecutado en el Hospital General Guasmo Sur.
Se determino mediante el análisis de varianza de los puntajes promedio por categorías de la escala SMART-COP según el germen identificado para la población en general, con valores de probabilidad >95% según la prueba ANOVA de un solo factor y la fórmula CHI CUADRADO. Se identifico al Haemophilus influenzae como el germen mas
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frecuente aislado en un 27,6% de los casos, Pseudomona aeruginosa produjo de forma más frecuente grados de riesgo muy alto en ambos géneros, se asoció al Staphylococcus aureus como principal germen en desarrollar compromiso multilobar en un 91,30% de los casos, se concluyó que Pseudomona aeruginosa fue el germen más habitual en producir niveles de PaO2 menores de 70mmHg en un 61,54% y quien produjo niveles bajos de albúmina(<35mg/dl) en un 50% de los casos, se encontró a Pseudomona aeruginosa como el patógeno que más produjo niveles de Ph<7,35.
Nosocomial pneumonia is a pathology that develops in the lung parenchyma characterized by the colonization and infection of microorganisms found in the hospital environment and its diagnosis must be related to a hospital stay longer than 48 hours. Its clinical definition is a collection of clinical manifestations of fever, chills, cough, pleuritic pain, sputum, tachypnea, crepitations, which are accompanied by infiltrates on the chest radiograph. The purpose of this research is to identify the differences in the clinical presentation and results of complementary tests in patients with nosocomial pneumonia, according to the identified causal germ; work carried out at the Guasmo Sur General Hospital. It was determined by means of the analysis of variance of the mean scores by categories of the SMART-COP scale according to the germ identified for the general population, with probability values> 95% according to the one-way ANOVA test and the CHI SQUARE formula. Haemophilus influenzae was identified as the most frequent germ ANEXO 14 22 isolated in 27.6% of the cases, Pseudomona aeruginosa produced more frequently degrees of very high risk in both genders, it was associated with Staphylococcus aureus as the main germ in developing multilobar compromise in In 91.30% of the cases, it was concluded that Pseudomona aeruginosa was the most common germ in producing PaO2 levels lower than 70mmHg in 61.54% and that it produced low levels of albumin (<35mg / dl) in 50% of the cases, Pseudomona aeruginosa was found as the pathogen that produced the most Ph levels <7.35.
Nosocomial pneumonia is a pathology that develops in the lung parenchyma characterized by the colonization and infection of microorganisms found in the hospital environment and its diagnosis must be related to a hospital stay longer than 48 hours. Its clinical definition is a collection of clinical manifestations of fever, chills, cough, pleuritic pain, sputum, tachypnea, crepitations, which are accompanied by infiltrates on the chest radiograph. The purpose of this research is to identify the differences in the clinical presentation and results of complementary tests in patients with nosocomial pneumonia, according to the identified causal germ; work carried out at the Guasmo Sur General Hospital. It was determined by means of the analysis of variance of the mean scores by categories of the SMART-COP scale according to the germ identified for the general population, with probability values> 95% according to the one-way ANOVA test and the CHI SQUARE formula. Haemophilus influenzae was identified as the most frequent germ ANEXO 14 22 isolated in 27.6% of the cases, Pseudomona aeruginosa produced more frequently degrees of very high risk in both genders, it was associated with Staphylococcus aureus as the main germ in developing multilobar compromise in In 91.30% of the cases, it was concluded that Pseudomona aeruginosa was the most common germ in producing PaO2 levels lower than 70mmHg in 61.54% and that it produced low levels of albumin (<35mg / dl) in 50% of the cases, Pseudomona aeruginosa was found as the pathogen that produced the most Ph levels <7.35.
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NEUMONIA, KLEBSIELLA PNEMONIAE, RESPIRACION ARTIFICIAL, ACIDOSIS RESPIRATORIA, LEUCOCITOS, HOSPITAL GENERAL GUASMO SUR., CANTON GUAYAQUIL, ECUADOR