Bernabé DMC

Language: Spanish
References: 10
Page: 271-275
PDF size: 246.10 Kb.

ABSTRACT

Introduction: acute infectious processes are one of the main conditions in the Intensive Care Unit, with multiple etiology being common. Respiratory tract, abdominal, surgical wound, urinary tract, soft tissue, bone, and other site infections are triggers for a poor prognosis in patients complicated by septic shock and multiple organ failure. Therefore, timely diagnosis and treatment with the most efficient antimicrobial scheme is necessary, thus reducing bacterial resistance. Objective: to describe the most common factors of bacterial resistance and its association with mortality in patients admitted to the intensive care unit of Hospital General La Villa. Results: the total number of clinical records studied were 99. Women represented 72.7% (n = 72). The average age recorded was 42 ± 15.1 years. The presence of one or more comorbidities was recorded in 55 (55.6%) patients. The majority of patients (n = 55; 55.6%) came from the emergency department. The most frequent admission diagnoses were septic shock (n = 30; 30.3%) and TBI (n = 11; 11.1%). The most used antibiotics were imipenem (n = 37; 37.3%) and ceftriaxone (n = 25; 25.2%). All patients had blood cultures, being negative in 12 (12.1%); of the positive results, 8 (9.2%) were multidrug resistant, 22 (25.3%) resistant, and 57 (65.5%) sensitive. Mortality was significantly associated with mechanical ventilation (p = 0.001) when recorded in 42 patients to whom it was administered. The association of the age group (p = 0.006) and sex (p = 0.001) with the result of the blood culture was statistically significant. Multidrug resistance occurred mainly in the 20-40-year-old group (n = 5). Likewise, women were the ones who presented all the cases of multiresistance. The most frequent diagnosis on admission was septic shock (n = 30; 30.3%), and the most frequent site of this diagnosis was abdominal (n = 17), pulmonary (n = 7), urinary (n = 4), and soft tissue (n = 2). Conclusions: inadequate administration and excessive use of antibiotics is associated with increased bacterial resistance and, therefore, an increased risk of mortality. Septic shock of pulmonary origin was associated with increased resistance and increased mortality.

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