2025, Number 06
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Med Int Mex 2025; 41 (06)
Prevalence and etiology of catheter-related infections in neurocritical patients
Meraz MFJ, Castillo MG, Robles MMA, Torres BJM, Morelos GEN, Aspera CT
Language: Spanish
References: 45
Page: 323-331
PDF size: 364.10 Kb.
ABSTRACT
Objective: To identify the prevalence of catheter-related infections and the microorganisms
obtained in neurocritical patients in the intensive care unit.
Materials and Methods: Descriptive, observational transversal and retrospective
study of neurocritical patients older than 18 years, assisted at the intensive care unit
from 2017 to 2022.
Results: Thirty patients were included, 28 were men. The mean age was 40 ± 16.99
years, with a mean in-hospital stay of 18.77 ± 9.09 days. The admission diagnoses
were traumatic brain injury (15 out of 30), subdural hematoma (7 of 30) and hemorrhagic
stroke (15 of 30). Surgical intervention (craniotomy, n = 11) was required in
16 patients. Bladder catheter and orotracheal intubation were installed in 28 patients,
and 4 with central venous catheters. Gram-negative pathogens were identified in 27
cultures, particularly in the case of the urinary catheter, enterobacteria were the main
pathogen,
P. aeruginosa in the orotracheal intubation and
K. pneumoniae in the central
venous catheter.
Conclusions: Neurocritical patients have more susceptibility to infections due to the
immunosuppression state caused by their neurological disease, permitting opportunistic
bacterium to appear, augmenting the morbidity and mortality.
REFERENCES
Chen Y, Wang S, Xu S, Xu N, et al. Current advances in neurocriticalcare. J Intens Med 2024. https://doi.org/10.1016/j.jointm.2024.04.005
Peixoto Brito ML, Reis Macedo LF, de Siqueira W, et al.Neurocritical patients: Review of the scope of nursingdiagnoses and care in the intensive care unit. SAGEOpen Nursing 2023; 9: 23779608231158978. https://doi.org/10.1177/23779608231158978
Mert D, Çalışkan Demirkıran B, İskender G, Avşar Z, et al.Six-year evaluation of device-associated nosocomial infectionsin intensive care units. J Infect Develop Countries2024; 18 (06): 937-42. https://doi.org/10.3855/jidc.19426
Rafa E, Kołpa M, Wałaszek MZ, Domański A, et al.Healthcare-acquired infection surveillance in neurosurgerypatients, incidence and microbiology, five years ofexperience in two polish units. International J Environ ResPublic Health 2022; 19 (12): 7544. https://doi.org/10.3390/ijerph19127544
Busl KM. Healthcare-associated infections in the neurocriticalcare unit. Current Neurol Neurosci Rep 2019; 19 (10).https://doi.org/10.1007/s11910-019-0987-y
Thompson HJ, Rivara F, Becker KJ, Maier R, Temkin N.Impact of aging on the immune response to traumaticbrain injury (AIm:TBI) study protocol. Inj Prev 2020; 26 (5):471-7. https://doi.org/10.1136/injuryprev-2019-043325
Reyes J, Velasco V, Caballero M, Contreras M, Aguirre M.Guía de Práctica Clínica GPC Intervenciones de enfermeríapara la atención inicial de pacientes con traumatismo craneoencefálicograve en urgencias. Evidencias y recomendaciones.Catálogo Maestro de Guías de Práctica Clínica:GPC-IMSS-604-18 2018.
INEGI. Estadísticas de defunciones registradas 2023. In:Comunicado De Prensa. 2024.
Blot S, Ruppé E, Harbarth S, Asehnoune K, et al. Healthcareassociatedinfections in adult intensive care unit patients:Changes in epidemiology, diagnosis, prevention and contributionsof new technologies. Intens Crit Care Nursing 2022;70 (103227). https://doi.org/10.1016/j.iccn.2022.103227
Secretaría de Salud. Boletín Infecciones Asociadas a laAtención de la Salud (IAAS) Red Hospitalaria de VigilanciaEpidemiológica (RHOVE). 2022https://www.gob.mx/cms/uploads/attachment/file/808320/BOLETINRHOVECIERRE2022_FINAL.pdf
Caceres E, Olivella JC, Yanez M, Viñan Eet al. Risk factorsand outcomes of lower respiratory tract infections aftertraumatic brain injury: a retrospective observational study.Frontiers Med 2023; 10.
Chen Z, Laing J, Li J, O’Brien TJ, et al. Hospital‐acquiredinfections as a risk factor for post‐traumatic epilepsy: Aregistry‐based cohort study. Epilepsia Open 2024; 9 (4):
1333-44. https://doi.org/10.1002/epi4.1295713. Cámara de Diputados del H. Congreso de la Unión. Reglamentode la Ley General de Salud en Materia de Investigaciónpara la Salud. 2014. https://www.diputados.gob.mx/LeyesBiblio/regley/Reg_LGS_MIS.pdf
Abulhasan YB, Abdullah AA, Shetty SA, Ramadan MA, et al.Health care-associated infections in a neurocritical care unitof a developing country. Neurocritical Care 2019. https://doi.org/10.1007/s12028-019-00856-8
Podkovik S, Toor H, Gattupalli M, Kashyap S, et al. Prevalenceof catheter-associated urinary tract infections inneurosurgical intensive care patients – the overdiagnosisof urinary tract infections. Cureus 2019; 11 (8). https://doi.org/10.7759/cureus.5494
Shi Y, Hu Y, Xu GM, Ke Y. Development and validation of apredictive model for pulmonary infection risk in patientswith traumatic brain injury in the ICU: a retrospectivecohort study based on MIMIC-IV. BMJ Open Respir Res2024; 11 (1): e002263-3. https://doi.org/10.1136/bmjresp-2023-002263
Yang W, Yao H, Xi C, Ye X, et al. Prevalence and clinicalcharacteristics of bacterial pneumonia in neurosurgicalemergency center patients: a retrospective study spanning13 years at a tertiary center. Microorganisms 2023;11 (8): 1992-2. https://doi.org/10.3390/microorganisms11081992
Dyvik EH. Global population from 2000 to 2022, by gender.Statista. Statista; 2024. https://www.statista.com/statistics/1328107/global-population-gender/
O’Neill A. Global age distribution by region in 2023. Statista.
2024. https://www.statista.com/statistics/932555/globalpopulation-by-age-by-continent/20. Feigin VL, Abate MD, Abate YH, Abd ElHafeez S, et al.Global, regional, and national burden of stroke and itsrisk factors, 1990–2021: a systematic analysis for theGlobal Burden of Disease Study 2021. Lancet Neurol2024; 23 (10): 973-1003. https://doi.org/10.1016/S1474-4422(24)00369-7
Campos-Nonato I, Oviedo-Solís C, Hernández-Barrera L,Márquez-Murillo M, et al. Detección, atención y control dehipertensión arterial. Salud Pública Méx 2024; 66: 537-46.
Campos-Nonato I, Hernández-Barrera L, Oviedo-Solís C,Ramírez-Villalobos D, et al. Epidemiología de la hipertensiónarterial en adultos mexicanos: diagnóstico, control ytendencias. Ensanut 2020. Salud Pública Méx 2021; 63:692-704.
Vyas MV, Silver FL, Austin PC, Yu AYX, et al. Stroke incidenceby sex across the lifespan. Stroke 2021; 52 (2): 447-51.https://doi.org/10.1161/STROKEAHA.120.032898
Perrin K, Vats A, Qureshi A, Hester J, et al. Catheterassociatedurinary tract infection (CAUTI) in the NeuroICU:Identification of risk factors and time-to-CAUTI using acase–control design. Neurocritical Care 2020; 34: 271-278.https://doi.org/10.1007/s12028-020-01020-3
Dewan MC, Rattani A, Gupta S, Baticulon RE, et al. Estimatingthe global incidence of traumatic brain injury. J Neurosurg2018; 130 (4): 1-18. https://doi.org/10.3171/2017.10.JNS17352
Guo S, Han R, Chen F, Ji P, et al. Epidemiological characteristicsfor patients with traumatic brain injury and thenomogram model for poor prognosis: an 18-year hospitalbasedstudy. Front Neurol 2023 May 23;14. https://doi.org/10.3389/fneur.2023.1138217
Cariello AN, Perrin PB, Rodríguez-Agudelo Y, Olivera PlazaSL, et al. A multi-site study of traumatic brain injury inMexico and Colombia: Longitudinal mediational and crosslaggedmodels of family dynamics, coping, and healthrelatedquality of life. Int J Environ Res Public Health 2020;17 (17): 6045. https://doi.org/10.3390/ijerph17176045
Holmes CL, Anderson MT, Mobley HLT, Bachman MA.Pathogenesis of gram-negative bacteremia. Clin MicrobiolRev 2021; 34 (2). https://doi.org/10.1128/CMR.00234-20
Jean SS, Chang YC, Lin WC, Lee WS, et al. Epidemiology,treatment, and prevention of nosocomial bacterialpneumonia. J Clin Med 2020; 9 (1): 275. https://doi.org/10.3390/jcm9010275
Calvo M, Stefani S, Migliorisi G. Bacterial infections inintensive care units: Epidemiological and microbiologicalaspects. Antibiotics 2024; 13 (3): 238. https://doi.org/10.3390/antibiotics13030238
Secretaría de Salud. Acciones Esenciales para la Seguridaddel Paciente. 2023. https://www.gob.mx/cms/uploads/attachment/file/920141/AESP_CSG-DGCES_16_junio_2023.pdf
Adams D, Bucior H, Day G, Rimmer JA. HOUDINI:Make that urinary catheter disappear – nurse-ledprotocol. J Infect Prev 2012; 13 (2): 44–6. https://doi.org/10.1177/1757177412436818
Odabasi Z, Mert A. Candida urinary tract infections inadults. World J Urol 2019. https://doi.org/10.1007/s00345-019-02991-5
Huang H, Chang Q, Zhou Y, Liao L. Risk factors of centralcatheter bloodstream infections in intensive care units:A systematic review and meta-analysis. PloS One 2024;19 (4): e0296723-3. https://doi.org/10.1371/journal.pone.0296723
Cheung GYC, Bae JS, Otto M. Pathogenicity and virulenceof Staphylococcus aureus. Virulence 2021; 12 (1): 547-69.https://doi.org/10.1080/21505594.2021.1878688
Folic MM, Djordjevic Z, Folic N, Radojevic MZ, Jankovic SM.Epidemiology and risk factors for healthcare-associated infectionscaused by Pseudomonas aeruginosa. J Chemother2020; 33 (5): 294-301. https://doi.org/10.1080/1120009X.2020.1823679
Thomas-Rüddel D, Holger Fröhlich, Schwarzkopf D, Bloos F,Riessen R. Sepsis and underlying comorbidities in intensivecare unit patients. Medizinische Klinik 2023. https://doi.org/10.1007/s00063-023-01037-4
Gómez-Ugarte AC, García-Guerrero VM. Inequality crossroadsof mortality: Socioeconomic disparities in life expectancyand life span in Mexico between 1990 and 2015.Popul Res Policy Rev 2023; 42 (4). https://doi.org/10.1007/s11113-023-09806-x
Martínez-Martínez OA, Rodríguez-Brito A. Vulnerability inhealth and social capital: A qualitative analysis by levels ofmarginalization in Mexico. Int J Equity Health 2020; 19 (24).https://doi.org/10.1186/s12939-020-1138-4
Secretaría de Salud. Manual de la Implementación de losPaquetes de Acciones para Prevenir y Vigilar las InfeccionesAsociadas a la Atención de la Salud (IAAS). 2019.
Bouras M, Asehnoune K, Roquilly A. Immune modulationafter traumatic brain injury. Front Med 2022; 9.
Iadecola C, Buckwalter MS, Anrather J. Immune responsesto stroke: mechanisms, modulation, and therapeutic potential.J Clin Invest 2020; 130 (6): 2777-88. https://doi.org/10.1172/JCI135530
Sharma R, Shultz SR, Robinson MJ, Belli A, et al. Infectionsafter a traumatic brain injury: The complex interplaybetween the immune and neurological systems. BrainBehav Immun 2019; 79: 63-74. https://doi.org/10.1016/j.bbi.2019.04.034
Ruhal R, Kataria R. Biofilm patterns in gram-positive andgram-negative bacteria. Microbiol Res 2021; 251: 126829.https://doi.org/10.1016/j.micres.2021.126829
Mishra A, Aggarwal A, Khan F. Medical device-associatedinfections caused by biofilm-forming microbial pathogensand controlling strategies. Antibiotics 2024; 13 (7): 623.https://doi.org/10.3390/antibiotics13070623