Language: Spanish
References: 21
Page: 542-550
PDF size: 601.58 Kb.
ABSTRACT
Background: Nosocomial pneumonia is the second most common
infection after urinary tract infection. Its frequency is increased as a
result of technological advances in medicine, to the increase in bacterial
resistance of nosocomial pathogens for use or abuse of the broadspectrum
antibiotics, to invasive procedures seeking by the patient’s
health status for their diagnosis and treatment, environmental factors
inherent to the microbiology of each unit, as well as so many causes.
Objetive: To determine the epidemiology and microbiology in
patients hospitalized in the internal medicine service who presented
pneumonia nosocomial between July the 1
st of 2014 to June 30
th of
2015 at Regional Hospital, ISSSTE, Puebla, Mexico.
Material and Method: A retrospective study, the sample comprised
patients who fulfilled the criteria of Johanson in bacteriology
studies, Excel was used for the elaboration of the database and statistical
analysis through elements as:
1) prevalence,
2) demographic
values,
3) main risk factors and status at discharge and
4) percentage
frequency of isolated germs.
Results:RESULTS: 65 episodes of nosocomial pneumonia were identified (16%)
of the total number of infections in hospital in the study period. The rate
of cumulative incidence was 2.8 per each 100 patients discharged, the
gender most affected was male/female 58/41.5%, respectively; overall
mortality was 51% and survival was 49%; mortality by sex male/female
was 57.5/42%, respectively. Intrinsic risk factors as diabetes mellitus
and cardiovascular disease with 35%, extrinsic risk mechanical ventilation
and endotracheal intubation treatments (68%) and nebulization
treatments (65%). The predominant microbiology was: gramnegative
rods (76%) of which non-fermenting were found and these were
Pseudomonas aeruginosa and
Stenotrophomona maltophilia (45 and
34%, respectively); of grampositive:
Staphylococcus aureus (50%),
Candida albicans and spp were identified in high percentage (31%).
Conclusion: The rate of nosocomial pneumonia observed in this
study is similar to that of other institutions of third level of attention
in Latin American countries. Risk factors were: male gender and comorbidities;
mortality corresponded to the group of studied hospital
population. The prevalent microbiology corresponded to gramnegative
bacteria with a predominance of non-fermenting, and among
grampositives
Staphylococcus aureus reported the highest incidence,
which involved the importance of implementing prevention measures
in this hospital.
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