Article

Incidencia de bacteriemia y neumonía nosocomial en una unidad de pediatría

Salud publica de Mexico (Impact Factor: 0.94). 12/2001; 43(6). DOI: 10.1590/S0036-36342001000600001
Source: DOAJ

ABSTRACT

Objetivo. Determinar la incidencia de bacteriemia relacionada con catéter y neumonía asociada a ventilador en niños hospitalizados. Material y métodos. Estudio prospectivo. En el servicio de Pediatría del Hospital General Regional (HGR) No 1 del Instituto Mexicano del Seguro Social (IMSS), de Durango, México, durante 18 meses, de enero de 1999 a junio del 2000, se implementó un sistema de vigilancia epidemiológica activa para identificar episodios de neumonía y bacteriemia nosocomial de acuerdo a las definiciones operacionales de la Norma Oficial Mexicana (NOM). A los pacientes hospitalizados que por su patología requirieron de ventilación mecánica o de catéter intravenoso central se les hizo seguimiento desde el primer día de exposición hasta la detección del episodio de infección o su retiro. Se efectuaron hemocultivos y cultivos de aspirado traqueal. Se calcularon tasas de incidencia para la neumonía asociada a ventilador y de bacteriemia/sepsis por 1 000 días de exposición con sus respectivos intervalos de confianza al 95%. También se presenta la tasa mensual de la infección por días de exposición por medio de gráficas de control estadístico. Resultados. Se identificaron 47 episodios de bacteriemia/sepsis relacionada con catéter y 44 de neumonía asociada a ventilador. La tasa de incidencia de neumonía fue de 28 eventos por 1 000 días de exposición a ventilador y la de bacteriemia/sepsis fue de 26 eventos por 1 000 días de exposición a catéter intravenoso central. Los microrganismos gram positivos (61.11%) predominaron sobre los gram negativos (38.88%). Conclusiones. Este estudio documentó tasas de neumonía y bacteriemia en niños, sustancialmente más elevadas que en otros informes, lo que hace necesario establecer lineamientos para la prevención de infecciones en niños con catéteres intravasculares y sobre los cuidados que requieren los niños sometidos a ventilación mecánica. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html

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    • "However, SE is primarily associated with infections in patients implanted with medical devices, such as prosthetic heart valves and orthopedic prostheses, mainly in immunocompromised children. Furthermore, SE was isolated with higher incidence to catheter-related bacteremia in a report from secondary care Hospital in Durango, México [3] [4]. �io�lm is mainly made of polysaccharide component; it seems to be the most important factor by which SE adheres to and coloni�es arti�cial materials (catheters) commonly implanted in patients with NI. �io�lm is believed to make clinical SE strains more resistant to administered antibiotics and to host defense mechanisms and highly contributed to cause NI in patients [2, 5–9]. "
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    ABSTRACT: Staphylococcus epidermidis strains isolated from nosocomial infections represent a serious problem worldwide. In various Mexican states several reports have shown isolates from hospitals with antibiotic resistance to methicillin. In Mexico City, there is scarce information on staphylococcal infections in hospitals. Here, our research findings are shown in a four-year period study (2006–2010) for Staphylococcus epidermidis strains. Susceptibility and/or resistance to antibiotics in SE strains were assessed by phenotypic and molecular methods as mecA gene by PCR, as well as the correlation with biofilm production for these isolates and the relationship to the infection site. Out of a total of 161 (66%) negative biofilm SE strains, just 103 (64%) SE strains were confirmed as MRSE by PCR to mecA gene. From 84 (34%) positive biofilm SE strains, 76 (91%) were confirmed as MRSE by PCR to mecA gene. Higher percentages of resistance to antibiotics and higher number of resistance markers were found in biofilm-forming clinical strains (9 to 14) than non-biofilm-forming SE strains (3 to 8). These research findings represent a guide to establish infection control programs for this hospital.
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    ABSTRACT: To revisited some aspects about diagnosis and management of nosocomial pneumonia in pediatrics.
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    ABSTRACT: Introduction Nosocomial infection is a frequent complication in neonatal intensive care units (NICUs) attending patients who require lengthy hospitalization and frequent invasive techniques. Patients and methods This study is part of a prospective surveillance program for nosocomial infection in Spain. All patients admitted to NICUs between June 1999 and March 2005 were observed. CDC criteria were used as the standard definition for nosocomial infection. Results A total of 1236 neonates (58% male) were admitted during the surveillance period, involving 19,420 days in the NICU. The average birth weight was 1947.6 ± 1009.5 g and average gestational age was 32.9 ± 5.4 weeks. The most frequent associated pathology was respiratory distress (23.06%). A total of 316 nosocomial infections were diagnosed in 226 neonates, 76.7% affecting premature neonates (< 1500 g). The most frequent location was bacteremia (56.3%), and there was a predominance of coagulase-negative staphylococci (46.05%). Gram-negative microorganisms were isolated in 32.1% of the cases (Escherichia coli and Pseudomonas aeruginosa were the most frequent pathogens). Overall incidence of nosocomial infection was 25.6%. Overall mortality was 6.6%, with higher mortality in the group with nosocomial infections (8.7%). Conclusions Nosocomial infection rates are acceptable, with a typical epidemiological pattern for these units. Presence of a central catheter increased the risk. A program to promote proper hand washing should be considered. We do not recommend a continuing surveillance strategy in these units.
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