Auditoría de infecciones del torrente sanguíneo en una Unidad de Cuidados Intensivos en Botswana

Alexei N/A Ortiz Milan; Megan Cox; Kesa Molebatsi

Auditoría de infecciones del torrente sanguíneo en una Unidad de Cuidados Intensivos en Botswana

Alexei N/A Ortiz Milan, Megan Cox, Kesa Molebatsi

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Resumen

Introducción: Las infecciones nosocomiales son un problema significativo en las Unidades de Cuidado Intensivo (UCI) a escala mundial; sin embargo, existen pocas investigaciones al respecto en el África subsahariana. La UCI más grande del Hospital Público de Botswana tuvo su primera auditoría interna entre 2017-2018 y las infecciones nosocomiales eran uno de los parámetros estudiados.

Objetivos: Determinar los principales microorganismos responsables de infección del torrente sanguíneo (ITS) en los pacientes admitidos en la UCI en los últimos 12 meses, así como los patrones de sensibilidad antimicrobiana y los resultados de los pacientes.

Métodos: Se realizó un estudio retrospectivo de los datos de los pacientes mayores de 14 años de edad admitidos en la UCI entre el 1 de abril del 2017 y 31 de marzo de 2018 para determinar la presencia de ITS, organismos responsables de la infección, sensibilidad a los antibióticos y mortalidad de pacientes.

Resultados: Se incluyeron 182 pacientes, de los cuales 13 presentaron ITS (7,4 %). No hubo ninguna diferencia estadística significativa en el APACHE II, entre los pacientes con ITS y sin este (25,8±4 contra 25±5; p = 0,50). El principal microorganismo causante de ITS fue Klebsiella spp. La ITS se asoció con un riesgo mayor de muerte en la UCI (61,5 % contra 40,1 %, OR 2,38; p = 0,14), así como con una proporción más alta de mortalidad a los 30 días en la UCI (92,3 %) para los pacientes con ITS contra 46,1 % sin ITS (OR 13,43; 95 %; p = 0,01).

Conclusiones: La ITS impacta negativamente en la estadía en la ICU, y en la proporción de mortalidad a los 30 días en la UCI. La infección de VIH se asoció con un riesgo más alto de bacteriemia. Hay un patrón de resistencia más alto al uso de betalactámicos, incluidas las cefalosporinas de tercera generación.

Palabras clave

infección del torrente sanguíneo; proporción de mortalidad; resistencia antimicrobiana

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