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Autor: Naveda, Omar omarnavedamd@yahoo.com
Oprima aquí para enviar un correo electrónico a esta dirección; Naveda, Andrea ; Naveda, Andrea
Título: INFECCIÓN DEL TORRENTE SANGUÍNEO NOSOCOMIAL PRIMARIA EN NIÑOS CRÍTICAMENTE ENFERMOS
NOSOCOMIAL PRIMARY BLOODSTREAM INFECTION IN CRITICALLY ILL CHILDREN
ISSN: 0798-0361
Fecha: 2016
Páginas/Colación: pp. 79-86
En:/ BOLETÍN MÉDICO DE POSTGRADO Vol. 32 Nro. 2 Mayo - Junio 2016
Información de existenciaInformación de existencia
Categoría Temática: Palabras: MED01 MED01
Palabras Claves del Autor: Palabras: INFECCIÓN TORRENTE SANGUINEO INFECCIÓN TORRENTE SANGUINEO, Palabras: NIÑOS CRITICOS NIÑOS CRITICOS, Palabras: NOSOCOMIAL NOSOCOMIAL
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RESUMEN
PALABRAS CLAVE: Infección torrente sanguíneo. Nosocomial. Niños críticos.

RESUMEN

INTRODUCCIÓN: Las infecciones del torrente sanguíneo (ITS) son una de las infecciones intrahospitalarias más graves que pueden adquirir los pacientes durante su hospitalización. MÉTODO: Para identificar factores de riesgo para infección del torrente sanguíneo nosocomial primaria, se diseñó un estudio observacional, analítico, prospectivo donde se incluyeron 706 niños críticamente enfermos; divididos en dos grupos, según el desarrollo de la infección. RESULTADOS: Hubo 54 episodios de ITS primaria en 47 pacientes (6.7%). El estafilococo coagulasa negativo fue el agente causal de la mayoría de las ITS (46%). La tasa de ITS fue de 15 ITS/1000 día-catéter venoso central. Nutrición parenteral total, síndrome genético, quemados, catéter venoso central (CVC), transfusión de glóbulos rojos y traslados fuera del hospital presentaron asociación significativa con ITS nosocomial. Mediante regresión logística binaria se identificó como factores predictores independientes para ITS nosocomial primaria: síndrome genético (OR: 3.3 IC 95% 2.1 - 9.7, p = 0.045), CVC (OR: 3.1 IC 95% 1.5 - 9.9, p = 0.005) y más de tres transfusiones de glóbulos rojos (OR: 2.3 IC 95% 0.9 - 8.5, p = 0.001). CONCLUSION: Optimizar el proceso de inserción y cuidados del CVC; así como, restringir la transfusión de paquetes de glóbulos rojos puede disminuir la tasa de ITS nosocomial primaria. El síndrome genético puede ser un marcador de trastornos inmunes que alteran las defensas del huésped contra microorganismos.

NOSOCOMIAL PRIMARY BLOODSTREAM INFECTION IN CRITICALLY ILL CHILDREN

KEY WORDS: Bloodstream infection. Nosocomial. Critically ill children.

ABSTRACT

INTRODUCTION: Bloodstream infections (BSI) are one of the most serious nosocomial infections that patients can acquire during their hospitalization. METHODOLOGY: To identify risk factors for nosocomial primary bloodstream infection, was conducted a study observational, analytical, prospective, where were enrolled 706 critically ill children divided into two groups according to development of bloodstream infection. RESULTS: There were 54 episodes of BSIs primary in 47 patients (6.7%). Coagulase-negative Staphylococcus organisms were the leading cause of BSIs (46%). The rate of BSI was 15 BSI/1000 central venous catheter-days. Total parenteral nutrition, genetic syndrome, burns, central venous catheter (CVC), red blood cells transfusion and transfers out of the hospital were significantly associated with nosocomial BSI. Multiple logistic regression analysis showed that independent predictors of nosocomial primary BSI included: genetic syndrome (OR: 3.3 IC 95% 2.1 - 9.7, p = 0.045), CVC (OR: 3.1 IC 95% 1.5 - 9.9, p = 0.005) and more than three packed red blood cell transfusions (OR: 2.3 IC 95% 0.9 - 8.5, p = 0.001). CONCLUSION: Optimizing the process of CVC insertion and care, as well as restrict packed red cells transfusions may decrease the rate of nosocomial primary BSI. Genetic syndrome may be markers of immune disorders that affect host defenses against microorganisms.

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