Infections associated with Health Care in a Hospital specialized in the nephro-urological patient
Abstract
Introduction: Infections associated with healthcare are a negative event for the patient when determining morbidity and mortality and hospital expenses, behaving as an indicator of the quality of care.
Objective: To describe the healthcare-associated infections that occurred during 2013 and 2014 in a hospital specialized in nephrological patient care.
Material and Methods: The data were collected through active research, review of medical records and records of infections associated with health care in each hospital service. In the statistical analysis we used frequency distributions, and as summary measures, rates and percentages.
Results: The frequency of infection associated with health care was 8 and 7.5% in each year of study, with a prevalence of infections related to vascular access in hemodialysis patients, and urinary tract infection in instrumented patients and endo-urological surgery. The most reported microorganisms were Staphylococcus aureus, Staphylococcus aureus methicillin resistant and Escherichia coli. The mortality associated with IAAS was 5.1%, in the 2 years of study.
Conclusions: Infections associated with health care are expected due to the complexity of the processes carried out in the center, in which infections associated with vascular access and reporting of Gram positive microorganisms are highlighted.
Keywords: Infections, health care, vascular access, nephrological patient, microorganisms, Gram positive, Gram negative.
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References
1-CDC/NHSN Surveillance Definition of Healthcare-Associated Infection and Criteria for Specific Types of Infections in the Acute Care Setting April 2013 CDC/NHSN Protocol Corrections, Clarification, and Additions April 2013
2. Nodarse Hernández R. Visión actualizada de las infecciones intrahospitalarias. Rev Cub Med Mil. 2002;31(3):201-108.
3. Valdés García LE, Leyva Miranda T. Prevalencia de infecciones asociadas a la asistencia sanitaria en hospitales provinciales de Santiago de Cuba. MEDISAN vol.17 no.12. 2013; 1029-3019
4. Rojo Pérez N, Laria Menchaca S, Castell-Florit Serrate P, Pérez Piñero J, Barroso Romero Z, Bayarre Vea H. Investigaciones en Sistemas y Servicios de Salud en Cuba y su proyección hasta el 2015. Rev Cubana Salud Pública [revista en la Internet]. Sep 2010; 36(3).
5. National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004;32(8):470-85.
6. Álvarez-Lerma F. Vigilancia de la infección nosocomial en pacientes críticos. Rev. Elect Med Int. 2007; 16(2):181-92.
7. Morales M, Varela M. Estudio comparativo de la prevalencia de infección intrahospitalaria en un hospital comunal valenciano. Rev Enferm Infecc Microbiol Clin. 2008; 7(3):23-2.
8. Olaechea PM, Insausti J, Blanco A, Luque P. Epidemiología e impacto de las infecciones nosocomiales. Med Intensiva. 2010;34(4):256-67 PubMed
9. Infecciones en Hemodialisis. Kidney International Supplements (2013) KDIGO3,91-111.
10. MINSAP. Programa de Prevención y Control de las Infecciones Asociadas con la Asistencia Sanitaria. Versión 05.2011. Dirección Nacional de Epidemiología. La Habana: MINSAP. 2011.
11. Izquierdo Cubas F, Zambrano A, Bastanzuri M, Malpica J. Prevalencia nacional de infecciones nosocomiales Cuba 1997. (PNIN Cuba 1997). Rev Panam Infectol. 2006;8(1):39-44.
12. Delpiano-Méndez L. Infecciones Asociadas a la Atención de Salud: de Semmelweis a nuestros días, una historia de logros y desafíos. Medwave. 2011;11(11):e5256.
13. Fernandes AT. Infecção hospitalar e suas interfaces na área da saúde. São Paulo: Atheneu, 2000.
14. Santos, S.L.V.; Sousab, T.K.; Costa, D.M.; Lopes, L.K.O.; Pelejad, E.B.; Sousa, D.M.; Palosa, M.A.P.; Pereira, M.S. Infecciones asociadas a la atención de salud en un Hospital de Oncología Brasileño: análisis de cinco años. Enferm. glob. vol.11 no.25 Murcia ene. 2012
15. Sauquillo MR. Enfermar en el hospital “Hay riesgo de que se estén haciendo demasiadas pruebas” Roma 8 DIC 2014 - 22:18 CET35
16. Miquel Pujol, Enric Limón. Epidemiología general de las infecciones nosocomiales. Sistemas y programas de vigilancia Enfermedades Infecciosas y Microbiología Clínica Volume 31, Issue 2, February 2013, 108–113
17. O´Grady N, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guideline for the prevention of intravascular Catheter-related infections. Clin Infect Dis 2011; 52:162-93.
18. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP et al. Clinical pratice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis 2009; 49:1-45.
19. Ferrer C, Almirante B. Infecciones relacionadas con el uso de catéteres vasculares. Enfermedades Infecciosas y Microbiologia Clinica. Vol 32, Issue 2. February 2014; 115-124.
20. Tamura MK, Tan JC, O’Hare AM: Optimizing renal replacement therapy in older adults: a framework for making individualized decisions. Kidney Int 82:261–269, 2012.
21. Vassalotti JA, Jennings WC, Beathard GA, et al: Fistula first breakthrough initiative: targeting catheter last in fistula first. Semin Dial 25:303–310, 2012.
22. Allon M: Current management of vascular access. Clin J Am Soc Nephrol 2:786–800, 2007.
23. Lok CE, Allon M, Moist L, et al: Risk equation determining unsuccessful cannulation events and failure to maturation in arteriovenous fistulas (REDUCE FTM I). J Am Soc Nephrol 17:3204–3212, 2006.
24. Ortega Maidana H. Control de Infecciones y Seguridad de los Pacientes en Hemodiálisis. Puesta al Día.*ECI - Volumen 2 No. 4 - Diciembre 2010: 270-280
25. McClellan WM, McClellan CB. Poverty and Mortality in Hemodialysis Patients. JASN enero 31/2013 24: 165-167
26. Stevenson KB, Adcox MJ, Mallea MC, Narasimham N, Wagnild JP. Standardized Surveillance of hemodiálisis vascular access infection: 18 month experience al an outpatient multifacility hemodialysis center. Infect Control Hosp. Epidemiol. 2000 Mar:21(3) 200-3
27. Cordero Ruíz DM, García Pérez AL, Barreal González RT, Jiménez Armada J, Rojas Hernández N. Comportamiento de la infección nosocomial en las unidades de terapia en un período de 5 años. Rev Cubana Hig Epidemiol. 2002;40(2):79-88.
28. Recomendations for Preventing Transmision of Infections among Chronic Hemodialysis Patients. April 27, 2001, vol.50 No.RR-5. CDC
29. Sabed Abdulrahman I, Almuello SH, Bokhary HA, Lapido GO, Al Rubaish A. A porspective study of Hemodialisis access-related bacterial infections. J Infect Chemother. 2002 Sep;8(3):242-6
30. Guanche-Garcell H, Reyes-Arencibia R, Pardo-Gómez G, Pisonero-Socías J. Profilaxis perioperatoria en cirugía urológica en hospitales cubanos. Revista Cubana de Cirugía. 2011;50(4):413-422.
31. Metodología para análisis de mortalidad asociada a infección hospitalaria. Secretaria Distrital de Salud Pública Bogota, febrero 2010.
32. Velázquez Brizuela IE, Aranda Gama J, Camacho Cortes JL, Gabriel Ortíz G. Epidemiología de infecciones nosocomiales en el Instituto Jalisciense de Cancerología. Rev Cubana Salud Pública. 39(1) 2013
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