Prevalencia de multirresistencia y factores asociados en pacientes con infección bacteriana, Hospital Vicente Corral Moscoso, Cuenca 2017

Abstract

Introduction: Bacterial infections that are caused by multi-resistant germs increase morbidity and mortality, health costs and make treatment difficult. Due to this, it is necessary to know the clinical factors associated with multiresistant infections, for an adequate management of and control that improve the attention of health. Objective: To determine the prevalence and factors associated with multiresistant bacterial infections in the Hospital “Vicente Corral Moscoso” Materials and methods: A cross-sectional study was carried out, using the medical records and interviews with hospitalized patients. Data analysis was performed with SPSS 21.0 software, descriptive and association measures were calculated. The Universe are the patients who enter the clinic and intensive care unit of the hospital, with diagnosis of infection in July to December 2017, the sample was selected in a simple randomized manner, corresponds to 204 patients. Comparisons of the variables studied were made and the PRs were calculated with their respective 95% confidence interval (CI) and a significant p value <0.05. Results: The prevalence of multiresistance was 62.7%. Factors associated with multiresistance with a significant difference were found: the clinical history of neurological disease (RP: 1.31, 95% CI: 1.07-1, 61, p = 0.02), infections associated with health care (PR: 2.28, 95% CI: 1.76-2.95, p-value = 0.0000), hospital stay in the ICU (RP: 0.67, 95% CI: 0.55-0.82, p = 0.01), history of previous hospitalization in the last 30 days (PR: 1.45, 95% CI: 1.09-1.66; = 0.02), the previous use of antibiotics (RP: 3.34, 95% CI: 2.27-4.91, p = 0.0000), hospital stay greater than 10 days (PR: 1.66, 95% CI: 1 , 35-2.04, p = 0.0000), surgical interventions during hospitalization (RP: 1.44, 95% CI: 1.18-1.75, p = 0.0007), and the use of medical invasive devices (RP: 1.97, 95% CI: 1.49-2.6, p = 0.000) like nasogastric tube (RP: 1.4, IC1,15-1.7, p = 0.0028), urinary catheter (RP: 1.74, 95% CI: 1.35-2.23, p = 0.0000), central venous catheter (CVC) (RP: 1.58, 95% CI: 1.31-1.9, p = 0.000), and endotracheal tube ( RP: 1.51, 95% CI: 1.26-1.81; p = 0.001). The risk factors that did not show significant difference were: lung disease (PR: 1.26 IC 95% 0.99-1.61, p = 0.1), renal failure (PR 0.92, 95% CI 0, 73-1.16 and p = 0.5), diabetes (RP: 0.99, 95% CI: 0.74-1.26, p = 0.96), immunodeficiency (RP: 0.98, 95% CI: 0.74-1.3, p = 0.93), hypoalbuminemia (RP: 1.12, 95% CI: 0.88-1.43, p = 0.324), parenteral nutrition (RP: 1.34, 95% CI: 0 , 92-1.94, p = 0.28), APACHE score (p = 0.07), smoking (PR: 1.11, 95% CI: 0.76-1.62, p = 0.61) and alcoholism (PR: 0.84, 95% CI: 0.57-1.22, p = 0.31).