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Browsing Maestrías by Author "Agreda Orellana, Ivanna Solmayra"

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    Detección de betalactamasas de espectro extendido en enterobacterales de la microbiota intestinal y su asociación con determinantes de salud en pacientes ambulatorios atendidos en laboratorio del Hospital Universitario del Río. Cuenca 2023
    (Universidad de Cuenca, 2025-01-07) León Orellana, Priscila Katherine; Agreda Orellana, Ivanna Solmayra
    Background: bacterial resistance is a global public health issue in both community and hospital settings, influenced by human, environmental, animal, and food chain factors. Objective: to determine the prevalence of extended-spectrum beta-lactamases (ESBL) in Enterobacterales from the intestinal microbiota and their association with health determinants in outpatients attended at the Hospital Universitario del Río laboratory in Cuenca, Ecuador. Methodology: a cross-sectional analytical study was conducted with 223 participants. Fecal samples were analyzed to identify ESBL-producing Enterobacterales (ESBL-PE), detecting the genes blaCTX-M-1, blaTEM and blaSHV through conventional PCR. The data obtained were statistically analyzed to explore associations between dependent and independent variables. Results: the frequency of ESBL-PE was 9.4%, with Escherichia coli being the only isolated bacterium. No statistically significant associations were found between ESBL presence and health determinants such as sex, origin, residence, potable water consumption, travel or antibacterial use history, recent hospitalization, or diagnosed diseases. The blaCTX-M-1 gene was present in 71% of the samples, blaTEM in 57%, and blaSHV in none. A total of 43% of isolates carried both blaCTX-M-1 and blaTEM, while 14% contained none of the studied genes. Conclusion: The study highlights an increase in beta-lactam resistance in E coli among the analyzed outpatient population, although no significant associations with health determinants were observed.
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    Prevalencia de la infecciones asociadas a la atención en salud y su relación con determinantes de la salud en pacientes de las UCIs del hospital José Carrasco Arteaga del IESS, en el año 2019
    (Universidad de Cuenca, 2022-05-25) Agreda Orellana, Ivanna Solmayra; Molina Matute, Marcos Fernando
    Background: Health care-associated infections, HAIs, represent a public health care problem, appearing for the first time 48 hours or more after hospitalization or within 30 days after receiving medical care. Objective: to determine the prevalence of Infections Associated with Health Care and its relationship with determinants of health over patients of the ICUs of the José Carrasco Arteaga Hospital of the IESS, in the year 2019. Methodology: an analytical study was carried out with the medical records of 515 patients treated in 2019 in the ICU of the José Carrasco Arteaga Hospital. The data was collected in a form and analyzed with SPSS version 22. Simple and double-entry tables were used, the RP statisticians represent risk when the value is greater than 1, with a significance level of 95% (p<0.05) to measure the relationship between the presence of I HAIs and the determinants of health. Results: Older adults (47.4%) predominated in the study population, with 53% male, preferably residing in urban areas (70.3%). The most common comorbidities were hypertension, diabetes and cancer. The majority used medical devices in their treatment (74%), with hospital stays of 3 to 6 days (76.3%). The HAIs were caused by both bacteria: Gram negative: Escherichia coli 25%, Klebsiella pneumoniae 12.7% and Gram positive: Staphylococcus spp 27%, the most frequent fungus was Candida glabrata with 2.5%. There was a significant relationship between in-hospital factors and HAIs, not so with out-of-hospital factors. Conclusions: The prevalence of HAIs was 15.3 per 100 patients. In-hospital factors were the most important, especially prolonged stay and the use of medical devices, mainly mechanical ventilation and bladder catheter.