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2003, Number 1

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Rev Inst Nal Enf Resp Mex 2003; 16 (1)

Clinical and microbiological diagnosis quality of lower respiratory sepsis.

Hernández ML, Reyes CA, Diez MCE, Chamero MS, Viera YJ, Bouza JY

Language: Spanish
References: 48
Page: 17-24
PDF size: 64.78 Kb.


ABSTRACT

Objective: To study the efficiency of clinical and microbiological diagnosis of parenchymatous respiratory infections based on death with necropsy. Patients: A sample of discharged patients who died between May 2000 and April 2001 was studied. The number of deaths rose to 244, of which 101 died with clinical diagnosis of sepsis and transthoracical lung puncture and a pharingeal exudate were performed. Method: Based on a correlational, decriptive, and prospective design. We used random sampling by conglomerate to select the subjects of study. The statistics package EPI INFO 6.04 CDC/OMS 2000. EPIDAT 2.0 Xunta de Galicia 1998 was used with significance level a= 0.05. Measurements: We obtained the rough concordance, Kappa's concordance index, sensitivity, specificity, predictive values and reasons for similarity. Results and conclusions: Clinical–pathologic concordance was moderate, with Kappa 0.50. Positive and negative predictive values were 61.3% and 87.4%, respectively. We obtained similar values for sensibility and specificity, above 76%. Transthoracical lung puncture and pharingeal exudate showed poor specificity (28.9% - 5.4%) and negative predictive values (42.3% - 40%); proportionally, the coincidence among these tests and necropsy was scarce. Most frequently Isolated microorganisms were Gram – negative enterobacteriaceae. Pseudomona aeruginosa and negative coagulase Staphylococcus coagulase showed the highest resistance percentage basically to tetracycline and kanamycin.


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