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2012, Number 3

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Med Crit 2012; 26 (3)

PECIN-ICU Project: Epidemiological profile and control of nosocomial infections in Intensive Care Unit

Fortuna CJA, Rivera MJR, Cervantes RC, Fierro FLL, Roldán GAM, Navarro GJM, Cedillo THI

Language: Spanish
References: 51
Page: 127-151
PDF size: 221.78 Kb.


ABSTRACT

Introduction: It is recognized that the UCI’s have a higher incidence of IN, a result of collecting a greater number of risk factors, costs reach $ 2,000 day. With effect: NAV, 45%, 23.3% UTI-SV, BP-CV 23.2. 54.9% are caused by Gram-negative, Gram-positive 32.4% and 12.2% fungi. Caused by P. aeruginosa (13.1%), E. coli (11.3%), S. aureus (7.2%), S. epidermidis (7.1%) and Candida albicans (6.0%).
Objective: The purpose of this report is to analyze the epidemiological behavior of NIs in the ICU and to identify risk factors, mortality, antibiotic sensitivity and cost of care.
Patients and methods: We studied 1,771 patients: Inclusion criteria: a) stay › 48 hours, b) VM› 48 hours, c) Time of vascular catheterization, bladder, and so on. d) And surgical wounds drains, f) State of shock g) Prior antimicrobial therapy. Exclusion criteria: a) Evidence in outside UCI, b) Transferred within 48 hours. Elimination criteria: a) Community or nosocomial infection in hospital or another hospital, b) Death within 48 hours c) Transfer to another unit and d) Without making crops or report.
Results: IN was observed in 34.66% patients and 12.1 days watching/stay, cost $ 28,226.63 care/day ($2192.64 U.S. dollars). Identified risk factors: CV 89.84%, 49.90% VM, severity, shock and coagulopathy 45.78%, 88.54%. Past infection; sedation › 5 days 90.74%, stay › 3 days 96.75%. The NAV 40.68%, HQA-CV 8.35 and BP 6.07%. The 68.62-negative are caused by gram-positive and 31.37% by frequency: P. aeruginosa (24.73%), Staphylococcus aureus (20.52%), A. baumannii (14.52%), K. pneumoniae (7.52%), E. cloacae (6.84%), E. coli (4.78%) and S. marcescens 4.0%. Sensitivity: -Positive: carbapemenes (91.86%), teicoplanin/90.70% linezolid, vancomycin and gentamicin 85%. Gram-negative enterobacteria: Carbapemenes (94%), cefotaxime (80.80), Cefepima (80.98%). Gram-negative enterobacteria not: carbapemenes 93%, monofloxacino 90%, cefotaxime, ceftriaxone, quinolones and Cefepima 85%.
Discussion and conclusions: The incidence of NI is similar to other studies. In Mexico, there are no studies that reflect the epidemiological profile in the UCI’s so PECINA Project is intended to apply nationally.


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