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2005, Number 5

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Rev Med Inst Mex Seguro Soc 2005; 43 (5)

Nosocomial Infections in a High Specialty Hospital. Factors Associated to Mortality in the Infected Patient

Ángeles-Garay U, Velázquez-Chávez Y, Anaya-Flores VE, Valencia-Martínez JC, López-Guerrero ME

Language: Spanish
References: 38
Page: 381-391
PDF size: 182.98 Kb.


ABSTRACT

Introduction: Nosocomial infections (NIs) are a quality indicator of health care centers. However, a decrement of NIs occurrence can be the cause of an effective prevention program or it could be the result of a poor NI case research. The patient’s characteristics and the complexity of his/her ailment are related to a higher risk of mortality.
Objective: The study was made to estimate the NIs prevalence, to know the NIs etiology, and to analyze the factors that determine the NI patient’s death.
Material and methods: All hospitalized patients from January to December 2003 were included in the study. NI was defined as that which has its origin at the hospital. The risk factors of a patient with NI were analyzed in order to explain the death of the infected patient; we also studied the etiology of NIs.
Statistical analysis: Simple frequencies, Mann and Whitney U, χ2, and the exact Fisher test were used. Taking the risk factors of the patient with NIs and the kind of NI, a multivariate analysis was made to explain the infected patient’s death.
Results: During the study time, 4.2 % of 17189 patients acquired one or more nosocomial infec-tion; the prevalence was of 7.02 and the incidence was of 8.4 cases per 1000 days-patient. The main infections found were pneumonia, urinary tract infection, and bloodstream infection. Besides, 359 microorganisms were isolated; Eschrerichia coli (15.88 %), Staphylococcus aureus (15.88 %), and Pseudomonas aeruginosa (11.8 %) were the most common ones. The specialties with higher risk of contracting NIs were Haematology, OR 3.65 (CI 95 % 2.99-4.46); Internal Medicine, OR 2.49 (CI 95 % 2.01-3.1); Neurology, OR 2.49 (CI 95 % 1.96-3.16); and Intensive Care Unit, OR 2.14 (CI 95 % 1.61-2.83).
Conclusion: Immunosupression, ventilator use, tracheotomy, advanced age, chronic-degenerative disease, pneumonia and bloodstream infection contributed to a fatal outcome in patients with NI.


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