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2017, Number 1

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Invest Medicoquir 2017; 9 (1)

Incidence of healthcare-associated infections in intensive care units in Cuba: year 2015 and trends report for the first five years

Abdo-Cuza A, Castellanos-Gutiérrez R

Language: Spanish
References: 34
Page: 67-95
PDF size: 590.69 Kb.


ABSTRACT

Healthcare-associated infections (HAI) are a major cause of morbidity and mortality in intensive care units (ICU). Objective: To characterize the incidence of HAI in ICU during the year 2015 and analyze the trends of the first five years of research. Methods: A multicenter, prospective, descriptive and cross-sectional study, which included patients from nine ICUs for Cuban adults (n = 1045) was conducted for three months. General variables were collected which were related to extrinsic and intrinsic risk factors, HAI diagnoses, and causative organisms. Incidence rates and densities were used as indicators of frequency. Results: The main risk factors were the use of antibiotics and devices (endotracheal tube and central venous catheter). At least one infection during admission was diagnosed in 15 % of the sample. The most frequent localizations were the respiratory ones, with prevalence of ventilator-associated pneumonia (VAP) 47,8 %, and primary bloodstream infections (22,3 %). The incidence density of VAP was 27, 86 days of risk factor. The most common organisms isolated were the group of Staphylococcus spp, Enterobacter spp., and Acinetobacter spp. The average length of stay for patients with HAI was 13,03 days vs 4,98 days in patients without them (p ‹ 0,001). The mortality of patients with HAI was 50,95 % vs.17,46 % in patients without them (p ‹ 0,001). Conclusion: There is a decrease in overall HAI rates and incidence densities of primary bacteremia. The incidence density of VAP has a variable behavior. A new consensus on diagnosis and prevention can be useful.


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