Mortalidad en pacientes adultos críticamente enfermos con aislamientos de Stenotrophomonas Maltophilia en cultivos de secreción bronquial admitidos en la red hospitalaria pública de Barranquilla (Colombia)
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Fecha
2023
Autores
Bustillo Marrugo, Sandra Patricia
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Introducción: Stenotrofomonas maltophilia es un patógeno reemergente oportunista asociado a infecciones nosocomiales en pacientes críticamente enfermos y aumenta la mortalidad.
Objetivos: Determinar la mortalidad en pacientes adultos críticamente enfermos con aislamientos de S. maltophilia en cultivos de secreción bronquial admitidos a la red hospitalaria publica de Barranquilla (Colombia) desde el 1 de enero del 2020 al 31 de diciembre del 2022.
Materiales y métodos: La información clínica y microbiológica de los pacientes fue recolectada de la red pública distrital de Barranquilla (Colombia). Obtuvimos las variables de interés de la historia clínica de los pacientes y las comparamos entre supervivientes y no supervivientes mediante pruebas estadísticas (exacta de Fisher y U de Mann- Whitney).
Resultados: De los 35 pacientes incluidos, 85,7% fallecieron. La neumonía por la COVID-19 estuvo en 18 (51,4%) pacientes, con una tasa de mortalidad del 60%. La mayoría de los pacientes requirieron vasoactivos (74,3%), ventilación mecánica (97,1%) y terapia de reemplazo renal (28,6%). No encontramos diferencias estadísticamente significativas entre los supervivientes y los fallecidos, salvo los que presentaban COVID-
19. Todos los pacientes recibieron tratamiento empírico con antibióticos de amplio espectro. Se encontraron bajas tasas de resistencia para trimetoprim-sulfametoxazol.
Introduction: Stenotrophomonas maltophilia is an opportunistic re-emerging pathogen associated with nosocomial infections in critically ill patients and increased mortality. Objectives: To determine mortality in critically ill adult patients with S. maltophilia isolates in bronchial secretion cultures admitted to the public hospital network of Barranquilla (Colombia) from January 1, 2020 to December 31, 2022. Materials and Methods: The clinical and microbiological information of the patients was collected the district public network of Barranquilla (Colombia). We obtained the variables of interest from the patients' medical records and compared them between survivors and non-survivors using statistical tests (Fisher's exact and Mann-Whitney U test). Results: Of the 35 patients included, 85.7% died. COVID-19 pneumonia was present in 18 (51.4%) patients, with a 60% mortality rate. Most of the patients required vasoactives (74.3%), mechanical ventilation (97.1%), and renal replacement therapy (28.6%). We did not find statistically significant differences between the survivors and the deceased, except for those with COVID-19. All patients received empirical treatment with broad- spectrum antibiotics. Low rates of resistance were found for trimethoprim- sulfamethoxazole.
Introduction: Stenotrophomonas maltophilia is an opportunistic re-emerging pathogen associated with nosocomial infections in critically ill patients and increased mortality. Objectives: To determine mortality in critically ill adult patients with S. maltophilia isolates in bronchial secretion cultures admitted to the public hospital network of Barranquilla (Colombia) from January 1, 2020 to December 31, 2022. Materials and Methods: The clinical and microbiological information of the patients was collected the district public network of Barranquilla (Colombia). We obtained the variables of interest from the patients' medical records and compared them between survivors and non-survivors using statistical tests (Fisher's exact and Mann-Whitney U test). Results: Of the 35 patients included, 85.7% died. COVID-19 pneumonia was present in 18 (51.4%) patients, with a 60% mortality rate. Most of the patients required vasoactives (74.3%), mechanical ventilation (97.1%), and renal replacement therapy (28.6%). We did not find statistically significant differences between the survivors and the deceased, except for those with COVID-19. All patients received empirical treatment with broad- spectrum antibiotics. Low rates of resistance were found for trimethoprim- sulfamethoxazole.
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Palabras clave
Stenotrofomonas maltophilia, Reemergente, Mortalidad, Neumonía, Ventilación mecánica, Stenotrophomonas maltophilia, Re-emerging, Mortality, Pneumoniae, Ventilation mechanical
