Coinfección bacteriana en los pacientes con SARSCoV-2 intubados en la Unidad de Cuidados Intensivos en una IPS de Barranquilla (Atlántico, Colombia)
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Fecha
2021
Autores
Velásquez Brito, Diana
Villacob Ruiz, Richard
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Uno de la principal complicación de los pacientes infectados con Covid-19 es el
desarrollo del Síndrome Respiratorio Agudo Severo (SARS), ya que en este punto
se requiere apoyo ventilatorio no invasivo y en subsecuentemente invasivo. La
ventilación mecánica invasiva tiene muchas complicaciones asociadas a la misma,
una de ella es la sepsis por el tubo, que mayoritariamente es causada por bacterias.
Objetivo: Determinar la existencia de coinfección Bacteriana en los Pacientes con
SARS-CoV-2 en la Unidad de Cuidados Intensivos con Ventilación Mecánica
Invasiva en un Centro Hospitalario d Alto nivel de Complejidad de Barranquilla
durante el último semestre del 2020.
Metodología: Se realiza un estudio analítico observacional, tipo retrospectivo. Este
se realizó en las UCI de la Red de Centros de Atención Hospitalaria en Barranquilla
(Atl, Co). La población estuvo constituida por pacientes mayores de edad positivos
a Covid-19 mediante RT-PCR con ventilación mecánica invasiva. Solo se incluyeron
pacientes con cultivo después de 10 días de intubación endotraqueal.
Resultados: Se recopilaron datos se 117 pacientes, la proporción de hombres fue
de 64.1% (p: 0.0003). La edad promedio global fue de 57±14 años. La comorbilidad
de mayor prevalencia fue la hipertensión arterial (43.2) y la segunda fue la obesidad
(33.9%). Más del 50% de los pacientes tenían una probabilidad de muerte mayor al
75%. La estancia promedio fue de 8.5±6 días y la mortalidad asociada fue del
88.9%. El 67.5% de los pacientes dieron positivo a infección asociada al ventilador.
Los gérmenes aislados de mayor ocurrencia fueron fueron Klepsiella pneumoniae,
Stenotrophomonas maltophilia y Pseudomona aeuroginosa.
Conclusiones: Al evaluar las comorbilidades y antecedentes con respecto al
resultado de aislado (POSITIVO/NEGATIVO), no se encontró asociación entre la
presencia de infección asociada a la intubación y ventilación mecánica y alguna
comorbilidad
One of the main complication of patients infected with Covid-19 is the development of Severe Acute Respiratory Syndrome (SARS), since at this point non-invasive and subsequently invasive ventilatory support is required. Invasive mechanical ventilation has many complications associated with it, one of which is tube sepsis, which is mainly caused by bacteria. Objective: To determine the existence of Bacterial coinfection in Patients with SARS-CoV-2 in the Intensive Care Unit with Invasive Mechanical Ventilation in a High Complexity Hospital Center in Barranquilla during the last semester of 2020. Methodology: An observational, retrospective analytical study is carried out. This was carried out in the ICUs of the Network of Hospital Care Centers in Barranquilla (Atl, Co). The population consisted of elderly patients positive for Covid-19 using RTPCR with invasive mechanical ventilation. Only patients with culture after 10 days of endotracheal intubation were included. Results: Data were collected from 117 patients, the proportion of men was 64.1% (p: 0.0003). The global mean age was 57 ± 14 years. The most prevalent comorbidity was hypertension (43.2) and the second was obesity (33.9%). More than 50% of the patients had a probability of death greater than 75%. The mean stay was 8.5 ± 6 days and the associated mortality was 88.9%. 67.5% of the patients were positive for ventilator-associated infection. The most common isolated germs were Klepsiella pneumoniae, Stenotrophomonas maltophilia and Pseudomona aeuroginosa. Conclusions: When evaluating the comorbidities and antecedents with respect to the isolate result (POSITIVE / NEGATIVE), no association was found between the presence of infection associated with intubation and mechanical ventilation and any comorbidity.
One of the main complication of patients infected with Covid-19 is the development of Severe Acute Respiratory Syndrome (SARS), since at this point non-invasive and subsequently invasive ventilatory support is required. Invasive mechanical ventilation has many complications associated with it, one of which is tube sepsis, which is mainly caused by bacteria. Objective: To determine the existence of Bacterial coinfection in Patients with SARS-CoV-2 in the Intensive Care Unit with Invasive Mechanical Ventilation in a High Complexity Hospital Center in Barranquilla during the last semester of 2020. Methodology: An observational, retrospective analytical study is carried out. This was carried out in the ICUs of the Network of Hospital Care Centers in Barranquilla (Atl, Co). The population consisted of elderly patients positive for Covid-19 using RTPCR with invasive mechanical ventilation. Only patients with culture after 10 days of endotracheal intubation were included. Results: Data were collected from 117 patients, the proportion of men was 64.1% (p: 0.0003). The global mean age was 57 ± 14 years. The most prevalent comorbidity was hypertension (43.2) and the second was obesity (33.9%). More than 50% of the patients had a probability of death greater than 75%. The mean stay was 8.5 ± 6 days and the associated mortality was 88.9%. 67.5% of the patients were positive for ventilator-associated infection. The most common isolated germs were Klepsiella pneumoniae, Stenotrophomonas maltophilia and Pseudomona aeuroginosa. Conclusions: When evaluating the comorbidities and antecedents with respect to the isolate result (POSITIVE / NEGATIVE), no association was found between the presence of infection associated with intubation and mechanical ventilation and any comorbidity.
Descripción
Palabras clave
Covid-19, VMI, Intubación orotraqueal, Problemas relacionados con el ventilador, Coinfección, Covid-19, VMI, Orotracheal intubation, Fan related problems, Coinfection
