Sobreinfección bacteriana y fúngica en pacientes admitidos con neumonía por Sars-Cov-2 en una unidad de cuidados intensivos de Barranquilla Colombia durante el año 2020
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Fecha
2022
Autores
Solano Sopo, Gustavo Andrés
González Molina, Fredy Enrique
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
La sobreinfección bacteriana y fúngica en adultos con COVID-19 en cuidado critico es poco conocida. La evidencia reporta que son un factor de riesgo importante para resultados adversos de la COVID-19, que impacta en mortalidad y la eficiencia de atención en salud.
Objetivos: Determinar la existencia de sobreinfección bacteriana y fúngica en pacientes admitidos con neumonía por SARS-CoV-2 hospitalizados en una unidad de cuidados intensivos de Barranquilla, Colombia.
Materiales y métodos: Se utilizó un estudio descriptivo, retrospectivo, cuantitativo de corte transversal. La población estuvo constituida con pacientes admitidos por neumonía con SARS-CoV-2 en una unidad de cuidados intensivos de Barranquilla, Colombia, desde el 14 de abril del 2020 al 31 de diciembre del 2020. Se revisaron los registros clínicos y microbiológicos. Las muestras de cultivos fueron tomadas previo al inicio de terapia antibiótica o durante las primeras 48 horas después de su inicio o antes de cumplir 48 horas de estancia en cuidados intensivos.
Resultados: Se recolectaron 167 pacientes, de los cuales el 36.5% (n=61) presentaban aislamientos positivos en alguno de los cultivos analizados. En el análisis univariado el requerimiento de ventilación mecánica, estancia hospitalaria prolongada y el uso de claritromicina presentaron diferencias estadísticamente significativas.
Conclusiones: La frecuencia de sobreinfección bacteriana y fúngica fue baja, sin embargo, en el uso de terapia antimicrobiana empírica fue alta. La vigilancia del consumo y uso de antimicrobianos puede ser de ayuda para identificar el uso inapropiado y el perfil de susceptibilidad local
Bacterial and fungal superinfection in adults with COVID-19 in critical care is poorly understood. The evidence reports that they are an important risk factor for adverse outcomes of COVID-19, which impacts mortality and the efficiency of health care. Objectives: To determine the existence of bacterial and fungal superinfection in patients admitted with SARS-CoV-2 pneumonia hospitalized in an intensive care unit in Barranquilla, Colombia. Materials and Methods: A descriptive, retrospective, quantitative cross-sectional study was used. The population consisted of patients admitted for confirmed SARS-CoV-2 pneumonia in an intensive care unit in Barranquilla, Colombia, from April 14, 2020 to December 31, 2020. Clinical and microbiological records were reviewed. Culture samples were taken prior to the start of antibiotic therapy, during the first 48 hours after its initiation or before completing 48 hours of stay in intensive care Results: 167 patients were collected, of which 36.5% (n=61) had positive isolates in any of the cultures analyzed. In the univariate analysis, the requirement for mechanical ventilation, prolonged hospital stay and the use of clarithromycin presented statistically significant differences. Conclusions: The frequency of bacterial and fungal superinfection was low, however, in the use of empiric antimicrobial therapy it was high. Surveillance of antimicrobial consumption and use can be helpful in identifying inappropriate use and the local susceptibility profile
Bacterial and fungal superinfection in adults with COVID-19 in critical care is poorly understood. The evidence reports that they are an important risk factor for adverse outcomes of COVID-19, which impacts mortality and the efficiency of health care. Objectives: To determine the existence of bacterial and fungal superinfection in patients admitted with SARS-CoV-2 pneumonia hospitalized in an intensive care unit in Barranquilla, Colombia. Materials and Methods: A descriptive, retrospective, quantitative cross-sectional study was used. The population consisted of patients admitted for confirmed SARS-CoV-2 pneumonia in an intensive care unit in Barranquilla, Colombia, from April 14, 2020 to December 31, 2020. Clinical and microbiological records were reviewed. Culture samples were taken prior to the start of antibiotic therapy, during the first 48 hours after its initiation or before completing 48 hours of stay in intensive care Results: 167 patients were collected, of which 36.5% (n=61) had positive isolates in any of the cultures analyzed. In the univariate analysis, the requirement for mechanical ventilation, prolonged hospital stay and the use of clarithromycin presented statistically significant differences. Conclusions: The frequency of bacterial and fungal superinfection was low, however, in the use of empiric antimicrobial therapy it was high. Surveillance of antimicrobial consumption and use can be helpful in identifying inappropriate use and the local susceptibility profile
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Palabras clave
Cuidados intensivos, COVID-19, Sobreinfección, Neumonía grave, Antibióticos, Intensive care, Superinfection, Severe pneumonia, Antibiotics
