prevalencia de infecciones nosocomiales en niños: encuesta de 21 hospitales en méxico nosocomial infections in children: prevalence survey in 21 public hospitals in mexico

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ID: 145396
1999
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Abstract
OBJETIVO. Determinar la prevalencia de infecciones nosocomiales, los factores de riesgo, su microbiología, la prevalencia de uso de antibióticos y la mortalidad asociada en niños hospitalizados. MATERIAL Y MÉTODOS. Se realizó un estudio transversal en 21 hospitales públicos que atienden a niños. Se incluyeron pacientes desde recién nacidos hasta de 17 años de edad. Los riesgos ajustados se estimaron mediante regresión logística múltiple. RESULTADOS. En 1 183 niños estudiados se identificaron 116 pacientes con infección nosocomial, con una prevalencia de 9.8% (IC95% 8.1-11.6). Los sitios de infección más frecuentes fueron: neumonía (25%), sepsis/bacteriemia (19%) e infección del tracto urinario (5%). El principal microrganismo identificado en hemocultivo fue Klebsiella pneumoniae (31%). La prevalencia de uso de antibióticos fue de 49% con una variación de entre 3 y 83%. Mediante regresión logística múltiple se encontraron cuatro factores independientemente asociados con el desarrollo de infección nosocomial: exposición a catéteres intravenosos (RM 3.3, IC95% 1.9-5.9), alimentación parenteral (RM 2.1, IC95% 1.0-4.5), ventilación mecánica (RM 2.3, IC95% 1.2-4.1) y ser recién nacido de bajo peso (RM 2.6, IC95% 1.0-6.8). La mortalidad general fue de 4.8%; sin embargo, el riesgo de morir en pacientes con infección nosocomial fue del doble comparado con los no infectados (RM 2.6, IC95% 1.3-5.1). CONCLUSIONES. Esta evaluación rápida, usando una metodología estándar, ha permitido caracterizar la epidemiología de las infecciones nosocomiales en niños. Los resultados dieron lugar a programas preventivos dirigidos específicamente al cuidado de catéteres intravasculares y al uso de ventilación asistida, a fin de reducir la ocurrencia de sepsis/bacteriemia y neumonías, infecciones nosocomiales de alta prevalencia y mortalidad.
OBJECTIVES. The purpose of this study was to determine the prevalence of nosocomial infections, associated risk factors, microbiology, use of antibiotics, and associated mortality among hospitalized children. MATERIAL AND METHODS.A 1-day prevalence survey was conducted among 1 183 children hospitalized in a nationwide network of 21 public hospitals caring for children. To attain consistency between hospitals, CDC nosocomial infection definitions were used. Adjusted relative odds of bacteremia were estimated using logistic regression analysis. RESULTS. The prevalence of nosocomial acquired infection was 9.8% (CI 95%, 8.1-11.6). The more prevalent infections were pneumonia (25%), sepsis/bacteremia (19%),and urinary tract infection (5%). The main microorganism isolated in blood cultures drown from patients with nosocomial infection was K. penumoniae (31%). The prevalence of antibiotics use was 49% with substantial variation between hospitals (range 3-83%). Using logistic regression analysis, four factors were independently associated with the risk of nosocomial infection: central venous catheters (OR 3.3; CI 95% 1.0-5.9), total parenteral nutrition (OR 2.1; CI 95%1.0-4.5) mechanical ventilation (OR 2.3; CI 95% 1.2-4.1), and low birth weight (OR 2.6; CI 95% 1.0-6.8). The overall mortality was 4.8%; however, patients with nosocomial infection had two times greater risk to die as compared to non-infected children (OR 2.6; CI 95% 1.3-5.1). CONCLUSIONS. This rapid assessment survey using a standard methodology allows to document the prevalence of nosocomial infections in children. The results were used to develop targeted programs on central catheters and mechanical ventilation aimed to reduce bacteremia/sepsis and pneumonia, two nosocomial infections characterized by high prevalence and mortality.
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avila-figueroa1999saludprevalencia Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Carlos Avila-Figueroa;Miguel Cashat-Cruz;Eduardo Aranda-Patrón;Angel R. León;Nancy Justiniani;Lucía Pérez-Ricárdez;Francisco Avila-Cortés;Manuel Castelán;Roberto Becerril;Enedina Luz Herrera
Journal journal of anatomy
Year 1999
DOI
DOI not found
URL
http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0036-36341999000700005
Keywords
hospitals nosocomial infection mexico pediatric mexicopublic aspects of medicine

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