Original
Microbiological profile of infections in the Intensive Care Units of Colombia (EPISEPSIS Colombia)
Perfil microbiológico de las Infecciones en Unidades de Cuidados Intensivos de Colombia (EPISEPSIS Colombia)
F.J. Molinaa,
, C.A. Díazb, L. Barrerac, G. De La Rosad, R. Dennise, C. Dueñasf, M. Granadosg, D. Londoñoh, G. Ortizi, F. Rodríguezj, F. Jaimesk
Corresponding author
a. Unidad de Terapia Intensiva, Clínica Universitaria Bolivariana, Medellín, Antioquia, Colombia
b. Universidad Pontificia Bolivariana, Medellín, Antioquia, Colombia
c. Departamentos de Medicina Interna, Hospital Universitario del Valle, Cali, Valle del Cauca, Colombia
d. Unidad de Cuidados Intensivos, Hospital Pablo Tobón Uribe, Medellín, Antioquia, Colombia
e. Departamentos de Medicina Interna y de Investigaciones, Fundación Cardioinfantil, Bogotá, Colombia
f. Universidad de Cartagena, Unidad de Cuidados Intensivos, Hospital Bocagrande y Clínica Madre Bernarda, Cartagena, Bolívar, Colombia
g. Unidad de Cuidados Intensivos, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
h. Unidad de Neumología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
i. Unidad de Cuidados Intensivos, Hospital Santa Clara, Bogotá, Colombia
j. Universidad de Antioquia, Medellín, Antioquia, Colombia
k. Universidad de Antioquia, Departamento de Medicina Interna, Hospital Universitario San Vicente de Paul, Medellín, Antioquia, Colombia
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"correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Perfil microbiológico de las Infecciones en Unidades de Cuidados Intensivos de Colombia (EPISEPSIS Colombia)" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-07-06" "fechaAceptado" => "2010-11-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec10655" "palabras" => array:5 [ 0 => "Infection" 1 => "Sepsis" 2 => "Microbiology" 3 => "Epidemiology" 4 => "Intensive care unit" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec10654" "palabras" => array:5 [ 0 => "Infección" 1 => "Sepsis" 2 => "Microbiología" 3 => "Epidemiología" 4 => "Unidad de cuidados intensivos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background and objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Valid and reliable data regarding sepsis is lacking in Colombia. Our aim was to determine the prevalence of the microorganisms in the main infections treated in Intensive Care Units (ICUs) in our country.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This is a sub-study of a prospective cohort with 10 general hospitals in Colombia during a 6-month period. The inclusion criteria were hospitalization in ICU and confirmation of infection according to the CDC definitions. Patients were classified into three groups, that is, community, hospital and intensive care, according to the site where the infection was acquired.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 826 patients were included in this analysis. Of these, 51% developed infections in the community, 5.33% in the hospital and 43.7% in intensive care unit. Overall, the most common diagnoses were pneumonia (29.54%), intra-abdominal infection (18.16%) and urinary tract infection (11.62%). The most frequent germ in community-acquired infections was <span class="elsevierStyleItalic">E. coli</span> −lung (16. 4%), peritoneum (57.7%), urine (55.5%), blood (22.4%)−. <span class="elsevierStyleItalic">E. Coli</span>−peritoneum (29.3%), urine (52.9%)− also predominated in the ICU-acquired infections, except for lung and blood in which <span class="elsevierStyleItalic">Staphylococcus aureus</span> (32.4%) and <span class="elsevierStyleItalic">Klebsiella pneumoniae</span> (15.7%) were the most prevalent. Cultures were requested from 655 patients, 40% of them having received antibiotics before cultures were taken, although this did not affected the percentages of positive cultures (P<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">=</span><span class="elsevierStyleHsp" style=""></span>0.583).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Pneumonia was the main cause of infection regardless of the site of acquisition. <span class="elsevierStyleItalic">E. coli</span> was the most prevalent germ, except in the pulmonary infections acquired in UCI in which <span class="elsevierStyleItalic">S. aureus</span> was the most prevalent.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción y objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">En Colombia faltan datos fiables sobre el comportamiento de la sepsis. Se pretende determinar la prevalencia de los microorganismos en las principales infecciones tratadas en las unidades de cuidados intensivos (UCI) de nuestro país.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este es un subestudio de una cohorte prospectiva recolectada en 10 hospitales durante 6 meses. Los criterios de inclusión eran hospitalización en UCI y confirmación de una infección según las definiciones del CDC, considerando tres grupos (comunidad, hospital, UCI) según el sitio de adquisición de la infección.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyó en el análisis a 826 pacientes; el 51% contrajeron procesos infecciosos extrahospitalarios; el 5,33%, en el hospital y el 43,7%, en UCI. Los diagnósticos más frecuentes fueron neumonía (29,54%), infección intraabdominal (18,16%) e infección del tracto urinario (11,62%). El microorganismo más frecuente en las infecciones extrahospitalarias fue <span class="elsevierStyleItalic">Escherichia coli</span> −pulmón (16,4%), peritoneo (57,7%), orina (55,5%) y sangre (22,4%)−. En las adquiridas en UCI predomina también <span class="elsevierStyleItalic">E. coli</span> −peritoneo (29,3%) y orina (52,9%)−, excepto en pulmón y sangre, en los que fueron <span class="elsevierStyleItalic">Staphylococcus aureus</span> (32,4%) y <span class="elsevierStyleItalic">Klebsiella pneumoniae</span> (15,7%) los más prevalentes. Se tomaron cultivos a 655 pacientes, de los que el 40% recibió antibióticos antes de la toma, sin que esto afectara al porcentaje de positividad (p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">=</span><span class="elsevierStyleHsp" style=""></span>0,583).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La neumonía fue la infección más frecuente independientemente del sitio de adquisición. <span class="elsevierStyleItalic">E. coli</span> fue el patógeno más prevalente, excepto en las infecciones pulmonares adquiridas en UCI, donde lo fue <span class="elsevierStyleItalic">S. aureus</span>.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| Year/Month | Html | Total | |
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