Asunto(s)
COVID-19 , SARS-CoV-2 , COVID-19/diagnóstico , Prueba de COVID-19 , Humanos , Nasofaringe , ARN Viral , Manejo de EspecímenesRESUMEN
La bacteriemia relacionada con catéteres (BRC) vasculares aumenta la morbimortalidad de los pacientes ingresados en la unidad de cuidados intensivos (UCI). La estrategia óptima para la prevención de la BRC no está bien definida. La comparación de las tasas de BRC con las facilitadas por programas como el National Nosocomial Infection Surveillance System de los EE. UU. o el Estudio Nacional de Vigilancia de Infección Nosocomial (ENVIN) permiten determinar la necesidad de aplicar medidas de control. En el año 2000 se detectaron tasas de BRC en las UCI del Hospital Universitario de Bellvitge muy por encima de las publicadas por el ENVIN. Objetivo Evaluar el impacto que tiene sobre las tasas de BRC la aplicación de un protocolo para el uso adecuado de catéteres intravasculares en una UCI. Metodología Estudio prospectivo de pacientes ingresados en las UCI de un hospital terciario en el período de mayo a junio durante los años 2000 a 2004. En el año 2001 se aplicó un programa de prevención de la BRC que incluía aspectos relacionados con la inserción y el mantenimiento del catéter en los pacientes de la UCI. Se calcularon las tasas de infección por 1.000 días de catéter en los diferentes períodos bimensuales y se compararon los resultados del año 2000 con los del año 2004 mediante el análisis de la odds ratio (OR) y de su intervalo de confianza (IC) (..) (AU)
Introduction Catheter-related bloodstream infection (CR-BSI) is a cause of morbidity and mortality in intensive care units, and the optimal approach for preventing these infections is not well defined. Comparison of CR-BSI rates with those provided by programs such as the National Nosocomial Infection Surveillance System (NNISS) from the USA and the Spanish National Nosocomial Infection Surveillance Study (ENVIN), enable determination of the need to implement control measures. In 2000, we found that the CR-BSI rates in UCIs of our hospital were much higher than the data reported by ENVIN. Objective To assess the impact of implementing a protocol for proper use of intravascular catheters on CR-BSI rates in the intensive care unit (ICU) of a tertiary hospital. Methods Prospective study of patients admitted to the ICUs of a tertiary hospital in the months of May and June, from 2000 to 2004. In 2001, a CR-BSI prevention program including aspects related to catheter insertion and maintenance in ICU patients was implemented. We calculated infection rates per 1000 days of catheter use in all the 2-month periods studied, and compared the 2000 and 2004 results by analysis of the odds ratios and confidence intervals. Results A total of 923 patients were included. Mean age was 58.7 years (SD: 15.4), mean ICU stay was 11.6 days (SD: 11.4), mean SAPSII was 28.2 (SD: 15.9), and mortality was 20.5%. There was a significant reduction in CR-BSI rates from 13.3 episodes per 1000 days of catheter use in the first period to 3.21 in the last period (OR=3.53, 95% CI: 2.365.31).Conclusions Application of a prevention program for CR-BSI and a system for monitoring BSI rates led to a significant, sustained reduction in these infections (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Bacteriemia/prevención & control , Infección Hospitalaria/prevención & control , Unidades de Cuidados Intensivos/estadística & datos numéricos , Hospitales Universitarios/estadística & datos numéricos , Antibacterianos/administración & dosificación , Infección Hospitalaria/epidemiología , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , España/epidemiologíaRESUMEN
INTRODUCTION: Catheter-related bloodstream infection (CR-BSI) is a cause of morbidity and mortality in intensive care units, and the optimal approach for preventing these infections is not well defined. Comparison of CR-BSI rates with those provided by programs such as the National Nosocomial Infection Surveillance System (NNISS) from the USA and the Spanish National Nosocomial Infection Surveillance Study (ENVIN), enable determination of the need to implement control measures. In 2000, we found that the CR-BSI rates in UCIs of our hospital were much higher than the data reported by ENVIN. OBJECTIVE: To assess the impact of implementing a protocol for proper use of intravascular catheters on CR-BSI rates in the intensive care unit (ICU) of a tertiary hospital. METHODS: Prospective study of patients admitted to the ICUs of a tertiary hospital in the months of May and June, from 2000 to 2004. In 2001, a CR-BSI prevention program including aspects related to catheter insertion and maintenance in ICU patients was implemented. We calculated infection rates per 1000 days of catheter use in all the 2-month periods studied, and compared the 2000 and 2004 results by analysis of the odds ratios and confidence intervals. RESULTS: A total of 923 patients were included. Mean age was 58.7 years (SD: 15.4), mean ICU stay was 11.6 days (SD: 11.4), mean SAPSII was 28.2 (SD: 15.9), and mortality was 20.5%. There was a significant reduction in CR-BSI rates from 13.3 episodes per 1000 days of catheter use in the first period to 3.21 in the last period (OR=3.53, 95% CI: 2.36-5.31). CONCLUSIONS: Application of a prevention program for CR-BSI and a system for monitoring BSI rates led to a significant, sustained reduction in these infections.