Incidencia de microorganismos Cepa Blee asociada a factores de riesgo séptico en pacientes con infecciones del tracto urinario en el servicio de UCI en un hospital de segundo nivel "Hospital General IESS Ceibos" en el periodo enero del 2017 a enero del 2019.

Abstract

The increase in resistance of microorganisms producing betalactamasas of extended or extended spectrum (ESBL) to betalactam antibiotics has become a global epidemiological problem in large proportions and a major threat to public health. The actual prevalence is unknown, being underestimated in the reported figures. Combined resistance to multiple antibiotics in human pathogenic bacteria is increasing in recent decades. This retrospective, descriptive and cross-sectional work was carried out at the IESS CEIBOS General Hospital, during the period 2017-2019, through indirect observation in patients who were admitted to the ICU area under the diagnosis of urinary tract infection for the purpose to associate the risk factors with the presence of the Bleelike microorganisms in this type of infection and to assess the scale for predicting morbidity and mortality in the ICU for risk of sepsis using Qsofa at the time of admission. The universe was made up of n = 61 patients who met the described inclusion and exclusion criteria. The data was obtained by reviewing medical records and using statistical programs for tabulation, graphing and data analysis. The incidence of ESBL microorganism in these patients was 14.7%, the most isolated pathogen was the E. coli Blee strain followed by the K. pneumoniae Blee strain. The risk factors that lead to increased septic risk were chronic diseases such as hypertension, DMII, and CKD in that order. Extreme age is one of the most common characteristics in these patients with a mean of 71 + - 10 standard deviation. The Qsofa scale was applied obtaining 1 point in 13, 2 points in 25 and 3 points in 23 of the total number of patients. Of these 23 suffered septic shock and 5 died. A low score does not eliminate the possibility of sepsis, but it has a high predictive value at the time of admission to the emergency room, such as screening and triage, which leads to greater vigilance with this patient in terms of monitoring with more precise diagnostic measures, prophylaxis and management of their pathology throughout their hospital stay and leading to a decrease in the delay of the initiation of appropriate therapy in the septic patient.