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Relación entre la muerte y el ingreso a cuidados intensivos de pacientes pediátricos con bacteriemia por Staphylococcus aureus adquirido en la comunidad, 2014-2017

INTRODUCTION: The bacteremia caused by Staphylococcus aureus acquired in the community (SA-AC) is a frequent pathology in pediatrics and it is considered a public health problem generating high rates of morbidity, mortality, and bacterial resistance. OBJECTIVES: To analyze the factors related to dea...

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Detalles Bibliográficos
Autores principales: Pantoja, Freddy Israel, Ricaurte, Willinton Robert, Rosero, Diana Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Biteca 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8055594/
https://www.ncbi.nlm.nih.gov/pubmed/33761197
http://dx.doi.org/10.7705/biomedica.5275
Descripción
Sumario:INTRODUCTION: The bacteremia caused by Staphylococcus aureus acquired in the community (SA-AC) is a frequent pathology in pediatrics and it is considered a public health problem generating high rates of morbidity, mortality, and bacterial resistance. OBJECTIVES: To analyze the factors related to death and admission to intensive care units of patients under 18 years of age with AC-SA bacteremia admitted to the Hospital Infantil Los Ángeles, Pasto, Colombia, from 2014 to 2017. MATERIAL AND METHODS: We conducted a descriptive, transversal, cross-sectional observational study. We analyzed 86 patients with bacteremia due to AC-SA that met the inclusion criteria for the study using a multivariate logistic regression model. RESULTS: Of the 86 cases, 25.6% died and 40.7% entered the intensive care unit. The resistance to methicillin was 52.3%. The main foci of infection were the soft tissues and the osteoarticular and respiratory systems; 32.6% of patients came from the Pacific area of Nariño. The predominant ethnic groups were the mestizo and the indigenous. Indigenous patients had higher mortality compared to the mestizo and Afro-Colombian ethnic groups. The multivariate analysis showed significance in terms of death for endocarditis (adjusted OR=20; CI: 1.5-254; p=0.02) while no statistical significance was registered for the admission to the intensive care unit. CONCLUSIONS: The AC-SA led to high mortality and admission to the intensive care unit; 52.3% of strains were resistant and resistance to methicillin showed higher mortality, although the mortality with sensitive strains was considerable. Endocarditis showed fairly high mortality. The empirical therapy should be adjusted when bacteremia due to AC-SA is suspected.