Asociación entre mortalidad y agentes etiológicos más frecuentes aislados en pacientes que desarrollan Neumonía Asociada a Ventilación Mecánica en la Unidad de Cuidados Intensivos del HGR No.1 Lic. Ignacio García Téllez, Mérida Yucatán

Abstract

Overall objective: To det the association between mortality and the most common etiologic agents, isolated in patients who develop pneumonia associated with mechanical ventilation in the intensive care unit HGR No. 1 "Lic Ignacio Garcia Tellez”. Material and methods: A descriptive study, to evaluate the association between etiologic agents and mortality of patients, who develop pneumonia associated with mechanical ventilation in the ICU service of the General Regional Hospital No. 1, Mexican Institute of Social Security, Mérida Yucatán, from January 1 to June 30, 2010. After 48 hrs of endotracheal intubation, placement of mechanical ventilatory support and without prior antimicrobial therapy patients, underwent bronchial secretion culture using sterile technique with suction catheter through the COT by the investigator and thus able to identify the causal agent of pneumonia, representing the results in charts and tables. Results: 107 patients in the ICU during the study period, 40 of whom developed VAP, 38 (same sex ratio) met the inclusion criteria and were eliminated 2 patients in the study. The medium age was 49.83 + / - 1.7 years (49.3 to 50.4). The times to onset of VAP, was considered in 7 days and was classified as early onset and appearance more than 7 days late onset (up to 13 days). Predominated by frequency of isolation in cultured bronchial secretions following organisms: Burkholderia cepacia in 4 patients (10.5%), Pseudomonas aeruginosa in 4 patients (10.5%), Staphylococcus aureus in 2 patients (5.2%), Staphylococcus epidermidis in 2 patients (5.2%). Candida albicans was an association of mortality from Staphylococcus haemolyticus, Staphylococcus aureus, Enterococcus fecalis, Pseudomonas aeruginosa with mortality of 79.99%. The distribution of patients who died was formed in 15.78% (6) for males. The average age of patients who died was 63 years for females and 46.1 years for males. Comorbidities are also associated with the development of VAP in 21 cases (78.90%), and the remaining 17 cases (44.70%) had no preexisting conditions. 14 Conclusion: this study found that the NAV can develop in times longer than those reported in the literature from 7 to 13 days. The existence of other organisms different from the literature such as Burkholderia cepacia, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis and Candida albicans, being the latter which has shown that when combined with the isolated bacteria mortality is 80% no differences between age and gender. In most study patients was found comorbidities which may be a risk factor for poor outcome.