Caracterización epidemiológica de las infecciones nosocomiales (in) por factores de riesgo en Pacientes Intrahospitalarios del IESS, Machala, Julio-Diciembre 2019

Abstract

Worldwide nosocomial infections represent a topic of interest because they are indicators in the quality of care of the public and private health network of each country, affecting in turn the socioeconomic level. Nosocomial infections or infections associated with health care are pathologies that are contracted during the hospital stay, in a time not less than 48 hours to be diagnosed, infections that occur after a medical discharge also enter this group, considering their contagion during hospitalization time. They are presented by different causes: use of invasive devices, post-surgical procedures and hospital hygiene by health personnel, the latter being the main route of transmission. In order to characterize nosocomial infections through epidemiological surveillance in order to evaluate the quality of medical care at the Hospital of the Ecuadorian Institute of Social Security of Machala (IESS) in a period from July-December 2019, a type of descriptive, cross-sectional and retrospective study with an analytical approach using data collection form which includes: hospital stay, demographic aspects, clinical characteristics, risk factors, type of infection and etiological agent where the units of analysis were the medical records of the patients who presented nosocomial infections during the study time. 56 cases of patients with a diagnosis of nosocomial infection were included in the research study, obtaining the following results by statistical program, a percentage of incidence of 1.23% of infections of a total of 4554 patients discharged, 58.93% is shown in the male gender, in adulthood (20 to 59 years) corresponding to 50%, 29.8% presented arterial hypertension as a pathological antecedent, 48.2% presented a type of infection of the superficial surgical site of which 61.3 % underwent abdominal surgery, 12.50% had a deep surgical site infection, 10.71% had a urinary tract infection, 7.19% corresponding to pneumonia associated with health care, bacteremia associated with central venous catheter and mechanical ventilation pneumonia, the etiologic agents responsible for the greatest case of infection highlighted Escherichia coli in 43.3% as well as Klebsiella pneumoniae e n 20% and the type of sample made for identification was by rectal swab which is equivalent to 39.3%. The critical analysis of the statistical results obtained in comparison with the ideas extracted from articles of high-impact journals was performed, for a validated discussion. According to the bibliographic analysis it was concluded that nosocomial infections were manifested by various factors both intrinsic those that are dependent on each patient, therefore they can not be modified while extrinsic factors are dependent on the means that the therapeutic treatment is performed, which they can be diminished by thoroughly complying with the protocols for epidemiological surveillance and biosafety manuals implemented by the World Health Organization (WHO) and Pan American Health Organization (PAHO). It is recommended that health personnel be educated and prepared for adherence to such preventive standards.