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Etiología de neumonías bacterianas en pacientes con COVID-19 / Etiology of bacterial pneumonias in patients with COVID-19
Resumen
Resumen
Introducción: la neumonía bacteriana agregada en pacientes COVID-19 tiene un papel determinante en la mortalidad hospitalaria.
Objetivo: estimar la asociación de neumonía bacteriana agregada con la mortalidad de pacientes COVID-19 en el Hospital Especialidades de “La Raza”.
Material y métodos: estudio transversal analítico con 252 pacientes con COVID-19; se obtuvieron los datos del expediente electrónico y plataforma IZASAlab, se tomó Rx de tórax y cultivo de secreción bronquial o expectoración.
Resultados: de 252 participantes resultó cultivo positivo en 89 pacientes (35.3%), aislamiento de K. pneumoniae (22.5%), A. baumannii (20.2%), P. aeruginosa (13.5%) y S. aureus (11.2%); hubo resistencia antimicrobiana en 37.1% y fallecieron 43.7%. El daño pulmonar mayor al 50% en la Rx de tórax tuvo RMa 2.25 (IC95%: 1.01-5.11) p = 0.04 para mortalidad; cultivo positivo RMa 9.04 (IC95%: 3.06-26.74) p = 0.000; resistencia antimicrobiana RMa 7.57 (IC95%: 1.34-42.79) p = 0.02; S. aureus RMa 1.24 (IC95%: 0.36-4.23) p = 0.73; A. baumannii RMa 3.74 (IC95%: 1.41-9.91) p = 0.008; K. pneumoniae RMa 4.12 (IC95%: 1.55-10.97) p = 0.005, y P. aeruginosa RMa 6.89 (IC95%: 1.62-17.61) p = 0.01. Diabetes Mellitus descontrolada RMa 1.61 (IC95%: 1.1-2.9) p = 0.018.
Conclusiones: el desarrollo neumonía bacteriana agregada en pacientes COVID-19 incrementa dos veces más la probabilidad de muerte y seis veces más si existe resistencia antimicrobiana de A. baumannii, K. pneumoniae o P. aeruginosa.
Abstract
Background: Aggregate bacterial pneumonia plays a fundamental role in mortality of patients hospitalized with COVID-19.
Objective: To estimate the association of aggregated bacterial pneumonia with mortality in patients at Hospital Especialidades “La Raza”.
Material and methods: Analytical cross-sectional study, 252 COVID-19 patients, chest x-ray and culture of bronchial secretion or expectoration. Data taken from the SIOC electronic file and the IZASAlab platform.
Results: 252 participants, positive culture, 89 patients, 35.3%, isolation of K. pneumoniae (22.5%), A. baumannii (20.2%), P. aeruginosa (13.5%) and S. aureus (11.2%), antimicrobial resistance 37.1%. 43.7% died, lung damage greater than 50% RMa 2.25 (95% CI 1.01-5.11) p = 0.04 against minor lung damage; microorganism in culture RMa 9.04 (95% CI 3.06-26.74) p = 0.000; antimicrobial resistance RMa 7.57 (95% CI 1.34-42.79) p = 0.02; S. aureus RMa 1.24 (95% CI 0.36-4.23) p = 0.73; A. baumannii RMa 3.74 (95% CI 1.41-9.91) p = 0.008; K. pneumoniae RMa 4.12 (95% CI 1.55-10.97) p = 0.005; and P. aeruginosa RMa 6.89 (95% CI 1.62-17.61) p = 0.01. Uncontrolled Diabetes RMa 1.61 (IC95% 1.1-2.9) p = 0.018.
Conclusions: The development of added bacterial pneumonia increases the probability of death 2 times more, it amounts to 6 times more if there is antimicrobial resistance, it is observed to a greater extent for A. baumannii, K. pneumoniae and P. aeruginosa.
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