[Nosocomial infections in a high specialty hospital. Factors associated to mortality in the infected patient].
BACKGROUND
Nosocomial infections (NIs) are a quality indicator of health care centers. However, a decrement of NIs occurrence can be the cause of an effective prevention program or it could be the result of a poor NI case research. The patient's characteristics and the complexity of his/her ailment are related to a higher risk of mortality.


OBJECTIVE
The study was made to estimate the NIs prevalence, to know the NIs etiology, and to analyze the factors that determine the NI patient's death.


METHODS
All hospitalized patients from January to December 2003 were included in the study. NI was defined as that which has its origin at the hospital. The risk factors of a patient with NI were analyzed in order to explain the death of the infected patient; we also studied the etiology of NIs.


METHODS
Simple frequencies, Mann and Whitney U, chi2, and the exact Fishertestwere used. Taking the risk factors of the patient with NIs and the kind of NI, a multivariate analysis was made to explain the infected patient's death.


RESULTS
During the study time, 4.2 % of 17189 patients acquired one or more nosocomial infection; the prevalence was of 7.02 and the incidence was of 8.4 cases per 1000 days-patient. The main infections found were pneumonia, urinary tract infection, and bloodstream infection. Besides, 359 microorganisms were isolated; Eschrerichia coli (15.88 %), Staphylococcus aureus (15.88 %), and Pseudomonas aeruginosa (11.8 %) were the most common ones. The specialties with higher risk of contracting NIs were Haematology, OR 3.65 (CI 95 % 2.99-4.46); Internal Medicine, OR 2.49 (CI 95 % 2.01-3.1); Neurology, OR 2.49 (CI 95 % 1.96-3.16); and Intensive Care Unit, OR 2.14 (CI 95 % 1.61-2.83).


CONCLUSIONS
Immunosupression, ventilator use, tracheotomy, advanced age, chronic-degenerative disease, pneumonia and bloodstream infection contributed to a fatal outcome in patients with NI.
Angeles-Garay
Ulises
U
Adscritos a la División de Medicina Preventiva y Epidemiología Hospitalaria, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social. ulises.angeles@imss.gob.mx
Velázquez-Chávez
Yesenia
Y
Anaya-Flores
Verónica E
VE
Valencia-Martínez
Juana Concepción
JC
López-Guerrero
María Esther
ME
D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence