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1. Colombian surgical outcomes study insights on perioperative mortality rate, a main indicator of the lancet commission on global surgery – a prospective cohort study

Author

Pérez Rivera, Carlos J., Lozano-Suárez, Nicolás, Agudelo-Mendoza, Silvia Valentina, Bohórquez-Tarazona, Maria Paz, García-Zambrano, Laura, Lara-Espinosa, Daniela, Polania-Sandoval, Camilo Andres, Rojas-Serrano, Luisa Fernanda, Vargas-Cuéllar, María Paula, Velandia-Sánchez, Alejandro, Cabrera-Rivera, Paulo Andrés, Briceno-Ayala, Leonardo, Cruz-Reyes, Danna, Barrera Carvajal, Juan Guillermo, Cabrera-Vargas, Luis Felipe, Guevara, Oscar, Arce Polania, Laura Cristina, Buendía Barrios, Laura Natalia, Cristina Camargo Areyanes, María Isabel, Casas, Felipe, Alfaro, Valeria Cormane, García-Méndez, Juan P., Guerra, Bayron, Idarraga-Ayala, Sharon V., Abiyomaa, Akram Kadamani, Montoya, Christopher, Mosquera Paz, Manuel Santiago, Pineda, María Alejandra, Pinzón-Luna, Juliana, Bastidas, Isabella Roa, Roman Ortega, Carlos Fernando, Saavedra Henao, Juan D., SanJuan-Arias, Laura Carolina, Barreto, Vanessa, Corso, Julian, Maksoud-Garcia, Mariana, Mateus, Eliana Pineda, Zabaraín, Alejandra Vega, Mantilla-Sylvain, Fabien, Perez, Nicolas, Alzate-Ricaurte, Sergio, Bejarano, Monica, Caicedo Holguin, Isabella, García, Alberto Federico, Sanchez, Stefania Rodriguez, Santos, Felipe Bernal, Jaspe, Carlos Luna, Maria Camila Luna-Jaspe Roa, OLIVERA Bolívar, Maria Paula, Diaz, MariaFernanda Valdivieso, Agudelo, Yuli, Castillo-Aristizábal, Maria Paula, Hoyos Burgos, Juan Pablo, Maria Clara Mendoza Arango, Maria Clara, Gabriel Arroyave, Preciado, Felipe Buitrago, Cardona González, Lina María, Correa-Cote, Juan Camilo, Franco Arias, Karen Lorena, Llano Sierra, Juan Felipe, López, Gustavo, Mancero, Cesar, Parra, Sebastian, Gonzalez, Beatriz Ramirez, Daniela Sierra, Amaya Muñoz, Maria Camila, Blanco-Ramírez, Ashley, Camacho, Paul Anthony, Campillo, Jorge, Carvajal Mejia, Andrea Ximena, María Alejandra González Yamil, Osorno Villegas, Juan Carlos, Eduardo Rubio, Herrera, Santiago Sánchez, Herrera, Sebastian Sanchez, Agudelo, Tatiana, Andrade, Valentina, Pérez, Laura Arango, Ariza-Gutiérrez, Anibal, Jacobo Berrio, Torres, Natalia Cantillo, Chamorro-Rodríguez, Maria Valeria, Conde, Lucia, Feo Lee, Oscar Hernando, González Nieto, María Camila, Ibañez-Pintor, Laura Cecilia, Ochoa, Catalina, Ospina, Juan, Pérez-Ocampo, Juan José, Rojas, Esteban Portilla, Rey, Daniela Saaibi, Serrano, Eduardo, Solorza Velásquez, Sharon Michelle, Toro Cubides, Angélica María, Aguiar, Raúl, Beltrán Rincón, Diego Armando, Figueroa, Juan Sebastian, Figueroa-Casanova, Rafael, Gonzalez Mosos, Maria Fernanda, Marcia Gabriela Gómez, Osorno, Susana, Laura Palacio, Laura, Venegas, Jose, Caicedo Ramírez, Liliana Marcela, Cardona Gomez, Diana Catalina, Alejandro Fernandez Bolaños, Daniel, Fernández-Diago, Adriana, Olave Montaño, Victor David, Pastás, César, Amorocho, Silvia Marcela, Barbosa-Santibañez, Jorge, Baron, Vladimir, Cartagena-Alvarado, Alejandra, Castillo, Maria, Castillo-Florez, Maria Carolina, Dimian Mayorga, Omar David, Delgado-Nieto, Elena Leonor, Fajardo, Ernesto, Gomez Polania, Omar Leonardo, Gonzalez, Tania, Guzman Mesa, Daniel Felipe, Isaza-Restrepo, Andres, Leal, Jaime A., Medina, Camilo, Navarro-Alean, Jorge, Ocampo, Maria Antonia, Oliveros, Guillermo, Ortiz, Maria, Ortiz-Mahecha, Jorge I., Abaunza, Katherine Parra, Pulido Reyes, Felipe Antonio, Rivera-Rincón, Natalia, Carlos Alfonso Rodriguez Pinedo, Sanchez, Lizeth Rodriguez, Romero, Juan Javier, Sabogal Olarte, Juan Carlos, Salgado Tovar, Javier Mauricio, Torres, Guillermo Andrés, Vallejo, Linda, Vargas-Barato, Felipe, Vargas Patiño, Ana María, Villate León, Juan Pablo, Montañez Aldana, Miguel Angel, Norato, Chiara, Borda, Hugo Rojas, Núñez, Miguel Á Romero, Sánchez, Alejandro, López, Jose Támara, Támara P, Jose, Wilmer Fernando Botache Capera, Rojas, Rolando Medina, Juan Torres, Trujillo, Gina Catalina, Cubillos Saavedra, Gabriela Estefanía, Francisco García-Laverde, Naffah Enciso, Jussef Camilo, Betancur, Julian Arango, Cortés-Coronado, Adriana, Susana Sepúlveda Tamayo, Cardenas, Valentina Arboleda, García-Barrero, Luis Guillermo, Jhonatan Enrique Garzón-Galindo, Torres Parada, Lina Fernanda, Quintero, Alejandro Arias, Cano, David, Montoya Quintero, Kevin Fernando, Santiago Nieto Muñoz, Mejía, Paula Saza, Gomez Barrios, Jesus David, Jimeno, María Angélica, Restrepo Hernandez, Ghandi Ignacio, Rodríguez-Sequea, Adrian, Varón Cotes, Juan Carlos, Hanner Enrique Acevedo Reyes, Barandica Bolaño, Claudia Marcela, Sierra-Cote, Maria Camila, Angarita Vargas, Laura Daniela, Báez Ramírez, Alix Yurany, Rodriguez Suarez, Jose Armando, Sánchez, David Leonardo, Sandoval Rangel, Silvia Natalia, Hurtado, Edwin Ulloa, Hernández Almanza, Olga Esther, Martínez Zubiria, Rosalba Inmaculada, Muegues Salas, Angel Alexis, Becerra Cardona, Diego Alexander, Cárdenas Santamaría, Fabio Hernán, Echeverri Castaño, Juan Daniel, Echeverri Uribe, Juan Sebastián, Gaitán Buitrago, María Helena, Galvis Valencia, Luis Felipe, Sabogal, Andrea Henao, López Atehortúa, David Felipe, Molina Uribe, Juan Manuel, Peñate Suárez, Edwin Enrique, Valencia, Heiller Torres, Salazar, Marcela Velásquez, Correa, Catalina, García, Hans, Leal, Juan Hernández, Muñoz Vargas, Paula Tatiana, Bolívar Sáenz, Dínimo José, Caicedo Medina, Camilo Andrés, Garcia Riaño, Camilo Andres, Gonzalez, Stephanye Carrillo, Gómez, Jaime Lorduy, Madrid, Carlos Torres, Villa, Walter Torres, Luengas Orozco, Juan Sebastian, Capriles, Camilo Avendaño, Blanco, Carolina Diaz, Brieva Hoyos, Maria Lucía, Cantillo Moreno, Paola Andrea, Granados Mendoza, Sofía Carolina, Vizcaino Lara, José Dario, Babativa Peñuela, Karla Lizeth, Jiménez Bahamón, Paula Andrea, Maldonado Rico, Jhonier Estiven, Martínez Cortes, Duvan Ernesto, Orjuela Aragón, José Alfredo, Castro Roa, Lizeth Daniela, Gallego, Julieth Sarmiento, Herazo Meza, Marta Maria, Hernández Castillo, Anlly Caterin, Rojas Moncada, Rosa Gabriela, Casanova Bermeo, Lucia Fernanda, Cortés Otero, Oscar Fernando, Pinilla, Nicolás Diaz, Herrera Delgado, Harrison Rene, Macías Segura, Simon Alberto, Muñoz Castrillón, David Ramiro, Nuñez Romero, Luis Ramiro, Polania Andrade, Cesar Andrés, Valdez Toro, Hector Alejandro, Cardozo Parrado, Ana María, Moros, Jose Gonzalo, Nieto, Paula Andrea, Patarroyo, Jorge Mario, Perilla Martínez, Jose Luis, Gutierrez, María del Pilar Torres, Benito Flórez, Erika Johana, Gómez, Mariana Vergel, Robayo Rodriguez, Diana Ximena, Salcedo Miranda, Diego Fernando, Triviño Cortés, Maria Alejandra, Sastre, William Baquero, Bonett, Juan Sebastian, Cortes, Eliana, Duque, Pedro Fernando, Gutierrez, Carlos Enrique, Echeverry, Piedad, Motta Amar, Andrés Felipe, Torres, Lorena, Bautista, Jeremias Carvajal, Figueroa Bohórquez, David Mauricio, Quintana, Manuel Latorre, Olivera Briñez, Diego Fernando, Quintero Contreras, Marcel Leonardo, Gamboa, Raúl Vera, Zapata, Mariana Arias, Benavides Caipe, Cristhian Daniel, Betancur Acevedo, Luisa Fernanda, Zuluaga, Valentina Botero, Figueroa-Espinoza, Vanessa, Londoño-Patiño, Arbey Leandro, Moncayo-Gonzalez, Santiago, Puerta Suárez, Laura Sofia, Vargas-Arboleda, Paula Camila, Gonzalez Cera, Lisbet Sofia, Toro, Katerine Henao, de Jesus Ortiz Pino, Leobardo, Vasquez Vargas, Sergio Andrés, Zuluaga, Lency Naranjo, Garzón, Jaime Chamorro, Franco Rodriguez, Adriana Paola, Acosta Alape, Nataly Johana, Arbelaez Mariño, Andrés Felipe, Mora Herrera, Juan José, Ayala Muñoz, Javier Felipe, Camacho Pinzon, Yeiny Carina, Cárdenas Chacón, José Francisco, Peña Arenas, Liliana Andrea, Rodriguez Camargo, Gustavo Adolfo, Sánchez Arango, Carlos Alberto, Bolaños Ñañez, Daniel Mauricio, Garcés-Palacios, Diana Sofía, Ñañez Pantoja, María Alejandra, Ortega-Valencia, Omar Alejandro, Gamboa Bernal, María Paula, Lotero Gómez, Juan David, Martínez-Gutiérrez, Juan Sebastián, Morales-Gómez, Daniel, Pardo-Jiménez, Lina, Fonseca Galindo, Leon Miguel, Garcia Ramirez, Angélica Maria, Saurith Ramirez, Juan David, Barrero Montoya, Ivan Ricardo, Espitia, Santiago Cadena, Rojas, Salomé Pallares, Zapata Berrio, Laura Camila, Benavides Rodríguez, Diana Andrea, Gonzalez, Juan Carlos, Idarraga, Sharon Valentina, Márquez Rodríguez, Óscar Eduardo, Marrugo Prieto, Ivi Yohana, Soledad Machado, Laura Vanessa, Luna, Rubén, Pulido, Nicolás Navarro, Nuñez Ricardo, Federico Javier, García López, Andrea Elena, Luque, Fernando Girón, Jaramillo, Nasly Patiño, Pedraza Alonso, Néstor Fabian, Acuña Acuña Rivera JY, Javier Yecid, Guevara Cruz, Oscar Alexander, Martínez Buitrago, Juan Sebastián, Oviedo, Nathalia Montoya, Santafe Guerrero, Marcia Roxana, Chaves Cortés, Juanita Carolina, Rincón Tello, Francisco Mauricio, Bejarano Ramirez, Diana Fernanda, Cortes Mejia, Nicolas Andres, Garzon Mesa, Camilo Ernesto, Pabon, Alejandra Moncada, Triviño Alvarez, Diego Rymel, Torres, Alonso Vera, Cote Martinez, Maria Alejandra, Machado Rodriguez, Juan Manuel, Martinez, Gonzalo Nuñez, Osuna, Laura Naranjo, Roldan Garay, Andres Felipe, Amado, Daniel, Camacho-Mackenzie, Jaime, Maria Ceballos Mora, Cifuentes-Navarrete, Sara, Donoso-Samper, Andrea, Ferro, Manuel A., Gómez-Cáceres, Juan C., Gómez-Galán, Sebastián, Leiva, Ana G., Lisarazo, Juan, López-Castaño, Maria G., Martínez-Gil, Sofía, Montoya, M.J., Niño-Basto, Santiago, Ortigoza-Espitia, Sergio Andrés, Páez, Gustavo, Ramos-Anaya, Jesús William, Rozo, María J., Umana, Juan P., Amar, Andres Motta, Barrera Vargas, Andrés Felipe, Maldonado Escalante, Javier Dario, Molina Marroquin, German Ricardo, Prada Lievano, Silvia Alejandra, Vargas-Cuellar, Maria Paula, Polanía-Sandoval, Camilo A., and Cabrera-Rivera, Paulo A.

Published
2024
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2. Highly sensitive scent-detection of COVID-19 patients in vivo by trained dogs.

Author

Vesga, Omar, Agudelo, Maria, Valencia-Jaramillo, Andrés F., Mira-Montoya, Alejandro, Ossa-Ospina, Felipe, Ocampo, Esteban, Čiuoderis, Karl, Pérez, Laura, Cardona, Andrés, Aguilar, Yudy, Agudelo, Yuli, Hernández-Ortiz, Juan P., and Osorio, Jorge E.

Subjects
COVID-19 pandemic, DOGS, VOLATILE organic compounds, REVERSE transcriptase polymerase chain reaction, HOSPITAL patients
Abstract

Timely and accurate diagnostics are essential to fight the COVID-19 pandemic, but no test satisfies both conditions. Dogs can scent-identify the unique odors of volatile organic compounds generated during infection by interrogating specimens or, ideally, the body of a patient. After training 6 dogs to detect SARS-CoV-2 by scent in human respiratory secretions (in vitro diagnosis), we retrained 5 of them to search and find the infection by scenting the patient directly (in vivo screening). Then, efficacy trials were designed to compare the diagnostic performance of the dogs against that of the rRT-PCR in 848 human subjects: 269 hospitalized patients (COVID-19 prevalence 30.1%), 259 hospital staff (prevalence 2.7%), and 320 government employees (prevalence 1.25%). The limit of detection in vitro was lower than 10−12 copies ssRNA/mL. During in vivo efficacy experiments, our 5 dogs detected 92 COVID-19 positive patients among the 848 study subjects. The alert (lying down) was immediate, with 95.2% accuracy and high sensitivity (95.9%; 95% C.I. 93.6–97.4), specificity (95.1%; 94.4–95.8), positive predictive value (69.7%; 65.9–73.2), and negative predictive value (99.5%; 99.2–99.7) in relation to rRT-PCR. Seventy-five days after finishing in vivo efficacy experiments, a real-life study (in vivo effectiveness) was executed among the riders of the Metro System of Medellin, deploying the human-canine teams without previous training or announcement. Three dogs were used to examine the scent of 550 volunteers who agreed to participate, both in test with canines and in rRT-PCR testing. Negative predictive value remained at 99.0% (95% C.I. 98.3–99.4), but positive predictive value dropped to 28.2% (95% C.I. 21.1–36.7). Canine scent-detection in vivo is a highly accurate screening test for COVID-19, and it detects more than 99% of infected individuals independent of key variables, such as disease prevalence, time post-exposure, or presence of symptoms. Additional training is required to teach the dogs to ignore odoriferous contamination under real-life conditions. [ABSTRACT FROM AUTHOR]

Published
2021
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4. Características sociodemográficas y clínicas de pacientes con infección por Leptospira spp. atendidos en cuatro centros hospitalarios de Medellín, Colombia, 2008-2013.

Author

Echeverri-Toro, Lina María, Penagos, Sara, Castañeda, Laura, Villa, Pablo, Atehortúa, Santiago, Ramírez, Faiver, Restrepo, Carlos, Ospina, Sigifredo, Agudelo, Yuli, Hidrón, Alicia, Agudelo, Paola, Valderrama, Eliana, and Andrés Agudelo, Carlos

Abstract

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2017
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5. Dependence to legally prescribed opioid analgesics in a university hospital in Medellin-Colombia: an observational study.

Author

Garcia-Orjuela, Maria G., Alarcon-Franco, Lineth, Sanchez-Fernandez, Juan C., Agudelo, Yuli, and Zuluaga, Andres F.

Subjects
OPIOID analgesics, DRUG prescribing, TRAMADOL, PAIN medicine, INTERNATIONAL Statistical Classification of Diseases & Related Health Problems, PATHOLOGICAL psychology
Abstract

Background: In some countries the misuse and diversion of prescribed opioid analgesic is increasing considerably, but there is no official data regarding the situation in Colombia. The aim of this study was to identify all dependent to opioid analgesics legally prescribed patients that were treated in a University Hospital in Medellin, Colombia during 4 years and to characterize this population. Methods: Observational study in a University Hospital in Medellin, Colombia, searching for patients with ICD-10 codes related with opioid related disorders, adverse events or pain and treated between January 2011 and December 2014. Results: Sixty patients with opioid dependence according to DSM-IV criteria were found from 3332 clinical charts reviewed. The median age was 43 years. Although all patients met the DSM-IV criteria, 33 % of patients were wrongly diagnosed by other ICD-10 codes. Almost all patient (88 %) initiated opioids after medical prescription although the adherence to pain scale was low (25 %). The median time of consumption was 48 months. Tramadol was the opioid more frequently used by patients, followed by morphine and oxycodone. A statistically significant higher consumption of other psychotropic substances was observed in male than female (P = 0.005 by Fisher's test). After be diagnosed, 55 % of patients gone a methadone-based replacement therapy. Conclusion: Legally prescribed opioid dependence was belatedly diagnosed in 60 patients in a University hospital, after prolonged use of drugs to treat chronic pain and with low adherence to pain scale or guidelines. This is the first report in Colombia. [ABSTRACT FROM AUTHOR]

Published
2016
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6. Características sociodemográficas y clínicas de pacientes con infección por Leptospira spp. atendidos en cuatro centros hospitalarios de Medellín, Colombia, 2008-2013.

Author

María Echeverri-Toro, Lina, Penagos, Sara, Castañeda, Laura, Villa, Pablo, Atehortúa, Santiago, Ramírez, Faiver, Restrepo, Carlos, Ospina, Sigifredo, Agudelo, Yuli, Hidrón, Alicia, Agudelo, Paola, Valderrama, Eliana, and Andrés Agudelo, Carlos

Abstract

Copyright of Revista Biomedica is the property of Centro de Investigaciones Regionales Dr. Hideyo Noguchi; Facultad de Medicina, UADY and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2017
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7. [Sociodemographic and clinical characteristics of patients infected with Leptospira spp. treated at four hospitals in Medellín, Colombia, 2008-2013].

Author

Echeverri-Toro LM, Penagos S, Castañeda L, Villa P, Atehortúa S, Ramírez F, Restrepo C, Ospina S, Agudelo Y, Hidrón A, Agudelo P, Valderrama E, and Agudelo CA

Subjects
Anti-Bacterial Agents chemistry, Colombia, Fever, Hospitals, Humans, Retrospective Studies, Anti-Bacterial Agents therapeutic use, Jaundice etiology, Leptospira chemistry, Leptospirosis epidemiology, Lung physiology
Abstract

Introduction: Leptospirosis remains a significant health problem in tropical regions including Latin America, where its presentation is 100 times higher than that observed in other regions of the world. Mortality reaches 10% in severe cases. Its diagnosis is challenging because clinical manifestations during the initial phase are non-specific and because of limited availability of diagnostic tests., Objective: To describe the demographic and clinical characteristics and the outcomes in hospitalized patients with leptospirosis., Materials and Methods: This retrospective study included patients treated at four institutions in Medellín between January, 2009, and December, 2013, with a compatible clinical picture and a positive IgM for Leptospira spp., Results: We included 119 patients, 80% male, and 58% of rural origin. The mean duration of symptoms was 9.6 days (SD=9.6). Eighty nine per cent of patients had fever; 62%, jaundice; 74%, myalgia; 46%, diarrhea; 41%, hepatomegaly; 13%, splenomegaly, and 13%, conjunctival injection. Fifty four per cent of patients had impaired renal function; 32%, pulmonary compromise, and 13%, liver failure. Sixteen per cent required admission to the ICU; 12%, mechanical ventilation, and 11%, vasopressor therapy.Weil's syndrome occurred in 38.6% and 5% died. The average hospital stay was 11 days (SD=9.6)., Conclusions: In this population, the clinical manifestations and complications of leptospirosis were similar to those reported in the literature. We observed a relatively low overall mortality in relation to global statistics.

Published
2017
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8. [Risk factors for multidrug-resistant Pseudomonas aeruginosa infection, in a tertiary hospital in Colombia].

Author

Ossa-Giraldo AC, Echeverri-Toro LM, Santos ZM, García MG, Agudelo Y, Ramírez F, and Ospina S

Subjects
Adult, Aged, Case-Control Studies, Colombia, Female, Humans, Length of Stay, Male, Middle Aged, Pseudomonas Infections microbiology, Risk Factors, Tertiary Care Centers, Cross Infection microbiology, Drug Resistance, Multiple, Bacterial, Pseudomonas Infections etiology, Pseudomonas aeruginosa
Abstract

Introduction: multi-resistant Pseudomonas aeruginosa (MR) is frequently associated with healthcare infections. Its epidemiology is complex and few studies help to understand it. A study about risk factors associated with this type of bacteria is needed., Objective: To determine risk factors associated with MR P. aeruginosa infection in hospitalized patients from the Hospital Universitario San Vicente Foundation-Medellin., Materials and Methods: case-control study to identify risk factors associated with infection by MR P. aeruginosa., Results: 140 patients were included, 70 in each group. Bivariate analysis found association with previous use of carbapenems (OR 3.12 - IC 1.21 to 8.03, p = 0.02), aminoglycosides (OR 5.09 - CI: 1.38 to 18, 77, p = 0.01) and days of stay prior to isolation of the organism (OR 1.03 - CI: 1.01-1.05, p = 0.01). In multivariate analysis MR P. aeruginosa infection was associated with hospital stay (OR 1.03 - IC 1.01 to 1.05), use of aminoglycosides (OR 1.30 to 19.28) and treatment with two or more antimicrobials in the last 30 days (OR 3.09 - CI: 1.26 to 7.58). The risk of developing infection was 3% per day of hospital stay prior to isolation of the agent., Conclusion: Developing MR P. aeruginosa infection was associated with prior use of antimicrobials and prior hospital stay.

Published
2014
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9. [Multidrug-resistant Klebsiella pneumoniae, predisposing factors and associated mortality in a tertiary-care hospital in Colombia].

Author

Echeverri-Toro LM, Rueda ZV, Maya W, Agudelo Y, and Ospina S

Subjects
Adolescent, Adult, Colombia epidemiology, Cross Infection microbiology, Epidemiologic Methods, Female, Hospitals, University, Humans, Klebsiella Infections microbiology, Klebsiella pneumoniae enzymology, Klebsiella pneumoniae isolation & purification, Male, Middle Aged, Young Adult, beta-Lactamases metabolism, Cross Infection mortality, Drug Resistance, Multiple, Bacterial, Klebsiella Infections mortality, Klebsiella pneumoniae drug effects
Abstract

Introduction: Bacterial resistance to antibiotics is a serious public health problem that is increasing worldwide. Resistant (R) Klebsiella pneumoniae is one of the main pathogens isolated in nosocomial infections. The aim of this study was to explore risk factors associated with the acquisition of infection by R-K. pneumoniae and mortality., Methods: Prospective cohort study conducted in a hospital of high complexity of Medellin, October/2009-April/2010. The exposed group was defined as patients infected with R-K. pneumoniae (producing b-lactamases or carbapenemases). In order to identify risk factors associated with infection by R-K. pneumoniae and 30 day mortality, logistic regression and Cox proportional hazards regression were used., Results: 243 patients were included in the study, 84 infected with R-K. pneumoniae and 159 infected with susceptible K. pneumoniae. Female sex (OR = 2.51 95% 1.37 to 4.6), the co-existence of cardiovascular disease (OR = 2.13 95% CI 1.14 to 3.99), previous use of ceftriaxone (OR = 9.52 95% CI 2.63 to 34.46) and carbapenems (OR = 4.23 95% CI 2.41 to 7.42) were risk factors associated to infection with R-K. pneumoniae. Some predictors of mortality were malignant neoplasia (HR = 4.43 95% CI 2.13 to 9.22) and mechanical ventilation (HR = 3.81 95% CI 1.99 to 7.28). There was no difference in 30-day mortality when comparing patients in both groups., Conclusions: Female gender, cardiovascular disease and previous use of antimicrobials were associated with infection by R-K. pneumoniae. Thirty-day mortality was similar in both groups of patients.

Published
2012
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