Impacto económico y clínico de la resistencia bacteriana a partir del análisis de Acinetobacter Baumannii en unidades de cuidado intensivo de instituciones de tercer nivel de Bogotá

dc.contributorPio de la Hoz, Fernando
dc.contributorAlvis, Nelson
dc.contributorMicrobiología y Epidemiología
dc.creatorLemos Luengas, Elkin Vladimir
dc.date.accessioned2020-07-10T20:44:18Z
dc.date.accessioned2022-09-21T16:29:38Z
dc.date.available2020-07-10T20:44:18Z
dc.date.available2022-09-21T16:29:38Z
dc.date.created2020-07-10T20:44:18Z
dc.date.issued2010-09-17
dc.identifierLemos, E. IMPACTO ECONÓMICO Y CLÍNICO DE LA RESISTENCIA BACTERIANA A PARTIR DEL ANÁLISIS DE ACITENOBATER BAUMANINII EN UNIDADES DE CUIDADO INTENSIVO DE INSTITUCIONES DE TERCER NIVEL DE BOGOTÁ (2010). Bogotá D.C.
dc.identifierhttps://repositorio.unal.edu.co/handle/unal/77763
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/3393377
dc.description.abstractBackground: The Acinetobacter baumannii was chosen for analysis because it is an important cause of nosocomial infection in Colombia. Infections caused by microorganisms such pledge life and are often difficult to treat due to intrinsic susceptibility of these microorganisms reduced to very few families of antimicrobials, as a result of this resistance generates an increased consumption of health resources. Objectives: To quantify the Impact on survival and costs from the perspective of society of Acinetobacter baumannii resistance in cohorts of patients with clinical isolates. Methodology: A cohort study (prospective) in three intensive care units in Bogotá between April 2006 and April 2010. We compared 10 pairs of subgroups by each of the markers and an additional pair formed by the multiresistance and multisensitive. Results: 165 adult patients who had nosocomial infections in three intensive care units, 62 of them were multisensitive and 102 were multiresistant; patients with resistant organisms had statistically significant difference in survival of 30 days (P<0.05) for patients with isolates resistant to any of the markers against the sensitive to all the markers, with a difference of 36%, we also found higher average cost for resistant organisms for each of the markers, the difference is on average $3,976,092 (Colombian pesos), and was statistically significant P <0.05 for the markers, ciprofloxacin, amikacin, ampicillin/sulbactam, cefepime, meropenem and imipenem, 50% of patients had to assume more than $76,000 (Colombian pesos) in transportation and productivity losses, wich means 15% of the current legal monthly minimum wage in 2010 for Colombia. Conclusion: There is a significant difference in survival of 30 days and cost between sensitive and resistant to several of the markers. The indirect costs of illness are a small percentage of society, but for the patient these have great relevance which means sacrificing other basic needs for most Colombian families
dc.description.abstractAntecedente: El Acinetobacter baumannii fue elegido para su análisis, ya que es una causa importante de infección nosocomial en Colombia. Las infecciones producidas por este tipo de microorganismos, comprometen frecuentemente la vida, y son difíciles de tratar debido a la susceptibilidad intrínseca de estos microorganismos, que a su vez es reducida a muy pocas familias de antimicrobianos. Como consecuencia de esta resistencia, se genera un aumento del consumo de los recursos en salud. Objetivos: Cuantificar el impacto sobre la sobrevida y los costos desde la perspectiva de la sociedad, de la resistencia de Acinetobacter baumannii en cohortes de pacientes con aislamientos clínicos. Metodología: Se realizó un estudio de cohortes (prospectivo) en tres unidades de cuidado intensivo de Bogotá entre abril de 2006 y abril de 2010. Se compararon 10 parejas de subgrupos, según cada uno de los marcadores, una pareja adicional formada por los multiresistentes y los multisensibles. Resultados: Se analizaron los cultivos de 165 pacientes adultos que presentaron infecciones intrahospitalarias en tres Unidades de Cuidados Intensivos (UCI). 62 de ellos se encontraron Multisensibles, y 103 Multiresistentes. Se encontró una diferencia estadísticamente significativa (P<0.05) para la sobrevida a los 30 días, de los pacientes con aislamientos Multiresistentes, frente a los Multisensibles, con una diferencia del 36%. Tambien se encontró que los pacientes con microorganismos resistentes tuvieron un costo promedio superior a sus homólogos con microorganismos sensibles para cada uno de los marcadores. La diferencia es en promedio de $3.976.092 pesos, y fue estadísticamente significativa P<0.05 para los marcadores ciprofloxacino, amikacina, ampicilina/sulbactam, cefepime, meropenem e imipenem. El 50% de los pacientes tuvo que asumir más de $76.000 pesos en transporte y pérdidas laborales, lo que representa un 15% del salario mínimo legal vigente en Colombia para el año 2010. Conclusión: Existe una diferencia significativa en la sobrevida a los 30 dias asi como una diferencia de costo entre sensibles y resistentes para varios de los marcadores. Los costos indirectos de la enfermedad son un pequeño porcentaje para la sociedad, pero para el paciente, estos tienen una gran relevancia, e implica sacrificar otras necesidades básicas para la mayoría de familias colombianas.
dc.languagespa
dc.publisherBogotá - Medicina - Doctorado en Salud Pública
dc.publisherUniversidad Nacional de Colombia - Sede Bogotá
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dc.rightsAtribución-NoComercial 4.0 Internacional
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dc.rightshttp://creativecommons.org/licenses/by-nc/4.0/
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dc.rightsDerechos reservados - Universidad Nacional de Colombia
dc.titleImpacto económico y clínico de la resistencia bacteriana a partir del análisis de Acinetobacter Baumannii en unidades de cuidado intensivo de instituciones de tercer nivel de Bogotá
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