Journal Information
Vol. 15. Issue 2.
Pages 111-117 (March - April 2001)
Vol. 15. Issue 2.
Pages 111-117 (March - April 2001)
Open Access
Factores de riesgo asociados con bacteriemia nosocomial en recién nacidos de bajo peso al nacimiento. Hospital Grady Memorial, Atlanta
Risk factors associated with nosocomial bacteremia in low birth weight neonates. Grady Memorial Hospital, Atlanta
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M.B. Robles García1,*, J.J. Díaz Argüello2, W.R. Jarvis3, G. Orejas Rodríguez-Arango4, C. Rey Galán5
1 Consejería de Salud y Servicios Sanitarios. Oviedo.
2 Hospital Da Costa. Burela. Galicia.
3 Chief, Investigation and Prevention Branch. Centers for Disease Control and Prevention. Atlanta. Estados Unidos.
4 Servicio de Pediatría. Hospital Carmen y Severo Ochoa. Cangas del Narcea. Asturias.
5 Unidad de Cuidados Intensivos Pediátrica. Hospital Central de Asturias. Oviedo.
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Abstract
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Resumen
Introducción

La bacteriemia nosocomial es una causa frecuente de infección nosocomial en los recién nacidos admitidos en las unidades de cuidados intensivos neonatales y está asociada con factores de riesgo, reconocidos y no reconocidos, de infección nosocomial. Aún existen pocas evidencias sobre los factores de riesgo de bacteriemia nosocomial en recién nacidos de bajo peso al nacimiento.

Objetivos

Investigar factores de riesgo de bacteriemia nosocomial en neonatos con un peso inferior a 1.500 g ingresados en la unidad de cuidados intensivos neonatal.

Métodos

Se realizó un estudio prospectivo en recién nacidos de bajo peso al nacimiento (≤ 1.500 g) durante 22 meses. Para determinar la asociación estadística entre la bacteriemia nosocomial y los factores de riesgo perinatales y nosocomiales, se llevó a cabo un análisis bivariante de regresión logística (método de regresión por pasos).

Resultados

Se estudió a un total de 72 pacientes con bacteriemia nosocomial y 174 sin ella. La permanencia del catéter umbilical un tiempo mayor o igual a 7 días y la permanencia del catéter periférico arterial durante un día o más resultaron ser los factores independientemente asociados con bacteriemia nosocomial.

Conclusión

El mantenimiento del catéter umbilical más de 7 días, la permanencia del catéter periférico arterial más de 1 día y el peso al nacimiento inferior a 1.500 g fueron factores determinantes de bacteriemia nosocomial. Por la importancia de estas técnicas invasivas como fuente de bacteriemia nosocomial, es preciso revisar su tiempo de permanencia con el objetivo de disminuir la incidencia de bacteriemia nosocomial.

Palabras clave:
Recién nacidos
Peso al nacimiento
Bacteriemia
Factores de riesgo
Técnicas invasivas
Unidad de cuidados intensivos neonatal
Abstract
Background

Nosocomial bloodstream infections occur frequently in Neonatal Intensive Care Units and are associated with recognized and unrecognized risk factors. Little has been published regarding risk factors for bloodstream infections in low birth weight neonates.

Objective

To investigate risk factors for bloodstream infection in neonates < 1,500 g admitted at a Neonatal Intensive Care Unit.

Methods

A prospective study was undertaken in low birth weight neonates (< 1,500g) during a 22 months period. Bivariant, and logistic regresion (stepwise procedure) analysis was used to determine the significance association of bloodstream infection and perinatal and nosocomial risk factors.

Results

A total of 72 patiens with nosocomial bacteriemia and 147 non bacteriemic patients were studied. Independent risk factors associated with bloodstream infection were birth weight, persistence of umbilical catheter > 7 days and persistence of peripheral arterial catheter > 1 day.

Conclusions

The uses of umbilical catheter > 7 days, peripheral arterial catheter > 1 day and birth weight < 1,500 g were significant determinants of nosocomial bloodstream infection risk. Because of the importance of invasive procedures as a source of nosocomial bloodstream infections, the lines duration needs to be reviewed with the aim of reducing the incidence of blood stream infection.

Key words:
Newborn
Birth weight
Bacteremia
Risk factors
Invasive procedures
Neonatal intensive care unit
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