Estudios de diferentes aspectos clínicos, epidemiológicos y de prevención de las bacteriemias

Introducción. La bacteriemia es una patología grave, con una elevada mortalidad, lo que hace prioritario tanto su prevención en aquellos casos en que es posible, como el seguimiento de estos pacientes dirigido a optimizar su tratamiento. La bacteriemia relacionada con los catéteres es la primera causa de bacteriemia nosocomial en un hospital general. 7 fueron marcadores independientes de mortalidad en pacientes con bacteriemia. Introduction. Bacteraemia is a serious disease, with a high mortality, making its prevention a priority when it is possible. The catheter related bacteraemia is the leading cause of healthcare related bacteraemia in a general hospital and it's preventable. It is also important to monitor these patients aimed to optimizing treatment, for this purpose have a prognostic marker may be useful. Objective. For objective 1. To evaluate a multidisciplinary and multifocal intervention in order to reduce catheter related bloodstream infections (CRBI) based on previously identified risk factors in non-critical patients. For objective 2. The aim of this study was to evaluate whether changes in eosinophil count, as well as the neutrophil-lymphocyte count ratio (NLCR), could be used as clinical markers of outcome in patients with bacteraemia. Methods: For objective 1. A pre-post-intervention study, 2004-2006. Population: patients with a central venous catheter (CVC). The primary endpoint was the CRBI. Other studied variables were patient characteristics, insertion, maintenance and removal of the catheter. The intervention consisted of baseline knowledge and identifying risk factors. In a second period, there was specific training on these identified risk factors and communication of the results, monitoring and evaluation of the CVC inserted. For objective 2. Retrospective study of patients with a first episode of community-acquired or healthcare-related bacteraemia during hospital admission between 2004 and 2009 was performed. A total of 2,311 patients were included. Cox regression was used to analyze the behaviour of eosinophil count and the NLCR in survivors and non-survivors. Results: For objective 1. We analysed 175 and 200 CVC, respectively. The incidence of CRBI was 15.4% during the pre-intervention and 4.0% in the post-intervention period (P 7 was also an independent risk factor but was of lesser importance. The mean eosinophil count in survivors showed a tendency to increase rapidly and to achieve normal values between the second and third