Inicio
Autor Gustavo Roncancio
|
|
Documentos disponibles escritos por este autor (2)
Clasificado(s) por (Año de edición descendente) Refinar búsquedaDevice-Associated Infections in COVID-19 Patients: Frequency of Resistant Bacteria, Predictors and Mortality in Medellín, Colombia / Echeverri Toro, Lina Maria
Título : Device-Associated Infections in COVID-19 Patients: Frequency of Resistant Bacteria, Predictors and Mortality in Medellín, Colombia Tipo de documento : documento electrónico Autores : Echeverri Toro, Lina Maria, Autor ; Ocampo, Diana Patricia, Autor ; Jiménez, Judy Natalia, Autor ; Salazar, Lorena, Autor ; Vargas, Carlos, Autor ; Gustavo Roncancio, Autor ; Roa, Maria Alejandra, Autor ; Vanegas, Johanna Marcela, Autor Fecha de publicación : 2024 Títulos uniformes : Microorganisms Idioma : Inglés (eng) Palabras clave : COVID-19; healthcare-associated infections; device-associated infections; bacterial resistance; carbapenemases Resumen : Introduction: Increased antimicrobial use during the COVID-19 pandemic has raised concerns about the spread of resistant bacteria. This study analyzed the frequency of device-associated infections (DAI) caused by resistant bacteria, the predictors of these infections, and 30-day all-cause mortality in patients with and without COVID-19. Methods: A retrospective cohort study was conducted on DAI patients admitted to the ICU (intensive care unit) in 20 hospitals in Medellin, Colombia (2020–2021). The exposure assessed was the COVID-19 diagnosis, and outcomes analyzed were resistant bacterial infections and 30-day mortality. Clinical and microbiological information was collected from surveillance databases. Statistical analysis included generalized linear mixed-effects models. Results: Of the 1521 patients included, 1033 (67.9%) were COVID-19-positive and 1665 DAI were presented. Carbapenem-resistant Enterobacteriaceae (CRE) infections predominated during the study (n = 98; 9.9%). The patients with COVID-19 had a higher frequency of metallo-beta-lactamase-producing CRE infections (n = 15; 33.3%) compared to patients without the disease (n = 3; 13.0%). Long-stay in the ICU (RR: 2.09; 95% CI:?1.39–3.16), diabetes (RR: 1.73; 95% CI: 1.21–2.49), and mechanical ventilation (RR: 2.13; 95% CI: 1.01–4.51) were CRE infection predictors in COVID-19 patients, with a mortality rate of 60.3%. Conclusion: CRE infections were predominant in COVID-19 patients. In pandemic situations, the strategies to control DAI should be maintained to avoid infections caused by resistant bacteria, such as length of stay in the ICU and duration of mechanical ventilation. Referencia : Ocampo, D.P.; Echeverri-Toro, L.M.; Jiménez, J.N.; Salazar, L.; Vargas, C.; Roncancio, G.; Roa, M.A. DOI (Digital Object Identifier) : 10.3390/microorganisms12040640 Derechos de uso : CC BY En línea : https://www.mdpi.com/2076-2607/12/4/640 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Device-Associated Infections in COVID-19 Patients: Frequency of Resistant Bacteria, Predictors and Mortality in Medellín, Colombia [documento electrónico] / Echeverri Toro, Lina Maria, Autor ; Ocampo, Diana Patricia, Autor ; Jiménez, Judy Natalia, Autor ; Salazar, Lorena, Autor ; Vargas, Carlos, Autor ; Gustavo Roncancio, Autor ; Roa, Maria Alejandra, Autor ; Vanegas, Johanna Marcela, Autor . - 2024.
Obra : Microorganisms
Idioma : Inglés (eng)
Palabras clave : COVID-19; healthcare-associated infections; device-associated infections; bacterial resistance; carbapenemases Resumen : Introduction: Increased antimicrobial use during the COVID-19 pandemic has raised concerns about the spread of resistant bacteria. This study analyzed the frequency of device-associated infections (DAI) caused by resistant bacteria, the predictors of these infections, and 30-day all-cause mortality in patients with and without COVID-19. Methods: A retrospective cohort study was conducted on DAI patients admitted to the ICU (intensive care unit) in 20 hospitals in Medellin, Colombia (2020–2021). The exposure assessed was the COVID-19 diagnosis, and outcomes analyzed were resistant bacterial infections and 30-day mortality. Clinical and microbiological information was collected from surveillance databases. Statistical analysis included generalized linear mixed-effects models. Results: Of the 1521 patients included, 1033 (67.9%) were COVID-19-positive and 1665 DAI were presented. Carbapenem-resistant Enterobacteriaceae (CRE) infections predominated during the study (n = 98; 9.9%). The patients with COVID-19 had a higher frequency of metallo-beta-lactamase-producing CRE infections (n = 15; 33.3%) compared to patients without the disease (n = 3; 13.0%). Long-stay in the ICU (RR: 2.09; 95% CI:?1.39–3.16), diabetes (RR: 1.73; 95% CI: 1.21–2.49), and mechanical ventilation (RR: 2.13; 95% CI: 1.01–4.51) were CRE infection predictors in COVID-19 patients, with a mortality rate of 60.3%. Conclusion: CRE infections were predominant in COVID-19 patients. In pandemic situations, the strategies to control DAI should be maintained to avoid infections caused by resistant bacteria, such as length of stay in the ICU and duration of mechanical ventilation. Referencia : Ocampo, D.P.; Echeverri-Toro, L.M.; Jiménez, J.N.; Salazar, L.; Vargas, C.; Roncancio, G.; Roa, M.A. DOI (Digital Object Identifier) : 10.3390/microorganisms12040640 Derechos de uso : CC BY En línea : https://www.mdpi.com/2076-2607/12/4/640 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
Reservar este documento
Ejemplares(1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD002162 AC-2024-015 Archivo digital Producción Científica Artículos científicos Disponible
Título : The potential impact of admission insulin levels on patient outcome in the intensive care unit Tipo de documento : documento electrónico Autores : Gisela de la Rosa Echavez, ; Esdras Martín Vásquez Mejía, ; Jorge Hernando Donado Gómez, ; Marisol Bedoya Arias, ; Álvaro Humberto Restrepo Cuartas, ; Gustavo Roncancio, ; Carlos Alberto Cadavid Gutiérrez, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2013 Títulos uniformes : Journal of Trauma and Acute Care Surgery Idioma : Inglés (eng) Palabras clave : Insulin insulin resistance critical care critical illness outcome Resumen : Background: Blood levels of insulin in patients with critical illness at admission to the intensive care unit (ICU) and its association with in hospital mortality are not fully defined. Our objective was to determine this association in a cohort of patients with critical illness who attended in a mixed ICU. Methods: Prospective cohort was nested in a randomized clinical trial conducted in a 12-bed mixed ICU in a tertiary hospital in Medellin (Colombia). One hundred sixty consecutively admitted patients, 15 years or older, were analyzed. Blood insulin and blood glucose levels were measured at admission to the ICU, as well as Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. A logistic regression model was created with in-hospital mortality as the outcome. Results: In-hospital mortality was 57 (35.6%) of 160. Survivors had lower Acute Physiology and Chronic Health Evaluation II (median, 13 vs. 17) and lower insulin levels (median, 6.5 vs. 9 µU/mL) than did nonsurvivors. More women than men died (27 [48.2%] of 56 vs. 30 [28.8%] of 104), and 39% of the deaths (n = 22) occurred in patients with sepsis. Patients with insulin levels greater than 15 µU/mL had a higher mortality rate compared with patients with values of 5 µU/mL to 15 µU/mL (odds ratio, 3.57; 95% confidence interval, 1.18–10.8). Conclusion: At admission to the ICU, patients with critical illness showed hyperglycemia and relatively decreased insulin levels. High levels of insulin were independently associated with in-hospital mortality in this study population. Mención de responsabilidad : Gisela De La Rosa, Esdras Martin Vasquez, Alvaro Mauricio Quintero, Jorge Hernando Donado, Marisol Bedoya, Alvaro Humberto Restrepo, Gustavo Roncancio, Carlos Alberto Cadavid, Fabian Alberto Jaimes, Grupo de Investigacion en Cuidado Intensivo GICI-HPTU Referencia : J Trauma Acute Care Surg. 2013 Jan;74(1):270-5. DOI (Digital Object Identifier) : 10.1097/TA.0b013e3182788042 PMID : 23271103 En línea : https://journals.lww.com/jtrauma/Abstract/2013/01000/The_potential_impact_of_adm [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis The potential impact of admission insulin levels on patient outcome in the intensive care unit [documento electrónico] / Gisela de la Rosa Echavez, ; Esdras Martín Vásquez Mejía, ; Jorge Hernando Donado Gómez, ; Marisol Bedoya Arias, ; Álvaro Humberto Restrepo Cuartas, ; Gustavo Roncancio, ; Carlos Alberto Cadavid Gutiérrez, ; Fabián Alberto Jaimes Barragán, . - 2013.
Obra : Journal of Trauma and Acute Care Surgery
Idioma : Inglés (eng)
Palabras clave : Insulin insulin resistance critical care critical illness outcome Resumen : Background: Blood levels of insulin in patients with critical illness at admission to the intensive care unit (ICU) and its association with in hospital mortality are not fully defined. Our objective was to determine this association in a cohort of patients with critical illness who attended in a mixed ICU. Methods: Prospective cohort was nested in a randomized clinical trial conducted in a 12-bed mixed ICU in a tertiary hospital in Medellin (Colombia). One hundred sixty consecutively admitted patients, 15 years or older, were analyzed. Blood insulin and blood glucose levels were measured at admission to the ICU, as well as Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. A logistic regression model was created with in-hospital mortality as the outcome. Results: In-hospital mortality was 57 (35.6%) of 160. Survivors had lower Acute Physiology and Chronic Health Evaluation II (median, 13 vs. 17) and lower insulin levels (median, 6.5 vs. 9 µU/mL) than did nonsurvivors. More women than men died (27 [48.2%] of 56 vs. 30 [28.8%] of 104), and 39% of the deaths (n = 22) occurred in patients with sepsis. Patients with insulin levels greater than 15 µU/mL had a higher mortality rate compared with patients with values of 5 µU/mL to 15 µU/mL (odds ratio, 3.57; 95% confidence interval, 1.18–10.8). Conclusion: At admission to the ICU, patients with critical illness showed hyperglycemia and relatively decreased insulin levels. High levels of insulin were independently associated with in-hospital mortality in this study population. Mención de responsabilidad : Gisela De La Rosa, Esdras Martin Vasquez, Alvaro Mauricio Quintero, Jorge Hernando Donado, Marisol Bedoya, Alvaro Humberto Restrepo, Gustavo Roncancio, Carlos Alberto Cadavid, Fabian Alberto Jaimes, Grupo de Investigacion en Cuidado Intensivo GICI-HPTU Referencia : J Trauma Acute Care Surg. 2013 Jan;74(1):270-5. DOI (Digital Object Identifier) : 10.1097/TA.0b013e3182788042 PMID : 23271103 En línea : https://journals.lww.com/jtrauma/Abstract/2013/01000/The_potential_impact_of_adm [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
Reservar este documento
Ejemplares(1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000233 AC-2013-001 Archivo digital Producción Científica Artículos científicos Disponible
