Análisis de factores asociados a la mortalidad por sepsis derivada de infecciones relacionadas con dispositivos

Abstract

Introduction

Health care-associated infections (HAIs) contribute to morbidity and mortality and to the dissemination of multidrug-resistant organisms. Children admitted to the intensive care unit undergo invasive procedures that increase their risk of developing HAIs and sepsis. The aim of the study was to analyse factors associated with mortality due to sepsis arising from HAIs.

Patients and methods

We conducted a case-control study in a 7-bed multipurpose paediatric intensive care unit in a tertiary care teaching hospital. The sample consisted of 90 children admitted between January 2014 and December 2018. The case group consisted of patients who died from sepsis associated with the main health care-associated infections; the control group consisted of patients who survived sepsis associated with the same infections.

Results

Death was associated with age less than or equal to 12 months, presence of comorbidity, congenital disease, recurrent ventilator-associated pneumonia and septic shock. In the multiple regression analysis, heart disease (OR: 12.48; 95% CI: 2.55-60.93; P = .002), infection by carbapenem-resistant bacteria (OR: 31.51; 95% CI: 4.01-247.25; P = .001), cancer (OR: 58.23; 95% CI: 4.54-746.27; P = .002), and treatment with adrenaline (OR: 13.14; 95% CI: 1.35-128.02; P = .003) continued to be significantly associated with death.

Conclusions

Hospital sepsis secondary to carbapenem-resistant bacteria contributed to a high mortality rate in this cohort. Children with heart disease or neoplasia or who needed vasopressor drugs had poorer outcomes.