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Factores asociados a la mortalidad en pacientes críticos con COVID-19 sobreinfectados por microorganismos carbapenémicos resistentes.

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Title: Factores asociados a la mortalidad en pacientes críticos con COVID-19 sobreinfectados por microorganismos carbapenémicos resistentes.
Alternate Title: Factors assoociated with mortality in critically ill patients with COVID-19 overinfected due to carbapenem resistant organisms.
Authors: Cobian Caballero, Carlos Olivers1 ocobianc83@gmail.com, Romero García, Lázaro Ibrahim2, Morales Pertuz, Carlos Alberto1, Parra Mancipe, Jhon Edison1, Leguizamón, Giovanni Rodríguez3
Source: MEDISAN. 2026, Vol. 30 Issue 1, p1-19. 19p.
Subjects: MORTALITY risk factors, CARBAPENEM-resistant bacteria, MULTIDRUG resistance, KLEBSIELLA pneumoniae, INTENSIVE care units, SUPERINFECTION, COVID-19, CRITICALLY ill
Abstract (English): Introduction: Gram-negative bacilli are the most commonly related to bacterial superinfection in critically ill patients with COVID-19. Multidrug resistance in ICUs, emerges as a medical challenge. Objective: To identify sociodemographic, epidemiological, clinical, microbiological and therapeutic factors associated with mortality, in patients superinfected by carbapenem-resistant gram-negative bacilli at El Tunal Hospital. Methods: An observational, analytic cross-sectional study was carried out in 150 critically ill patients infected by COVID-19, with superinfection by carbapenemresistant gran-negative bacilli CRGNB, from March 2020 to March 2022, the data were obtained from the clinical records of patients and the automated system Phoenix M50 that provided the isolations of CRGNB. The Regression of Cox was used to identify factors associated with the mortality, and Kaplan-Meier Curves, for analysis of survival. Results: The isolated microorganism with more frequency was K. Pneumoniae in 96 (64%) patients. One hundred patients died (66.6%). The survival after the beginning of superinfection at 7, 14 and 21 days was 83.1%; 60.4% and 48.7% respectively, the predictive variable of mortality were the TRR (OR = 3,3), the age (OR = 3.0), the microbiologic isolation of K. pneumoniae (OR = 3.2) and to require vasopresor support at the beginning of superinfection (OR = 6.7). Conclusions: The K. pneumoniae was associated with most of the infections. The Cox pattern of regression implied that; to require TRR and vasopresor support at the beginning of sobreinfection, advanced age, and infection by K. pneumoniae, were predictors of mortality. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción: Los bacilos gram negativos constituyen los más relacionados con sobreinfección bacteriana en pacientes críticos con COVID-19. La multiresistencia, en las UCI, emerge como desafío médico. Objetivo: Identificar factores sociodemográficos, epidemiológicos, clínicos, microbiológicos y terapéuticos asociados a la mortalidad, en pacientes, sobreinfectados por bacilos gram negativos resistentes a carbapenémicos (BGNRC), en el hospital El Tunal. Métodos: Estudio observacional, de corte transversal analítico, en 150 pacientes críticos infectados por COVID-19, con sobreinfección por BGNRC, en el período marzo 2020 a marzo 2022, los datos se obtuvieron de los registros clínicos de los pacientes y del sistema automatizado Phoenix M50, que proporcionó los aislamientos de BGNRC. Se empleó la Regresión de Cox para identificar factores asociados a la mortalidad, y las Curvas de Kaplan-Meier, para análisis de supervivencia. Resultados: El microorganismo aislado con más frecuencia fue K. Pneumoniae en 96 (64 %) pacientes. Fallecieron 100 (66,6 %) pacientes. La supervivencia luego del inicio de la sobreinfección a los 7, 14 y 21 días fue 83,1 %; 60,4 % y 48,7 % respectivamente, las variables predictivas de mortalidad resultaron ser la TRR (OR= 3,3), la edad (OR= 3,0), el aislamiento microbiológico de K. pneumoniae (OR= 3,2) y requerir soporte vasopresor al inicio de sobreinfección (OR= 6,7). Conclusiones: La K. pneumoniae se asoció a la mayoría de las infecciones. El modelo de regresión de Cox implicó que; requerir TRR y soporte vasopresor a inicios de la sobreinfección, edad avanzada, e infección por K. pneumoniae, fueron predictores de mortalidad. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
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Abstract:Introduction: Gram-negative bacilli are the most commonly related to bacterial superinfection in critically ill patients with COVID-19. Multidrug resistance in ICUs, emerges as a medical challenge. Objective: To identify sociodemographic, epidemiological, clinical, microbiological and therapeutic factors associated with mortality, in patients superinfected by carbapenem-resistant gram-negative bacilli at El Tunal Hospital. Methods: An observational, analytic cross-sectional study was carried out in 150 critically ill patients infected by COVID-19, with superinfection by carbapenemresistant gran-negative bacilli CRGNB, from March 2020 to March 2022, the data were obtained from the clinical records of patients and the automated system Phoenix M50 that provided the isolations of CRGNB. The Regression of Cox was used to identify factors associated with the mortality, and Kaplan-Meier Curves, for analysis of survival. Results: The isolated microorganism with more frequency was K. Pneumoniae in 96 (64%) patients. One hundred patients died (66.6%). The survival after the beginning of superinfection at 7, 14 and 21 days was 83.1%; 60.4% and 48.7% respectively, the predictive variable of mortality were the TRR (OR = 3,3), the age (OR = 3.0), the microbiologic isolation of K. pneumoniae (OR = 3.2) and to require vasopresor support at the beginning of superinfection (OR = 6.7). Conclusions: The K. pneumoniae was associated with most of the infections. The Cox pattern of regression implied that; to require TRR and vasopresor support at the beginning of sobreinfection, advanced age, and infection by K. pneumoniae, were predictors of mortality. [ABSTRACT FROM AUTHOR]
ISSN:10293019