MICROORGANISMOS CAUSANTES DE NEUMONÍA INTRAHOSPITALARIA POR VENTILACIÓN MECÁNICA EN LA UNIDAD DE CUIDADOS INTENSIVOS, SOLCA MANABÍ

Abstract

Nosocomial pneumonia is one of the most frequent infections presented by hospitalized patients, after 48 to 72 hours or more of the patient's admission and at the time of patient admission, it was not present or in the incubation period. The pneumonia associated with mechanical ventilation is defined as nosocomial pneumonia that develops after 48 hours of subjecting the patient to an intubation by ventilation and that was not present at the time of admission, presenting a higher morbidity, mortality, and prolongation of the hospital stay, the respiratory system is exposed in every breath to innumerable invading agents, however, thanks to these agents, only rarely, can be cause for infection. The majority of the studies that identify risk factors recognize among them as pathogenic mechanisms to the aspiration of oropharyngeal secretions, aspiration of gastrointestinal flora and inhalation of bacteria in aerosols, phenomena facilitating the arrival of pathogens to the lower respiratory tract, in the Bacterial resistance of the clinical impact in the treatment of nosocomial pneumonia is given by methicillin-resistant Staphylococcus spp. Enterococcus spp. multiresistant, including resistance to vancomycin, Staphylococcus aureus terror with decreased susceptibility to vancomycin, Gram-negative with resistance to cephalosporins of third generation and monolactams by production of extended-spectrum b-lactamases (BLEEs): Klebsiella spp, Enterobacter spp, Serratia spp among others Resistance of other Gram negative to b-lactams by the production of b-lactamases. The assessment of the initial Apache II as a predictor of mortality in patients ventilated worldwide has been done in clinical studies to evaluate the prognostic scales; The most accepted until now is APACHE II, because it has been shown to be reliable in the stratification of the severity of the clinical picture since for every 5 points of increase, mortality increases significantly. The APACHE II scale has been evaluated in different populations, for example, in patients with acute myocardial infarction, eclampsia, liver transplant, abdominal sepsis and cirrhosis, among others. A large group of respiratory diseases can cause ventilatory failure and sometimes requires the use of artificial mechanical ventilation (VMA). Mortality in this group of patients usually high, therefore, knows the prognosis of ventilated patients guarantees optimizing the resources available for their care and allows the individualization of medical assistance. The microorganisms found were Pseudomonas aeruginosa, Eschericha coli, Klebsiella pneumoniae, Serratia marcescens, Acenitobacter baumannii, Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus epidermidis, Streptococcus faecalis and some fungi such as C. albicans, C. tropicalies, C. no albicans and Asperguillus. Finding that the NAVM was caused in greater frequency by the presence of microorganisms such as A. baumanii, K. pneumoniae and S. marcenscens of which we could see that, both Gram Positive and Gram Negative, have presented a higher percentage of resistance to antibiotics tested. The resistance of some microorganisms included MRSA, ESBL and carbapenemase producers