Impacto clínico de la utilización del panel de PCR múltiple Filmarray para neumonía en pacientes hospitalizados en Unidad de Cuidados Intensivos con sospecha de neumonía

ilustraciones a color, diagramas

Autores:
Riaño Sánchez, Luisa Fernanda
Tipo de recurso:
Fecha de publicación:
2024
Institución:
Universidad Nacional de Colombia
Repositorio:
Universidad Nacional de Colombia
Idioma:
spa
OAI Identifier:
oai:repositorio.unal.edu.co:unal/85675
Acceso en línea:
https://repositorio.unal.edu.co/handle/unal/85675
https://repositorio.unal.edu.co/
Palabra clave:
610 - Medicina y salud::616 - Enfermedades
610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva pública
Neumonía - Diagnóstico
Reacción en Cadena de la Polimerasa
Programas de optimización del uso de los antimicrobianos
Infecciones por coronavirus
Pneumonia - Diagnosis
Polymerase Chain Reaction
Antimicrobial stewardship
Coronavirus infections
Neumonía
Diagnóstico
Reacción en cadena de la polimerasa múltiple
Unidades de cuidado intensivo
Programas de optimización de antimicrobianos
Pneumonia
Diagnosis
Multiplex polymerase chain reaction
Intensive care units
Antimicrobial stewardship
Unidades de Cuidados Intensivos
Intensive care unit
Rights
openAccess
License
Atribución-NoComercial-SinDerivadas 4.0 Internacional
id UNACIONAL2_cf149b0930bf03dfac336a1811686f73
oai_identifier_str oai:repositorio.unal.edu.co:unal/85675
network_acronym_str UNACIONAL2
network_name_str Universidad Nacional de Colombia
repository_id_str
dc.title.spa.fl_str_mv Impacto clínico de la utilización del panel de PCR múltiple Filmarray para neumonía en pacientes hospitalizados en Unidad de Cuidados Intensivos con sospecha de neumonía
dc.title.translated.eng.fl_str_mv Clinical impact of using multiplex PCR pneumonia panel Filmarray in critically ill patients with suspected pneumonia
title Impacto clínico de la utilización del panel de PCR múltiple Filmarray para neumonía en pacientes hospitalizados en Unidad de Cuidados Intensivos con sospecha de neumonía
spellingShingle Impacto clínico de la utilización del panel de PCR múltiple Filmarray para neumonía en pacientes hospitalizados en Unidad de Cuidados Intensivos con sospecha de neumonía
610 - Medicina y salud::616 - Enfermedades
610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva pública
Neumonía - Diagnóstico
Reacción en Cadena de la Polimerasa
Programas de optimización del uso de los antimicrobianos
Infecciones por coronavirus
Pneumonia - Diagnosis
Polymerase Chain Reaction
Antimicrobial stewardship
Coronavirus infections
Neumonía
Diagnóstico
Reacción en cadena de la polimerasa múltiple
Unidades de cuidado intensivo
Programas de optimización de antimicrobianos
Pneumonia
Diagnosis
Multiplex polymerase chain reaction
Intensive care units
Antimicrobial stewardship
Unidades de Cuidados Intensivos
Intensive care unit
title_short Impacto clínico de la utilización del panel de PCR múltiple Filmarray para neumonía en pacientes hospitalizados en Unidad de Cuidados Intensivos con sospecha de neumonía
title_full Impacto clínico de la utilización del panel de PCR múltiple Filmarray para neumonía en pacientes hospitalizados en Unidad de Cuidados Intensivos con sospecha de neumonía
title_fullStr Impacto clínico de la utilización del panel de PCR múltiple Filmarray para neumonía en pacientes hospitalizados en Unidad de Cuidados Intensivos con sospecha de neumonía
title_full_unstemmed Impacto clínico de la utilización del panel de PCR múltiple Filmarray para neumonía en pacientes hospitalizados en Unidad de Cuidados Intensivos con sospecha de neumonía
title_sort Impacto clínico de la utilización del panel de PCR múltiple Filmarray para neumonía en pacientes hospitalizados en Unidad de Cuidados Intensivos con sospecha de neumonía
dc.creator.fl_str_mv Riaño Sánchez, Luisa Fernanda
dc.contributor.advisor.spa.fl_str_mv Cortés Luna, Jorge Alberto
Álvarez Moreno, Carlos Arturo
dc.contributor.author.spa.fl_str_mv Riaño Sánchez, Luisa Fernanda
dc.contributor.researchgroup.spa.fl_str_mv Grupo de Investigacion en Enfermedades Infecciosas
dc.subject.ddc.spa.fl_str_mv 610 - Medicina y salud::616 - Enfermedades
610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva pública
topic 610 - Medicina y salud::616 - Enfermedades
610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva pública
Neumonía - Diagnóstico
Reacción en Cadena de la Polimerasa
Programas de optimización del uso de los antimicrobianos
Infecciones por coronavirus
Pneumonia - Diagnosis
Polymerase Chain Reaction
Antimicrobial stewardship
Coronavirus infections
Neumonía
Diagnóstico
Reacción en cadena de la polimerasa múltiple
Unidades de cuidado intensivo
Programas de optimización de antimicrobianos
Pneumonia
Diagnosis
Multiplex polymerase chain reaction
Intensive care units
Antimicrobial stewardship
Unidades de Cuidados Intensivos
Intensive care unit
dc.subject.decs.spa.fl_str_mv Neumonía - Diagnóstico
Reacción en Cadena de la Polimerasa
Programas de optimización del uso de los antimicrobianos
Infecciones por coronavirus
dc.subject.decs.eng.fl_str_mv Pneumonia - Diagnosis
Polymerase Chain Reaction
Antimicrobial stewardship
Coronavirus infections
dc.subject.proposal.spa.fl_str_mv Neumonía
Diagnóstico
Reacción en cadena de la polimerasa múltiple
Unidades de cuidado intensivo
Programas de optimización de antimicrobianos
dc.subject.proposal.eng.fl_str_mv Pneumonia
Diagnosis
Multiplex polymerase chain reaction
Intensive care units
Antimicrobial stewardship
dc.subject.umls.spa.fl_str_mv Unidades de Cuidados Intensivos
dc.subject.umls.eng.fl_str_mv Intensive care unit
description ilustraciones a color, diagramas
publishDate 2024
dc.date.accessioned.none.fl_str_mv 2024-02-09T15:40:32Z
dc.date.available.none.fl_str_mv 2024-02-09T15:40:32Z
dc.date.issued.none.fl_str_mv 2024-02-08
dc.type.spa.fl_str_mv Trabajo de grado - Especialidad Médica
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.content.spa.fl_str_mv Text
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TM
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv https://repositorio.unal.edu.co/handle/unal/85675
dc.identifier.instname.spa.fl_str_mv Universidad Nacional de Colombia
dc.identifier.reponame.spa.fl_str_mv Repositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourl.spa.fl_str_mv https://repositorio.unal.edu.co/
url https://repositorio.unal.edu.co/handle/unal/85675
https://repositorio.unal.edu.co/
identifier_str_mv Universidad Nacional de Colombia
Repositorio Institucional Universidad Nacional de Colombia
dc.language.iso.spa.fl_str_mv spa
language spa
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dc.publisher.spa.fl_str_mv Universidad Nacional de Colombia
dc.publisher.program.spa.fl_str_mv Bogotá - Medicina - Especialidad en Infectología
dc.publisher.faculty.spa.fl_str_mv Facultad de Medicina
dc.publisher.place.spa.fl_str_mv Bogotá, Colombia
dc.publisher.branch.spa.fl_str_mv Universidad Nacional de Colombia - Sede Bogotá
institution Universidad Nacional de Colombia
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spelling Atribución-NoComercial-SinDerivadas 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Cortés Luna, Jorge Alberto0c464a67eb12c6c3cc5db2876f58accdÁlvarez Moreno, Carlos Arturo86e050e03fd60ead574ecf8977c990b3600Riaño Sánchez, Luisa Fernanda9221169566ac1ad00a33b056d53a276eGrupo de Investigacion en Enfermedades Infecciosas2024-02-09T15:40:32Z2024-02-09T15:40:32Z2024-02-08https://repositorio.unal.edu.co/handle/unal/85675Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones a color, diagramasIntroducción: La neumonía es una causa frecuente de hospitalización. En pacientes en condición crítica, la identificación del agente podría permitir ajustes oportunos de antibióticos. El objetivo es evaluar si la realización del panel de PCR múltiple para neumonía en pacientes con neumonía en unidades de cuidado intensivo (UCI) tiene efecto sobre la mortalidad, estancia hospitalaria global y en UCI y duración de la terapia antimicrobiana. Materiales y métodos: Se realizó un estudio de cohorte retrospectiva de pacientes adultos con neumonía que requirieron UCI en 4 hospitales de Bogotá entre noviembre 2019 y junio 2023. Se evaluó mortalidad a 30 días, estancia hospitalaria y en UCI, duración de antibióticos y su asociación con la realización del panel PCR múltiple de neumonía (Filmarray), utilizando un puntaje de propensión y asignación de pesos para ajustar por covariables y potenciales confundidores. Resultados: Se incluyeron 304 pacientes, 150 expuestos y 154 no expuestos, con una edad media de 65,0 años (DE 14,6), 206 hombres (67.8%) y con una escala de Charlson promedio de 4.5 (DE 2.8). 186 (61.2%) presentaron COVID-19 y 256 (84.2%) tuvieron neumonía adquirida en comunidad. La estancia hospitalaria fue de 20.8 (DE 17.0) días, la de UCI 12.2 (DE 10.9) días, con un promedio de antibióticos de 2.7 (DE 1.7). No se encontró asociación entre la mortalidad a 30 días y la exposición HR 1.14 (IC 95% 0.76-1.70), aunque la valoración por infectología se relaciona con menor mortalidad HR 0.29 (IC 95% 0.19-0.45). Tampoco se encontró asociación entre la duración de antimicrobianos con la exposición IRRa 1.17 (IC 95% 0.90-1.54). Discusión: El uso del panel Filmarray neumonía en pacientes adultos críticamente enfermos no se relaciona con cambios en la mortalidad ni en la duración de antibióticos. Se requiere integrar este tipo de pruebas a los programas de optimización de antimicrobianos para contribuir a la toma de decisiones más racionales. (Texto tomado de la fuente)Introduction: Pneumonia is a frequent cause of hospitalization. In critically ill patients, identification of the pathogen may allow timely adjustment of antibiotics. The aim of the study was to assess whether performing a multiplex PCR pneumonia panel in patients with pneumonia in Intensive Care Units (ICU), has any effect on mortality, overall hospital stay, ICU stay and duration of antimicrobial therapy. Materials and methods: A retrospective cohort study was conducted on adult patients with pneumonia who required ICU admission in four institutions in Bogotá between November 2019 and June 2023. Mortality at 30-day, length of hospital and ICU stay, and duration of antibiotics, and their association with the performance of the multiplex PCR pneumonia panel (Filmarray) were evaluated using an inverse propensity of the treatment weighting to adjust for covariates and potential confounders. Results: 304 patients were included, 150 exposed, 154 non exposed. Mean age 65,0 years (DE 14,6), 206 males (67.8%) and mean Charlson index 4.5 (SD 2.8). 186 (61.2%) patients had COVID-19 pneumonia and 256 (84.2%) community acquired pneumonia. Length of hospital stay was 20.8 days (SD 17.0), ICU stay was 12.2 days (SD 10.9), total number of antibiotics administered was 2.73 (SD 1.74). No association was found between 30-day mortality and exposition HR 1.14 (CI 95% 0.76-1.70), although the assessment by infectious diseases specialist is associated with a lower mortality HR 0.29 (CI 95% 0.19-0.45). There was no association between exposure and antimicrobial therapy duration IRRa 1.17 (CI 95% 0.90-1.54). Discussion: The use of multiplex PCR pneumonia panel Filmarray is not associated with changes in mortality or duration of antimicrobial therapy. It is necessary to integrate this type of testing into antimicrobial stewardship programs to contribute to more rational decision-making.Convocatoria Nacional para el Fortalecimiento a través del apoyo a proyectos de investigación, creación artística o innovación de la Universidad Nacional de Colombia. 2022-2024. Código Hermes 57576, QUIPÚ 202010040463.Especialidades MédicasEspecialista en InfectologíaEstudio de cohorte retrospectiva de pacientes adultos con neumonía grave en Unidad de Cuidados Intensivos (UCI) entre noviembre de 2019 y junio de 2023 con el fin de analizar los desenlaces de mortalidad a 30 días, estancia hospitalaria y estancia en UCI y su asociación con la realización de una prueba de PCR múltiple panel de neumonía; utilizando un puntaje de propensión y asignación de pesos ajustados por covariables y potenciales confundidores para balancear las variables en la población.xvi, 54 páginasapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Medicina - Especialidad en InfectologíaFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede Bogotá610 - Medicina y salud::616 - Enfermedades610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva públicaNeumonía - DiagnósticoReacción en Cadena de la PolimerasaProgramas de optimización del uso de los antimicrobianosInfecciones por coronavirusPneumonia - DiagnosisPolymerase Chain ReactionAntimicrobial stewardshipCoronavirus infectionsNeumoníaDiagnósticoReacción en cadena de la polimerasa múltipleUnidades de cuidado intensivoProgramas de optimización de antimicrobianosPneumoniaDiagnosisMultiplex polymerase chain reactionIntensive care unitsAntimicrobial stewardshipUnidades de Cuidados IntensivosIntensive care unitImpacto clínico de la utilización del panel de PCR múltiple Filmarray para neumonía en pacientes hospitalizados en Unidad de Cuidados Intensivos con sospecha de neumoníaClinical impact of using multiplex PCR pneumonia panel Filmarray in critically ill patients with suspected pneumoniaTrabajo de grado - Especialidad Médicainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TMBogotá, Colombia1. 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