Objetivo. Describir la evolución clínica de personas con insuficiencia renal crónica (IRC) del Instituto salvadoreño del seguro social (ISSS). Tipo de investigación. Transversal multivariado de fuentes secundarias, muestra: 375 personas (Conf.95, alfa 5%), recolección y procesamiento: EXCEL y STATA 14.0. Resultados. Hombres: 65.3%, edad: 57 +/- 17, 68.5% mayores de 50 años, 23.7% adolecían de hipertensión arterial (HTA) 16% diabetes mellitus (DM) y 8.8% cardiopatías crónicas, la proporción de muerte fue de 21.8%, causas directas de muerte: Insuficiencia Renal Crónica (IRC):63.6%, infecciones: 14%, eventos cardiovasculares: 10.9%, años de vida potencial perdidos (AVPP) generados: 877 (60.5% por hombres). El 50.1% presentaba IRC desde primer egreso, supervivencia: 1 año: 93% y 71% a 10 años, comorbidos: HTA (Log Rank/p): 12.3/0.0005, DM: 4.9/0.027 (juntos: 16.6/0.0008), Enfermedad pulmonar obstructiva crónica (EPOC): 6.45/0.011, edad > 50 años: 5.45/0.019 y más de 2 comorbilidades:14.26/0.0065. Riesgo de muerte se incrementó por EPOC (HR/IC95%/p): 3.92/1.23-12.6/0.055, HTA: 2.16/1.38-3.38/0.0012, DM: 1.79/1.05-3.07/0.0043 y edad > 50 años: 1.83/1.1-3.09/0.016. Conclusiones. IRC afectó más a hombres mayores de 50 años, también generaron la mayoría de AVPP, etiología principal HTA, DM y cardiopatías crónicas, principal causa directa de muerte, la mitad de personas ya presentaban IRC desde su primer egreso, un 71% sobrevivió 10 años, la mortalidad de IRC con HTA, DM, EPOC y edad > 50 años es mayor que al no presentarlos e incrementan el riesgo de morir. Alerta Año 2018, Vol. 1 No. 2: 37-44 Palabras clave. Insuficiencia Renal Crónica, supervivencia, diálisis, Epidemiología, comorbilidades.
Objective. To determine which are the bacteria most frequently isolated in the cultures of greater demand in general hospitalization of the Salvadoran Social Security Institute facilities (ISSS) between 2010 and 2017. Methodology. Quantitative, retrospective study on bacterial isolates of greater hospital cultures demand, contents in the ISSS bacteriology archives. Results. 79 693 culture reports generated between 2010 and 2017 in the 10 ISSS hospitals were reviewed, 58.5% (46 681 cultures) were suitable for analysis, mainly 39.9% urine, 17.5% blood, 15.5% abscess, lower respiratory tract 8.4% and surgical wound infections 2.7%. In 54.8%, enterobacteria, coagulasepositive staphylococci in 20.0%, and non-fermenting Gram-negative bacilliin 14.2% were the most common finding, according to nosological entity Staphylococcus aureus (SAU) predominated in bacteremias, abscesses, diabetic foot infections and catheter related infections, Klebsiella pneumoniae (KPN) in lower airway, Pseudomona aeruginosa (PAE) in pressure ulcers, Streptococcus agalactiae (SGA) in female reproductive infection and for the rest Escherichia coli (ECO) prevailed. Conclusion. The proportion of positivity obtained in cultures in hospitalization wards was around 60%, the main demand was for urinary infections, septicemias or bacteremia and abscesses evaluation, Gramnegative enterobacteria, mainly Escherichia coli and Klebsiella pneumoniae and coagulase positive cocci, mainly Staphylococcus aureus and epidermidis and non-fermenters like Pseudomona aeruginosa were the most common findings.
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