Keywords
Surgical Wound Infection
Mortality
Surgical Procedures
Surgical Wound
Mortality
Surgical Procedures
Surgical Wound
How to Cite
Andrade-Mendez, B. ., Ramos-Castaneda, J. A. ., Ruiz-García, M. del M. ., & Suaza-Calderón, E. . (2020). Factores asociados a letalidad en pacientes con infección de herida quirúrgica. Estudio de casos y controles. Duazary, 17(1), 27–35. https://doi.org/10.21676/2389783X.3219
Abstract
There is evidence of risk factors associated with surgical site infection (SSI), but there are no studies that have evaluated the factors associated with SSI lethality. We propose a study to determine factors associated with lethality in patients who developed an SSI. A nested case - control study was conducted in adult patients who developed SSI during the period 2015 - 2016 in a university hospital in the southern region of Colombia. The cases were patients with SSI who presented lethality within 30 days after the onset of infection, and the controls who did not die during the 30 days. 150 patients met the selection criteria. The cases (deceased) corresponded to 19.3%, leaving the group of controls (alive) with 80.7%. It was found that controlling the age and days of hospitalization prior to the surgical procedure, organ/space SSI was a factor associated with lethality in infected patients (OR = 2.5 95% CI 1.1 - 6.1). Lethality in patients with SSI was high and represents a public health problem due to the consequences that it causes to the patient and to the health system.References
1. Instituto Nacional de Salud, Ministerio de Salud. Protocolo de Vigilancia en Salud Pública. Infecciones Asociadas a Dispositivos. Bogotá: INS; 2014 [internet]. [Consultado 2018 Jun 20]. Disponible en: http://bvs.minsa.gob.pe/local/MINSA/3450.pdf
2. Organización Mundial de la Salud. Una atención más limpia es una atención más segura. Washington DC: WHO; 2015 [internet]. [Consultado 2018 Jun 20]. Disponible en: http://www.who.int/gpsc/background/es/
3. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36(5):309-32. Doi: https://doi.org/10.1016/j.ajic.2008.03.002
4. Centers for Diseases Control and Prevention. Others. Surgical Site Infection (SSI) Event. Atlanta: CDC; 2014. [internet]. [Consultado 2018 May 18]. Disponible en: http://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf
5. Ministerio de la Protección Social. Informe Nacional de Calidad de la Atención en Salud, 2015. Bogotá D.C.; 2015. [internet]. [Consultado 2018 Jun 20]. Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/informe-nal-calidad-atencion-salud-2015.pdf
6. Allegranzi B, Nejad SB, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. The Lancet. 2011;377(9761):228-41. Doi: http://doi.org/10.1016/S0140-6736(10)61458-4
7. Fierro JD, Naranjo MA, Cabrera C, Ramos JA. Caracterización epidemiológica de las infecciones asociadas a la atención en salud en una IPS privada. Neiva 2013. Rev Fac Salud-RFS. 2016;7(2):29-34. Doi: http://doi.org/10.25054/rfs.v7i2.952
8. González L, Toledo S, Parra Y, Santofimio D, Osorio J, Ramos J. Infecciones intrahospitalarias en servicios de medicina interna y cirugía del Hospital Universitario de Neiva, 2012. RFS. 2015;5(2):27-33. Doi: http://doi.org/10.25054/rfs.v5i2.139
9. Lemos EV, Fernando P, Alvis N, Quevedo E, Einarson TR, Castañeda C, et al. Costos en pacientes con infección por Acinetobacter baumannii en Colombia. Infectio. 2013;17(4):185-192. [internet]. [Consultado 2018 Jun 20]. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0123-93922013000400004
10. Laloto TL, Gemeda DH, Abdella SH. Incidence and predictors of surgical site infection in Ethiopia: prospective cohort. BMC Infect Dis. 2017;17(1):119. Doi: http://dx.doi.org/10.1186/s12879-016-2167-x.
11. Hawser SP, Bouchillon SK, Lascols C, Hackel M, Hoban DJ, Badal RE, et al. Susceptibility of Klebsiella pneumoniae isolates from intra-abdominal infections and molecular characterization of ertapenem-resistant isolates. Antimicrob Agents Chemother. 2011;55(8):3917-21. Doi: http://dx.doi.org/10.1128/AAC.00070-11.
12. Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Multistate point-prevalence survey of health care–associated infections. N Engl J Med. 2014;370(13):1198-208. Doi: http://dx.doi.org/10.1056/NEJMoa1306801
13. Isik O, Kaya E, Dundar HZ, Sarkut P. Surgical Site Infection: Re-assessment of the Risk Factors. Chirurgia. 2015;110(5):457-461. [internet]. [Consultado 2018 May 18]. Disponible en: http://revistachirurgia.ro/pdfs/2015-5-457.pdf
14. Khan M, Rooh-ul-Muqim ZM, Khalil J, Salman M. Influence of ASA score and Charlson Comorbidity Index on the surgical site infection rates. J Coll Physicians Surg Pak. 2010;20(506):e509. Doi: http://dx.doi.org/08.2010/JCPSP.506509.
15. Chen LF, Kaye D. Current use for old antibacterial agents: polymyxins, rifamycins, and aminoglycosides. Infect Dis Clin North Am. 2009;23(4):1053-75. Doi: http://dx.doi.org/10.1016/j.idc.2009.06.004
16. Allegranzi B, Zayed B, Bischoff P, Kubilay NZ, Jonge S de, Vries F de, et al. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis. 2016;3099(16)30402-9. Doi: http://dx.doi.org/10.1016/S1473-3099(16)30402-9
17. Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the Proportion of Healthcare-Associated Infections That Are Reasonably Preventable and the Related Mortality and Costs. Infect Control Amp Hosp Epidemiol. 2011;32(2):101-14. Doi: http://dx.doi.org/ 10.1086/657912.
18. Horasan ES, Dağ A, Ersoz G, Kaya A. Surgical site infections and mortality in elderly patients. Med Mal Infect. 2013;43(10):417-22. Doi: http://dx.doi.org/10.1016/j.medmal.2013.07.009.
19. Ferreira FL, Bota DP, Bross A, Mélot C, Vincent J-L. Serial evaluation of the SOFA score to predict outcome in critically ill patients. Jama. 2001;286(14):1754-8. Doi: http://dx.doi.org/10.1001/jama.286.14.1754
20. González et al. Infecciones intrahospitalarias en servicios de medicina interna y cirugía del Hospital Universitario de Neiva, 2012. Rev Fac Salud-RFS. 2015;5(2):27-33. Doi: http://doi.org/10.25054/rfs.v5i2.139
21. R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2008 [internet]. [Consultado 2017 Sep 12]. Disponible en: http://softlibre.unizar.es/manuales/aplicaciones/r/fullrefman.pdf
22. Engemann JJ, Carmeli Y, Cosgrove SE, Fowler VG, Bronstein MZ, Trivette SL, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis. 2003;36(5):592-8. Doi: http://doi.org /10.1086/367653
23. Anderson DJ, Podgorny K, Berríos-Torres SI, Bratzler DW, Dellinger EP, Greene L, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(S2):S66-88. Doi: http://doi.org/10.1086/676022
24. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Committee HICPA, et al. Guideline for prevention of surgical site infection, 1999. Am J Infect Control. 1999;27(2):97-134. Doi: http://doi.org/10.1016/S0196-6553(99)70088-X
25. Raymond DP, Pelletier SJ, Crabtree TD, Schulman AM. Surgical infection and the aging population/Discussion. Am Surg. 2001;67(9):827. [internet]. [Consultado 2017 Sep 12]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/11565758
26. Kaye KS, Anderson DJ, Sloane R, Chen LF, Choi Y, Link K, et al. The Effect of Surgical Site Infection on Older Operative Patients. J Am Geriatr Soc. 2009;57(1):46-54. Doi: http://doi.org/10.1111/j.1532-5415.2008.02053.x.
27. Londoño Á, Morales J, Murilla M. Características epidemiológicas y factores de riesgo relacionados con la infección en el sitio operatorio en procedimientos de cirugía general. Rev Chil Cir. 2011;63(6):559-565. Doi: http://doi.org/10.4067/S0718-40262011000600003
28. Kaye KS, Schmit K, Pieper C, Sloane R, Caughlan KF, Sexton DJ, et al. The effect of increasing age on the risk of surgical site infection. J Infect Dis. 2005;191(7):1056-62. Doi: http://doi.org/10.1086/428626
29. Despaigne Alba I, Rodríguez Fernández Z, Pascual Bestard M, Lozada Prado GA, Mustelier Ferrer HL. Consideraciones actuales sobre las infecciones posoperatorias. Medisan. 2013;17(4):686-707. [internet]. [Consultado 2018 May 18]. Disponible en: http://scielo.sld.cu/pdf/san/v17n4/san16413.pdf
30. Fajardo Rodríguez HA, Quemba Gordillo J, Eslava Schmalbach J. Escalas de predicción e infección de sitio quirúrgico en 15 625 cirugías 2001-2003. Rev Salud Pública. 2005;7(1):89-98. [internet]. [Consultado 2017 Sep 10]. Disponible en: http://www.scielo.org.co/pdf/rsap/v7n1/v7n1a7.pdf
31. National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) system report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004;32:470-85. Doi: http://doi.org/10.1016/j.ajic.2004.10.001
32. Emori TG, Culver DH, Horan TC, Jarvis WR, White JW, Olson DR, et al. National nosocomial infections surveillance system (NNIS): Description of surveillance methods. Am J Infect Control. 1991;19(1):19-35. Doi: http://doi.org/10.1016/0196-6553(91)90157-8
33. Daabiss M. American Society of Anaesthesiologists physical status classification. Indian J Anaesth. 2011;55(2):111-5. Doi: http://doi.org/10.4103/0019-5049.79879
34. Tang R, Chen HH, Wang YL, Changchien CR, Chen J-S, Hsu K-C, et al. Risk Factors For Surgical Site Infection After Elective Resection of the Colon and Rectum: A Single-Center Prospective Study of 2,809 Consecutive Patients. Ann Surg. 2001;234(2):181-9. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1422004/
35. Ridgeway S, Wilson J, Charlet A, Kafatos G, Pearson A, Coello R. Infection of the surgical site after arthroplasty of the hip. Bone Jt J. 2005;87-B(6):844-50. Doi: http://doi.org/10.1302/0301-620X.87B6.15121
36. López Tagle D, Hernández Ferrer M, Saldivar Arias T, Sotolongo Hernández T, Valdés Dupeyrón O. Infección de la herida quirúrgica: Aspectos epidemiológicos. Rev Cuba Med Mil. 2007;36(2):0-0. [internet]. [Consultado 2018 Mar 22]. Disponible en: http://scielo.sld.cu/pdf/mil/v36n2/mil08207.pdf
37. Clara L, Stern L, Barcán L, Marchetti M, Greco G. Mediastinitis post-quirúrgica: Estudio caso - control. Rev Chil Infectol. 2002;19(1):37-48. Doi: http://dx.doi.org/10.4067/S0716-10182002000100006
38. Ramos-Castañeda JA, Ruano-Ravina A, Barbosa-Lorenzo R, Paillier-Gonzalez JE, Saldaña-Campos JC, Salinas DF, et al. Mortality due to KPC carbapenemase-producing Klebsiella pneumoniae infections: Systematic review and meta-analysis: Mortality due to KPC Klebsiella pneumoniae infections. J Infect. 2018;76(5):438-448 Doi: http://doi.org/10.1016/j.jinf.2018.02.007
39. Osorio J, Barreto J, Samboni CF, Cándelo LA, Álvarez LC, Benavidez S, et al. Factores asociados a nefrotoxicidad por polimixina B en un hospital universitario de Neiva, Colombia. 2011-2015. Rev Chil Infectol. 2017;34(1):7-13. Doi: http://dx.doi.org/10.4067/S0716-10182017000100001
40. Rodríguez Fernández Z, Wendy G, Tamayo M, Elmer M, García R, Ibrahim L, et al. Mortalidad y reintervenciones en cirugía general. MEDISAN. 2012;16(11):1676-89. [internet]. [Consultado 2018 Jun 20]. Disponible en: http://scielo.sld.cu/pdf/san/v16n11/san041112.pdf
41. Rodríguez Fernández Z, Fernández López O, Romero García LI. Factores asociados a la mortalidad por infecciones posoperatorias. Rev Cuba Cir. 2016;55(2). [internet]. [Consultado 2018 May 16]. Disponible en: http://scielo.sld.cu/pdf/cir/v55n2/cir04216.pdf
2. Organización Mundial de la Salud. Una atención más limpia es una atención más segura. Washington DC: WHO; 2015 [internet]. [Consultado 2018 Jun 20]. Disponible en: http://www.who.int/gpsc/background/es/
3. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36(5):309-32. Doi: https://doi.org/10.1016/j.ajic.2008.03.002
4. Centers for Diseases Control and Prevention. Others. Surgical Site Infection (SSI) Event. Atlanta: CDC; 2014. [internet]. [Consultado 2018 May 18]. Disponible en: http://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf
5. Ministerio de la Protección Social. Informe Nacional de Calidad de la Atención en Salud, 2015. Bogotá D.C.; 2015. [internet]. [Consultado 2018 Jun 20]. Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/informe-nal-calidad-atencion-salud-2015.pdf
6. Allegranzi B, Nejad SB, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. The Lancet. 2011;377(9761):228-41. Doi: http://doi.org/10.1016/S0140-6736(10)61458-4
7. Fierro JD, Naranjo MA, Cabrera C, Ramos JA. Caracterización epidemiológica de las infecciones asociadas a la atención en salud en una IPS privada. Neiva 2013. Rev Fac Salud-RFS. 2016;7(2):29-34. Doi: http://doi.org/10.25054/rfs.v7i2.952
8. González L, Toledo S, Parra Y, Santofimio D, Osorio J, Ramos J. Infecciones intrahospitalarias en servicios de medicina interna y cirugía del Hospital Universitario de Neiva, 2012. RFS. 2015;5(2):27-33. Doi: http://doi.org/10.25054/rfs.v5i2.139
9. Lemos EV, Fernando P, Alvis N, Quevedo E, Einarson TR, Castañeda C, et al. Costos en pacientes con infección por Acinetobacter baumannii en Colombia. Infectio. 2013;17(4):185-192. [internet]. [Consultado 2018 Jun 20]. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0123-93922013000400004
10. Laloto TL, Gemeda DH, Abdella SH. Incidence and predictors of surgical site infection in Ethiopia: prospective cohort. BMC Infect Dis. 2017;17(1):119. Doi: http://dx.doi.org/10.1186/s12879-016-2167-x.
11. Hawser SP, Bouchillon SK, Lascols C, Hackel M, Hoban DJ, Badal RE, et al. Susceptibility of Klebsiella pneumoniae isolates from intra-abdominal infections and molecular characterization of ertapenem-resistant isolates. Antimicrob Agents Chemother. 2011;55(8):3917-21. Doi: http://dx.doi.org/10.1128/AAC.00070-11.
12. Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Multistate point-prevalence survey of health care–associated infections. N Engl J Med. 2014;370(13):1198-208. Doi: http://dx.doi.org/10.1056/NEJMoa1306801
13. Isik O, Kaya E, Dundar HZ, Sarkut P. Surgical Site Infection: Re-assessment of the Risk Factors. Chirurgia. 2015;110(5):457-461. [internet]. [Consultado 2018 May 18]. Disponible en: http://revistachirurgia.ro/pdfs/2015-5-457.pdf
14. Khan M, Rooh-ul-Muqim ZM, Khalil J, Salman M. Influence of ASA score and Charlson Comorbidity Index on the surgical site infection rates. J Coll Physicians Surg Pak. 2010;20(506):e509. Doi: http://dx.doi.org/08.2010/JCPSP.506509.
15. Chen LF, Kaye D. Current use for old antibacterial agents: polymyxins, rifamycins, and aminoglycosides. Infect Dis Clin North Am. 2009;23(4):1053-75. Doi: http://dx.doi.org/10.1016/j.idc.2009.06.004
16. Allegranzi B, Zayed B, Bischoff P, Kubilay NZ, Jonge S de, Vries F de, et al. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis. 2016;3099(16)30402-9. Doi: http://dx.doi.org/10.1016/S1473-3099(16)30402-9
17. Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the Proportion of Healthcare-Associated Infections That Are Reasonably Preventable and the Related Mortality and Costs. Infect Control Amp Hosp Epidemiol. 2011;32(2):101-14. Doi: http://dx.doi.org/ 10.1086/657912.
18. Horasan ES, Dağ A, Ersoz G, Kaya A. Surgical site infections and mortality in elderly patients. Med Mal Infect. 2013;43(10):417-22. Doi: http://dx.doi.org/10.1016/j.medmal.2013.07.009.
19. Ferreira FL, Bota DP, Bross A, Mélot C, Vincent J-L. Serial evaluation of the SOFA score to predict outcome in critically ill patients. Jama. 2001;286(14):1754-8. Doi: http://dx.doi.org/10.1001/jama.286.14.1754
20. González et al. Infecciones intrahospitalarias en servicios de medicina interna y cirugía del Hospital Universitario de Neiva, 2012. Rev Fac Salud-RFS. 2015;5(2):27-33. Doi: http://doi.org/10.25054/rfs.v5i2.139
21. R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2008 [internet]. [Consultado 2017 Sep 12]. Disponible en: http://softlibre.unizar.es/manuales/aplicaciones/r/fullrefman.pdf
22. Engemann JJ, Carmeli Y, Cosgrove SE, Fowler VG, Bronstein MZ, Trivette SL, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis. 2003;36(5):592-8. Doi: http://doi.org /10.1086/367653
23. Anderson DJ, Podgorny K, Berríos-Torres SI, Bratzler DW, Dellinger EP, Greene L, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(S2):S66-88. Doi: http://doi.org/10.1086/676022
24. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Committee HICPA, et al. Guideline for prevention of surgical site infection, 1999. Am J Infect Control. 1999;27(2):97-134. Doi: http://doi.org/10.1016/S0196-6553(99)70088-X
25. Raymond DP, Pelletier SJ, Crabtree TD, Schulman AM. Surgical infection and the aging population/Discussion. Am Surg. 2001;67(9):827. [internet]. [Consultado 2017 Sep 12]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/11565758
26. Kaye KS, Anderson DJ, Sloane R, Chen LF, Choi Y, Link K, et al. The Effect of Surgical Site Infection on Older Operative Patients. J Am Geriatr Soc. 2009;57(1):46-54. Doi: http://doi.org/10.1111/j.1532-5415.2008.02053.x.
27. Londoño Á, Morales J, Murilla M. Características epidemiológicas y factores de riesgo relacionados con la infección en el sitio operatorio en procedimientos de cirugía general. Rev Chil Cir. 2011;63(6):559-565. Doi: http://doi.org/10.4067/S0718-40262011000600003
28. Kaye KS, Schmit K, Pieper C, Sloane R, Caughlan KF, Sexton DJ, et al. The effect of increasing age on the risk of surgical site infection. J Infect Dis. 2005;191(7):1056-62. Doi: http://doi.org/10.1086/428626
29. Despaigne Alba I, Rodríguez Fernández Z, Pascual Bestard M, Lozada Prado GA, Mustelier Ferrer HL. Consideraciones actuales sobre las infecciones posoperatorias. Medisan. 2013;17(4):686-707. [internet]. [Consultado 2018 May 18]. Disponible en: http://scielo.sld.cu/pdf/san/v17n4/san16413.pdf
30. Fajardo Rodríguez HA, Quemba Gordillo J, Eslava Schmalbach J. Escalas de predicción e infección de sitio quirúrgico en 15 625 cirugías 2001-2003. Rev Salud Pública. 2005;7(1):89-98. [internet]. [Consultado 2017 Sep 10]. Disponible en: http://www.scielo.org.co/pdf/rsap/v7n1/v7n1a7.pdf
31. National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) system report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004;32:470-85. Doi: http://doi.org/10.1016/j.ajic.2004.10.001
32. Emori TG, Culver DH, Horan TC, Jarvis WR, White JW, Olson DR, et al. National nosocomial infections surveillance system (NNIS): Description of surveillance methods. Am J Infect Control. 1991;19(1):19-35. Doi: http://doi.org/10.1016/0196-6553(91)90157-8
33. Daabiss M. American Society of Anaesthesiologists physical status classification. Indian J Anaesth. 2011;55(2):111-5. Doi: http://doi.org/10.4103/0019-5049.79879
34. Tang R, Chen HH, Wang YL, Changchien CR, Chen J-S, Hsu K-C, et al. Risk Factors For Surgical Site Infection After Elective Resection of the Colon and Rectum: A Single-Center Prospective Study of 2,809 Consecutive Patients. Ann Surg. 2001;234(2):181-9. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1422004/
35. Ridgeway S, Wilson J, Charlet A, Kafatos G, Pearson A, Coello R. Infection of the surgical site after arthroplasty of the hip. Bone Jt J. 2005;87-B(6):844-50. Doi: http://doi.org/10.1302/0301-620X.87B6.15121
36. López Tagle D, Hernández Ferrer M, Saldivar Arias T, Sotolongo Hernández T, Valdés Dupeyrón O. Infección de la herida quirúrgica: Aspectos epidemiológicos. Rev Cuba Med Mil. 2007;36(2):0-0. [internet]. [Consultado 2018 Mar 22]. Disponible en: http://scielo.sld.cu/pdf/mil/v36n2/mil08207.pdf
37. Clara L, Stern L, Barcán L, Marchetti M, Greco G. Mediastinitis post-quirúrgica: Estudio caso - control. Rev Chil Infectol. 2002;19(1):37-48. Doi: http://dx.doi.org/10.4067/S0716-10182002000100006
38. Ramos-Castañeda JA, Ruano-Ravina A, Barbosa-Lorenzo R, Paillier-Gonzalez JE, Saldaña-Campos JC, Salinas DF, et al. Mortality due to KPC carbapenemase-producing Klebsiella pneumoniae infections: Systematic review and meta-analysis: Mortality due to KPC Klebsiella pneumoniae infections. J Infect. 2018;76(5):438-448 Doi: http://doi.org/10.1016/j.jinf.2018.02.007
39. Osorio J, Barreto J, Samboni CF, Cándelo LA, Álvarez LC, Benavidez S, et al. Factores asociados a nefrotoxicidad por polimixina B en un hospital universitario de Neiva, Colombia. 2011-2015. Rev Chil Infectol. 2017;34(1):7-13. Doi: http://dx.doi.org/10.4067/S0716-10182017000100001
40. Rodríguez Fernández Z, Wendy G, Tamayo M, Elmer M, García R, Ibrahim L, et al. Mortalidad y reintervenciones en cirugía general. MEDISAN. 2012;16(11):1676-89. [internet]. [Consultado 2018 Jun 20]. Disponible en: http://scielo.sld.cu/pdf/san/v16n11/san041112.pdf
41. Rodríguez Fernández Z, Fernández López O, Romero García LI. Factores asociados a la mortalidad por infecciones posoperatorias. Rev Cuba Cir. 2016;55(2). [internet]. [Consultado 2018 May 16]. Disponible en: http://scielo.sld.cu/pdf/cir/v55n2/cir04216.pdf
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