Prevalencia de asma en pacientes hospitalizados por neumonía asociada a infección por SARS-CoV-2

Antecedentes: La asociación el asma con la COVID-19 continúa siendo controversial. Objetivo: establecer la prevalencia de asma en una muestra de pacientes con neumonía asociada COVID-19; además, describir las características clínicas de los pacientes con asma en comparación con los pacientes sin asma. Métodos: Se analizaron los datos clínicos correspondientes a120 pacientes hospitalizados por neumonía asociada a infección por SARS-CoV-2. Los pacientes con y sin asma fueron comparados en función de la gravedad de la COVID-19. Resultados: La prevalencia de asma en los pacientes con neumonía por COVID-19 fue del 3.5% (IC 95%: 1.5% a 9.6%). Al comparar la gravedad de la COVID-19 entre los pacientes con asma con los pacientes sin asma, ésta no difirió en función de los síntomas, la comorbilidad, la duración de los síntomas, la necesidad de ventilación mecánica asistida, los biomarcadores de inflamación y la ocurrencia de muerte. Los pacientes con asma y COVID-19 mostraron un fenotipo T2 alto, con pobre función respiratoria y sin uso de tratamiento regular para el control del asma. Conclusiones: No se observaron diferencias significativas en la frecuencia de la ventilación mecánica asistida o de la muerte entre los pacientes hospitalizados por neumonía asociada con COVID-19 con y sin historia de asma. Palabras clave: asma; COVID-19; prevalencia; SARS-CoV-2

A case–control study of infections caused by Klebsiella pneumoniae producing New Delhi metallo-beta-lactamase-1: Predictors and outcomes

IntroductionInfections caused by antimicrobial-resistant bacteria are a significant cause of death worldwide, and carbapenemase-producing bacteria are the principal agents. New Delhi metallo-beta-lactamase-1 producing Klebsiella pneumoniae (KP-NDM-1) is an extensively drug-resistant bacterium that has been previously reported in Mexico. Our aim was to conduct a case–control study to describe the risk factors associated with nosocomial infections caused by K. pneumoniae producing NDM-1 in a tertiary-care hospital in Mexico.MethodsA retrospective case–control study with patients hospitalized from January 2012 to February 2018 at the Hospital Civil de Guadalajara “Fray Antonio Alcalde” was designed. During this period, 139 patients with a culture that was positive for K. pneumoniae NDM-1 (cases) and 486 patients hospitalized in the same department and on the same date as the cases (controls) were included. Data were analyzed using SPSS v. 24, and logistic regression analysis was conducted to calculate the risk factors for KP-NDM-1 infection.ResultsOne hundred and thirty-nine case patients with a KP-NDM-1 isolate and 486 control patients were analyzed. In the case group, acute renal failure was a significant comorbidity, hospitalization days were extended, and significantly more deaths occurred. In a multivariate analysis of risk factors, the independent variables included the previous use of antibiotics (odds ratio, OR = 12.252), the use of a urinary catheter (OR = 5.985), the use of a central venous catheter (OR = 5.518), the use of mechanical ventilation (OR = 3.459), and the length of intensive care unit (ICU) stay (OR = 2.334) as predictors of infection with NDM-1 K. pneumoniae.ConclusionIn this study, the previous use of antibiotics, the use of a urinary catheter, the use of a central venous catheter, the use of mechanical ventilation, and ICU stay were shown to be predictors of infection with NDM-1 K. pneumoniae and were independent risk factors for infection with NDM-1 K. pneumoniae