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Revista Cubana de Salud Pública

Print version ISSN 0864-3466On-line version ISSN 1561-3127

Abstract

ORTEGA GONZALEZ, Lilia María; DUQUE VIZCAINO, Milena; VALDES CASANOVA, Jesús  and  VERDASQUERA CORCHO, Denis. Severe sepsis in the intensive care unit of “Pedro Kourí” Tropical Medicine Institute. Rev Cubana Salud Pública [online]. 2018, vol.44, n.2, pp.213-223. ISSN 0864-3466.

Introduction:

The last decade shows an increase in the prevalence of severe sepsis by multidrug resistant microorganisms which represent an alert for governments and health systems in relation with multiresistance management.

Objective:

To identify the microorganisms that cause severe sepsis and sensitivity to the antimicrobials, as well as to relate the levels of C-reactive protein with the severe sepsis.

Methods:

A descriptive, cross-sectional study was carried out involving 30 patients diagnosed with severe sepsis and admitted in 2016 to the Intensive Care Unit of the Hospital in ´´ Pedro Kourí ´´ Tropical Medicine Institute.

Results:

The prevalence of severe sepsis was 24.8% mainly in male patients (71.1%) and with ages from 41 to 50 years old (40.0%). Pneumonias were the predominant primary source (43.3%), and infections caused by negative Gram germs were the most frequent. Microbiological isolates (pseudomonas and acinetobacterbaumannii) showed multidrug resistance including carbapenems and colistin, which suggests an indiscriminate and non-justified use of antibiotics in HIV inmunodepressed patients. It was demonstrated a relation between infection by negative Gram germs and elevated levels of C-reactive protein with the development of severe sepsis and unfavorable evolution. The increasing survival rate in patients with HIV showed a predisposition of them to infections caused by multidrug resistant germs.

Conclusions:

HIV positive patients have a predisposition to infections caused by multidrug resistant microorganisms. C-reactive protein is useful as a marker of severe sepsis in this kind of patients. Studies of this type show to health systems the need to develop strategies in short term for managing HIV patients and the severe sepsis caused by multidrug resistant microorganisms.

Keywords : Severe sepsis; HIV; immunodepression; causal microorganism.

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