Diseño de un programa para el control de infecciones bacterianas en hogares de acogida.

Abstract

Older adults are a vulnerable population group that due to their physiological and bodily alterations typical of aging, the long periods of hospitalization to which they are subjected, the use of inadequate antibiotic treatments and the existing comorbidities, make them predisposed to suffer infectious diseases that lead to severe clinical pictures, sepsis and in many cases death (Esme et al., 2019). Therein lies the importance of knowing how infectious diseases affect this population group, and the risk of contagion that residents of foster homes possess. Objective To design a program for the control of bacterial infections in elderly residents of foster homes Methodology. The type of study was descriptive, cross-sectional with a mixed approach, the risk of infection of the subjects under study was determined, the microbiological analysis of urine, stool and sputum samples of the elderly was performed by urine culture, stool culture and sputum culture, to determine whether they presented bacterial development; In addition, the antibiogram test was performed to check if the isolated microorganisms presented resistance phenotypes. A survey was made to the personnel working in this institution to be aware of their knowledge about the care of the residents, and a program was developed for the control of bacterial infections in the Instituto Estupiñán foster home. Results. Of the 45 urines analyzed, 66.7% (30) showed no bacterial growth and 33.3% (15) showed bacterial growth. Among the group of microorganisms that grew, 15.5% were Escherichia coli, 4.4% Citrobacter freundii, 2.2% Pseudomonas aeruginosa and 2.2% Edwarsiella tarda. Among the group of Escherichia coli isolated, 9.0% presented the BLEE (extended spectrum beta-lactamase) resistance phenotype. The study of the 45 sputum samples established that 49.0% showed no bacterial growth, 28.9% developed normal flora, 8.9% showed coagulase-negative staphylococcus, 4.4% Escherichia coli, 2.2% Citrobacter freundii, 2.2% Klebsiella oxytoca and 4.4% Klebsiella pneumoniae BLEE (extended spectrum beta-lactamases). The 45 stool samples studied showed the development of normal intestinal flora. Based on the "Scale for measuring the risk of infection associated with adult care", 48.9% of the elderly in this study were at medium risk of suffering a bacterial disease, 35.6% at high risk and 15.6% at low risk. Conclusions. The xiv microbiological study of urine, sputum and stool samples of the residents of the Instituto Estupiñán foster home by means of culture and antibiogram, proved the presence of bacteria causing infections; and antibiotic resistance phenotypes. It was evidenced that, due to intrinsic factors, these individuals have a medium risk level of acquiring a bacterial infection. On the other hand, the knowledge of the personnel in charge of the care of older adults was assessed, and based on the information obtained, an infection control program for nursing homes was developed.