[Prospective study of nosocomial infections in a medical ICU. A proposal for the generalized use of the National Nosocomial Infection Surveillance System rates]. / Estudio prospectivo de la infección nosocomial en una UCI médica. Una propuesta para el uso generalizado de las tasas del National Nosocomial Infection Surveillance System.

OBJECTIVE: To know the more relevant nosocomial infection (NI) rates in our Intensive Care Unit (ICU), risk factors associated with NI and trends in the infective flora. METHODS: During a three-month period, the cumulative incidence, density of overall incidence and device associated infection rates were determined in a total of 308 patients admitted to the medical ICU, following the recommendations of the National Nosocomial Infection Surveillance System (NNIS) in the USA. RESULTS: The cumulative incidence was 8.4 infections per 100 admissions. The density of overall incidence was 12.9 nosocomial infections per 1,000 days of ICU stay. Device-associated infection rates were: 28.9 pneumonia per 1,000 mechanical ventilation days, 5.3 urinary tract infections per 1,000 days of catheter use and 0.4 bacteremia per 1,000 days of central venous catheter. Pneumonia was the more common NI, followed by urinary tract infection. Pseudomonas aeruginosa was the microorganism recovered most frequently. The most common used antibiotics were third generation cephalosporins, followed by quinolones and macrolides. CONCLUSIONS: The use of NNIS rates is advisable because its allows to know the impact of NI on our unit and to perform comparative studies with other units of similar characteristics.

[The female sex is an independent prognostic factor for mortality in the acute phase of myocardial infarction]. / El sexo femenino es un factor pronóstico independiente de mortalidad en la fase aguda del infarto de miocardio.

BACKGROUND: To assess the effect of female gender on mortality after acute myocardial infarction (AMI), we studied a cohort of 876 consecutive patients, being women 253 of them (28.8%), admitted to the intensive Care Unit (ICU) because of a first AMI, from September 1992 to October 1995. PATIENTS AND METHODS: We compared the clinical characteristics, the complications and the treatment in both sexes. We estimated the relative risk using logistic regression, being the sex, the independent variable and dependent variables age, history of hypertension and diabetes, AMI location and thrombolytic treatment. RESULTS: The age was higher and the history of hypertension and diabetes more frequent. The AMI location was less often inferior. Women received fibrinolytic treatment less frequently in women than in men. The mortality in the ICU was higher in the women (29.2 vs. 13.5% in the men) and, after adjusting for the previous factors the relative risk was 1.51 (95% confidence internal of 1.01-2.26). CONCLUSIONS: In the population studied, the female gender is an independent risk factor for early mortality in the AMI.