Revision sistemática: Factores asociados a colonización e infección por bacterias gram negativas resistentes a carbapenemicos
Bibliographic record
Abstract
INTRODUCCION: Los carbapenemicos (CP) son una de las ultimas lineas de tratamiento para infecciones por microorganismos multirresistentes (MDR), especialmente Gram-negativos productores de betalactamasas de espectro extendido. Es creciente la preocupacion a nivel mundial por el aumento de aislamientos resistentes a CP, en EEUU hasta 60% de las infecciones nosocomiales son causadas por bacterias MDR. En la Union Europea, cerca de 25.000 pacientes mueren anualmente por esta causa. En Latinoamerica hay una tendencia creciente en las tasas de resistencia.OBJETIVO: Identificar y describir factores protectores o de riesgo, relacionados con colonizacion o infeccion por Gram negativos resistentes a CP en pacientes adultos hospitalizados, mediante una revision sistematica de la literatura.METODOS: Revision sistematica de literatura, busqueda de estudios observacionales analiticos en las bases de datos PubMed, Embase, Scopus, BVS, Scielo y busqueda de literatura gris, publicados desde el 01/01/2004 al 15/04/2015. Se evaluo la calidad de los estudios con escala Newcastle-Ottawa y FLC Osteba. RESULTADOS: Se seleccionaron 36 estudios de alta calidad, diseno de casos y controles. Los factores de riesgo estadisticamente significativos observados son estancia en UCI OR:36.46, insuficiencia renal aguda OR:6.23, dialisis OR:10.80 ventilacion mecanica OR:17.5, cateterismo vesical OR:14.3, uso de carbapenemicos OR:18,52,quinolonas OR17.30, cefepime OR:28.05, glicopeptidos OR:19.1; metronidazol OR:4.17, p:0.03, colistina OR:12.1, linezolid OR:7 CONCLUSION: Pese a que hay alta heterogeneidad en las variables incluidas en los estudios, se encontro que los factores de riesgo principales para adquirir GNR-CP en pacientes hospitalizados son: antecedente de insuficiencia renal aguda y dialisis, ventilacion mecanica, cateterismo vesical, estancia en UCI y uso previo de antibioticos carbapenemicos, quinolonas, cefepime, glicopeptidos, metronidazol, linezolid y colistina. No se hallaron factores protectores. factores de riesgo
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.052 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.024 | 0.019 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".