<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0123-9392</journal-id>
<journal-title><![CDATA[Infectio]]></journal-title>
<abbrev-journal-title><![CDATA[Infect.]]></abbrev-journal-title>
<issn>0123-9392</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Infectología.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0123-93922017000200074</article-id>
<article-id pub-id-type="doi">10.22354/in.v21i2.650</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Traqueobronquitis y neumonía asociadas a ventilación mecánica en unidades de cuidado intensivo de Latinoamérica: epidemiología, curso clínico y desenlaces (Estudio LATINAVE)]]></article-title>
<article-title xml:lang="en"><![CDATA[Epidemiology, clinical evolution and outcomes of tracheobronchitis and pneumonia associated with mechanical ventilation in intensive care units of Latin America (LATINAVE study)]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Varón-Vega]]></surname>
<given-names><![CDATA[Fabio Andrés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Parra]]></surname>
<given-names><![CDATA[Ángela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Molina]]></surname>
<given-names><![CDATA[Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Poveda]]></surname>
<given-names><![CDATA[Claudia Marcela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Meza]]></surname>
<given-names><![CDATA[Rafael Arturo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro]]></surname>
<given-names><![CDATA[Heidi]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vergara]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mayorga]]></surname>
<given-names><![CDATA[Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cepeda]]></surname>
<given-names><![CDATA[Ernesto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vega-Barrientos]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pareja]]></surname>
<given-names><![CDATA[Massimo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Urbina]]></surname>
<given-names><![CDATA[Zulma]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mercado]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Pino]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Camargo]]></surname>
<given-names><![CDATA[Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alí-Munive]]></surname>
<given-names><![CDATA[Abraham]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Fundación Neumológica Colombiana  ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Clínica Universitaria Bolivariana  ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Clínica Abood Shaio  ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Santa Clara  ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Clínica del Rosario  ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Hospital Luis Vernaza  ]]></institution>
<addr-line><![CDATA[Guayaquil ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Hospital Central de la Fuerza Aérea del Perú  ]]></institution>
<addr-line><![CDATA[Lima ]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Hospital Universitario de Los Andes  ]]></institution>
<addr-line><![CDATA[Mérida ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,Hospital Regional PEMEX  ]]></institution>
<addr-line><![CDATA[México ]]></addr-line>
<country>México</country>
</aff>
<aff id="A10">
<institution><![CDATA[,INER, Instituto Nacional de Enfermedades Respiratorias de México  ]]></institution>
<addr-line><![CDATA[México ]]></addr-line>
<country>México</country>
</aff>
<aff id="A11">
<institution><![CDATA[,Clínica Aman  ]]></institution>
<addr-line><![CDATA[Manizales ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="A12">
<institution><![CDATA[,Hospital Universitario Erasmo Meoz  ]]></institution>
<addr-line><![CDATA[Cúcuta ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="A13">
<institution><![CDATA[,Clínica de los Olivos  ]]></institution>
<addr-line><![CDATA[Cochabamba ]]></addr-line>
<country>Bolivia</country>
</aff>
<aff id="A14">
<institution><![CDATA[,Policlínica Metropolitana  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="A15">
<institution><![CDATA[,IMSS Centro Médico Nacional La Raza Hospital General Dr. Gaudencio González Garza]]></institution>
<addr-line><![CDATA[México ]]></addr-line>
<country>México</country>
</aff>
<aff id="A16">
<institution><![CDATA[,Clínica Zayma  ]]></institution>
<addr-line><![CDATA[Montería ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<volume>21</volume>
<numero>2</numero>
<fpage>74</fpage>
<lpage>80</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0123-93922017000200074&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0123-93922017000200074&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0123-93922017000200074&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción:  Las infecciones asociadas a ventilación mecánica son causa importante de morbimortalidad en el paciente crítico. La diferenciación entre traqueobronquitis y neumonía no es siempre fácil, y es controvertida. Algunos trabajos describen aumento de mortalidad, mayor estancia en Unidades de Cuidado Intensivo (UCI), mayor requerimiento de ventilación mecánica e incremento de costos en pacientes con traqueobronquitis asociada a ventilador (TAV), sin diferencias significativas en pacientes con neumonía asociada a ventilador (NAV). Estos estudios no describen el comportamiento clínico y epidemiológico de la TAV y la NAV como 2 entidades independientes, por lo que es necesario describirlo.  Métodos:  Estudio multicéntrico de cohorte prospectiva, de pacientes adultos que desarrollaron TAV o NAV durante su estancia en UCI, entre noviembre de 2013 y octubre de 2014. A cada una de las variables demográficas, clínicas, de laboratorio y de desenlace, como tiempo de ventilación mecánica, estancia hospitalaria y muerte, se le realizó análisis descriptivo; para evaluar las diferencias entre los grupos se utilizó test de chi cuadrado, t de Student o U de Mann Whitney.  Resultados:  Se incluyó a 143 pacientes, con edad promedio de 55 años, 57% eran hombres, de 6 países en Latinoamérica; 63% con NAV y 37% con TAV. Las comorbilidades más frecuentes fueron cardiovascular (44%) y neurológica (30%); esta última fue más frecuente en TAV (41,5 vs. 23%; p = 0,02). No se encontró diferencia en APACHE II de ingreso. El índice SOFA fue mayor en NAV (8 vs. 5; p = 0,02). No hubo diferencias en el aislamiento microbiológico, ni en los patrones de resistencia bacteriana entre las 2 entidades. Se observó mayor número de complicaciones cardiovasculares y SDRA en pacientes con NAV. No se encontró diferencia entre los 2 grupos en estancia en UCI, los días de ventilación mecánica ni en mortalidad.  Conclusiones:  La prevalencia de TAV fue mayor a lo descrito hasta ahora en la literatura. No se encontraron diferencias significativas en el aislamiento microbiológico, la resistencia bacteriana ni el esquema antibiótico utilizado en los 2 grupos. Aunque la NAV cursó con mayor proporción de complicaciones médicas asociadas, el hallazgo de una estancia hospitalaria, tiempo de ventilación mecánica y mortalidad similares sustenta la importancia clínica de la TAV.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  The infections associated with mechanical ventilation are a major cause of morbidity and mortality in critically ill patients. Limited studies report increased mortality and intensive care units (ICU) stays, requirements for mechanical ventilation and higher costs in ventilator-associated tracheobronchitis (TAV) in comparison to patients with ventilator-associated pneumonia (NAV). These studies do not describe the clinical and epidemiological behavior in the same population as independent entities, so it is necessary to describe the epidemiology of patients with TAV and NAV.  Methods:  Multicenter cross-sectional study of adult patients who developed TAV and/or NAV during their stay in the ICU in 2013 to 2014. A descriptive analysis was performed on each of the variables. For qualitative variables we assessed differences between groups using the Chi-squared test; for continuous variables, we used Student's t test or the Mann Whitney U test.  Results:  A total of 147 patients from 6 countries in Latin America were included; 63% with NAV and 37% with TAV. The average age was 55 years; 57% male. The most frequent comorbidity was cardiovascular (44%) and neurological (30%), the latter was more frequent in those with TAV (41.5 vs. 23%, P = .02). No differences were found in APACHE II on entry, but the difference appears in the SOFA index (8 vs. 5, P = .02). There were no differences in microbiological isolation, or bacterial resistance patterns between the 2 entities. A greater number of cardiovascular complications and ARDS were observed in patients with NAV. The ICU stay, days on mechanical ventilation and mortality were not different between the 2 groups.  Conclusions:  The TAV prevalence was higher than heretofore described in the literature. No significant differences were found in the microbiological isolation, bacterial resistance and antibiotic therapy used in the 2 groups, which might suggest that therapeutic approach be similar to that recommended for NAV. No differences were observed in clinical outcomes such as hospital stay, duration of mechanical ventilation and mortality, although NAV was associated with a greater proportion of medical complications.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Neumonía asociada a ventilador]]></kwd>
<kwd lng="en"><![CDATA[Ventilator-associated tracheobronchitis]]></kwd>
<kwd lng="en"><![CDATA[Ventilator-associated pneumonia]]></kwd>
<kwd lng="en"><![CDATA[Critical Care]]></kwd>
<kwd lng="en"><![CDATA[Mortality]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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