Lipari Flavio G, Hernández Daniela, Vilaró Mario, Caeiro Juan P, Saka Héctor Alex
Servicio de Infectología, Hospital Privado Universitario de Córdoba, Argentina.
Laboratorio de Microbiología, Hospital Privado Universitario de Córdoba, Argentina.
Rev Chilena Infectol. 2020 Aug;37(4):362-370. doi: 10.4067/S0716-10182020000400362.
Enterobacteriaceae are a major cause of bloodstream infections and their antimicrobial resistance continues to increase. This leads to higher morbidity-mortality rates and public health costs. Carbapenem-resistant Enterobacteriaceae represent a serious challenge globally, since there are few therapeutic options available.
Clinical/microbiological characterization of the carbapenem-resistant bacteremia observed over a period of 4 years.
Retrospective, observational and descriptive study about bacteremia caused by carbapenem-resistant and susceptible Enterobacteriaceae.
A total of 84 patients with bacteremia including carbapenem-resistant and susceptible Enterobacteriaceae were analyzed. We found that patients infected with carbapenem-resistant strains presented a higher proportion of: previous antibiotic treatment, hospitalization in intensive care unit (ICU), onset of the bacteremia during hospitalization in ICU and previous infection with extended-spectrum-beta-lactamase producing Enterobacteriaceae. Additionally, we observed a predominance of KPC-producing Klebsiella pneumoniae and an attributable mortality rate of 52.4%.
This study allowed for a better understanding of an emerging problem with high mortality, which in turn is useful for the design and adoption of infection control strategies and effective treatment regimens adapted to our local epidemiology.
肠杆菌科细菌是血流感染的主要原因,其抗菌耐药性持续上升。这导致更高的发病率和死亡率以及公共卫生成本。耐碳青霉烯类肠杆菌科细菌在全球范围内构成严峻挑战,因为可用的治疗选择很少。
对4年期间观察到的耐碳青霉烯类菌血症进行临床/微生物学特征分析。
对由耐碳青霉烯类和敏感肠杆菌科细菌引起的菌血症进行回顾性、观察性和描述性研究。
共分析了84例包括耐碳青霉烯类和敏感肠杆菌科细菌菌血症患者。我们发现,感染耐碳青霉烯类菌株的患者在以下方面比例更高:既往抗生素治疗、入住重症监护病房(ICU)、在ICU住院期间发生菌血症以及既往感染产超广谱β-内酰胺酶肠杆菌科细菌。此外,我们观察到产KPC的肺炎克雷伯菌占主导,归因死亡率为52.4%。
本研究有助于更好地理解这一死亡率高的新出现问题,进而有助于设计和采用适应我们当地流行病学情况的感染控制策略和有效治疗方案。