Factores asociados a mortalidad en pacientes con infecciones por bacterias tipo KPC en la unidad de cuidado intensivo
| Autor: | Devia Alvira, Johan Fernando, Sánchez Muñoz, José Alexander, Carrizosa González, Jorge |
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| Přispěvatelé: | Sanchez Muñoz, Jose Alexander, Carrizosa Gonzalez, Jorge Armando |
| Jazyk: | Spanish; Castilian |
| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Villegas MV, Lolans K, Correa A, Suarez CJ, Lopez JA, Vallejo M, et al. First detection of the plasmid-mediated class a carbapenemase KPC-2 in clinical isolates of Klebsiella pneumoniae from South America. Antimicrob Agents Chemother. 2006 Aug 1;50(8):2880–2. Bassetti M, Giacobbe DR, Giamarellou H, Viscoli C, Daikos GL, Dimopoulos G, et al. Management of KPC-producing Klebsiella pneumoniae infections. Clinical Microbiology and Infection. 2017 Feb;133–44 Watkins RR, Bonomo RA. Overview: Global and Local Impact of Antibiotic Resistance. Vol. 30, Infectious Disease Clinics of North America. 2016. p. 313–22. Ocampo A, Vargas C, Sierra P, Biomédica AC-, 2015 undefined. Caracterización molecular de un brote de Klebsiella pneumoniae resistente a carbapenémicos en un hospital de alto nivel de complejidad de Medellín. redalyc.org Fernández-Canigia L, Dowzicky MJ. Susceptibility of important Gram-negative pathogens to tigecycline and other antibiotics in Latin America between 2004 and 2010. Ann Clin Microbiol Antimicrob. 2012 Oct 22;11(1):29 Park R, O’Brien TF, Huang SS, Baker MA, Yokoe DS, Kulldorff M, et al. Statistical detection of geographic clusters of resistant Escherichia coli in a regional network with WHONET and SaTScan. Expert Rev Anti Infect Ther. 2016 Nov 6;14(11):1097–107. Livermore DM. Current epidemiology and growing resistance of gram-negative pathogens. Korean J Intern Med. 2012 Jun;27(2):128–42. Lopez JA, Correa A, Navon-Venezia S, Correa AL, Torres JA, Briceño DF, et al. Intercontinental spread from Israel to Colombia of a KPC-3-producing Klebsiella pneumoniae strain. Clin Microbiol Infect. 2011 Jan;17(1):52–6 Costerton JW. The structure and function of the cell envelope of gram-negative bacteria. Rev Can Biol. 1970 Sep;29(3):299–316 Bratu S, Landman D, Haag R, Recco R, Eramo A, Alam M, et al. Rapid spread of carbapenem-resistant Klebsiella pneumoniae in New York City: a new threat to our antibiotic armamentarium. Arch Intern Med. 2005 Jun 27;165(12):1430–5. Ambler RP. The structure of beta-lactamases. Philos Trans R Soc Lond B Biol Sci. 1980 May 16;289(1036):321–31 Rodloff AC, Goldstein EJC, Torres A. Two decades of imipenem therapy. J Antimicrob Chemother. 2006 Sep 6;58(5):916–29 Yigit H, Queenan AM, Anderson GJ, Domenech-Sanchez A, Biddle JW, Steward CD, et al. Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella 53 pneumoniae. Antimicrob Agents Chemother. 2001 Apr 1;45(4):1151–61. Villegas MV, Lolans K, Correa A, Kattan JN, Lopez JA, Quinn JP, et al. First identification of Pseudomonas aeruginosa isolates producing a KPC-type carbapenem-hydrolyzing beta-lactamase. Antimicrob Agents Chemother. 2007 Apr 1;51(4):1553–5. Heitman M.D., Ph.D. J. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Mycopathologia. 2000;149(1):47–8. Munoz-Price LS, Poirel L, Bonomo RA, Schwaber MJ, Daikos GL, Cormican M, et al. Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases. Lancet Infect Dis. 2013 Sep;13(9):785–96. Mathers AJ, Carroll J, Sifri CD, Hazen KC. Modified Hodge test versus indirect carbapenemase test: prospective evaluation of a phenotypic assay for detection of Klebsiella pneumoniae carbapenemase (KPC) in Enterobacteriaceae. J Clin Microbiol. 2013 Apr 1;51(4):1291–3. Anderson KF, Lonsway DR, Rasheed JK, Biddle J, Jensen B, McDougal LK, et al. Evaluation of Methods To Identify the Klebsiella pneumoniae Carbapenemase in Enterobacteriaceae. J Clin Microbiol. 2007 Aug 1;45(8):2723–5 Hirsch EB, Tam VH. Detection and treatment options for Klebsiella pneumoniae carbapenemases (KPCs): an emerging cause of multidrug-resistant infection. J Antimicrob Chemother. 2010 Jun;65(6):1119–25. Rapp RP, Urban C. Klebsiella pneumoniae carbapenemases in Enterobacteriaceae: history, evolution, and microbiology concerns. Pharmacotherapy. 2012 May;32(5):399–407. Zarkotou O, Pournaras S, Tselioti P, Dragoumanos V, Pitiriga V, Ranellou K, et al. Predictors of mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae and impact of appropriate antimicrobial treatment. Clin Microbiol Infect. 2011 Dec;17(12):1798–803. Gasink LB, Edelstein PH, Lautenbach E, Synnestvedt M, Fishman NO. Risk factors and clinical impact of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae. Infect Control Hosp Epidemiol. 2009 Dec 2;30(12):1180–5. Tumbarello M, Trecarichi EM, Tumietto F, Del Bono V, De Rosa FG, Bassetti M, et al. Predictive models for identification of hospitalized patients harboring KPC-producing Klebsiella pneumoniae. Antimicrob Agents Chemother. 2014 Jun;58(6):3514–20. Papadimitriou-Olivgeris M, Marangos M, Christofidou M, Fligou F, Bartzavali C, Panteli ES, et al. Risk factors for infection and predictors of mortality among patients with KPC-producing Klebsiella pneumoniae bloodstream infections in the intensive care unit. Scand J Infect Dis. 2014 Sep 14;46(9):642–8 Camargo JF, Tobón GJ, Fonseca N, Diaz JL, Uribe M, Molina F, et al. Autoimmune rheumatic diseases in the intensive care unit: experience from a tertiary referral hospital and review of the literature. Lupus. 2005 Apr 2;14(4):315–20. Papadimitriou-Olivgeris M, Marangos M, Fligou F, Christofidou M, Sklavou C, Vamvakopoulou S, et al. KPC-producing Klebsiella pneumoniae enteric colonization acquired during intensive care unit stay: the significance of risk factors for its development and its impact on mortality. Diagn Microbiol Infect Dis. 2013 Oct;77(2):169–73. Falcone M, Russo A, Iacovelli A, Restuccia G, Ceccarelli G, Giordano A, et al. Predictors of outcome in ICU patients with septic shock caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae. Clin Microbiol Infect. 2016 May;22(5):444–50. Fraenkel-Wandel Y, Raveh-Brawer D, Wiener-Well Y, Yinnon AM, Assous M V. Mortality due to bla KPC Klebsiella pneumoniae bacteraemia. J Antimicrob Chemother. 2016 Apr;71(4):1083–7. Papadimitriou-Olivgeris M, Fligou F, Bartzavali C, Zotou A, Spyropoulou A, Koutsileou K, et al. Carbapenemase-producing Klebsiella pneumoniae bloodstream infection in critically ill patients: risk factors and predictors of mortality. Eur J Clin Microbiol Infect Dis. 2017 Jul 19;36(7):1125–31. da Silva KE, Maciel WG, Sacchi FPC, Carvalhaes CG, Rodrigues-Costa F, da Silva ACR, et al. Risk factors for KPC-producing Klebsiella pneumoniae: watch out for surgery. J Med Microbiol. 2016 Jun 1;65(6):547–53. Zhang Y, Wang Q, Yin Y, Chen H, Jin L, Gu B, et al. Epidemiology of Carbapenem-Resistant Enterobacteriaceae Infections: Report from the China CRE Network. Antimicrob Agents Chemother. 2018 Feb 4;62(2):e01882-17. Yoon E-J, Kim JO, Kim D, Lee H, Yang JW, Lee KJ, et al. Klebsiella pneumoniaeCarbapenemase Producers in South Korea between 2013 and 2015. Front Microbiol. 2018 Jan 25;9:56. De Waele JJ, Akova M, Antonelli M, Canton R, Carlet J, De Backer D, et al. Antimicrobial resistance and antibiotic stewardship programs in the ICU: insistence and persistence in the fight against resistance. A position statement from ESICM/ESCMID/WAAAR round table on multi-drug resistance. Intensive Care Med. 2018 Feb;44(2):189–96. Tumbarello M, Trecarichi EM, De Rosa FG, Giannella M, Giacobbe DR, Bassetti M, et al. Infections caused by KPC-producing Klebsiella pneumoniae: differences in therapy and mortality in a multicentre study. J Antimicrob Chemother. 2015 Jul;70(7):2133–43. León AL, Hoyos NA, Barrera LI, De La Rosa G, Dennis R, Dueñas C, et al. Clinical course of sepsis, severe sepsis, and septic shock in a cohort of infected patients from ten Colombian hospitals. BMC Infect Dis. 2013 Jul 24;13(1):345. Levy MM, Artigas A, Phillips GS, Rhodes A, Beale R, Osborn T, et al. Outcomes of the Surviving Sepsis Campaign in intensive care units in the USA and Europe: a prospective cohort study. Lancet Infect Dis. 2012 Dec;12(12):919–24. Repositorio EdocUR-U. Rosario Universidad del Rosario instacron:Universidad del Rosario |
| DOI: | 10.48713/10336_18212 |
| Popis: | Introducción: Las infecciones son uno de los motivos de ingreso más frecuentes a la unidad de cuidado intensivo. A su vez las infecciones asociadas al cuidado de la salud de gérmenes resistentes pueden presentarse dentro del espectro de condiciones adicionales como problema en los pacientes con estancias prolongadas. La identificación de factores de riesgo para su presentación es importante. Objetivo general: Identificar factores asociados a mortalidad en pacientes que ingresaron a la Unidad de Cuidado Intensivo en el Hospital Universitario de la Samaritana y presentaron infecciones por bacterias Gram negativas productores de carbapenemasas tipo KPC. Materiales y Métodos: Se realizó un tipo de estudio analítico, retrospectivo, de casos y controles entre enero de 2013 y diciembre de 2016, donde analizaron 47 aislamientos de gérmenes productores de KPC (Klebsiella pneumoniae carbapenemasa) extraídos de los reportes de cultivos tipificados consignados en las historias clínicas. Resultados: La edad promedio fue de 58 años y un porcentaje mayor en hombres. 19% de pacientes tenían autoinmunidad y 66% de presentación con choque séptico. 36% de aislamientos en secreción orotraqueal con germen más frecuente Klebsiella pneumoniae (72%). La mortalidad por gram negativos es del 45% y los factores de riesgo encontrados fueron aislamiento en LCR OR 18,905 P 0,046 (IC 1,048 – 340,971), bacteriemia asociada al catéter OR 10.1 P 0,021 (IC 1,408 – 72,619) y patrón de resistencia KPC OR 32 P 0,015 (IC 1,975 – 529,480) 10 Conclusiones: Los factores de riesgo más importantes encontrados para tener un aislamiento por KPC son, bacteriemia asociada a catéter y aislamientos en líquido cefalorraquídeo. Faltan estudios para especificar los factores de riesgo más comunes asociados a infecciones por este tipo de carbapenemasas. Introduction: Infections are one of the most frequent reasons for admission to the intensive care unit. In turn, infections associated with the health care of resistant germs can occur within the spectrum of additional conditions as a problem in patients with prolonged stays. The identification of risk factors for its presentation is important Objective: To identify factors associated with mortality in patients admitted to the Intensive Care Unit at the University Hospital of La Samaritana and had infections due to Gram-negative bacteria producing KPCtype carbapenemase. Materials and methods: A type of retrospective, analytical, case-control study was conducted between January 2013 and December 2016, where 47 isolates of KPC-producing germs (Klebsiella pneumoniae carbapenemasa) extracted from the reports of typified cultures consigned in the clinical histories were analyzed Results: The average age was 58 years and a higher percentage in men. 19% of patients had autoimmunity and 66% presented with septic shock. 36% of isolates in orotracheal secretion with more frequent germ Klebsiella pneumoniae (72%). Gram-negative mortality is 45% and the risk factors found were CSF isolation OR 18.905 P 0.046 (CI 1.048 - 340.971), catheter-associated bacteremia OR 10.1 P 0.021 (IC 1.408 - 72.619) and KPC OR resistance pattern 32 P 0.015 (IC 1,975 - 529,480). Conclusions: The most important risk factors found to have an isolation by KPC are catheter-associated bacteremia and cerebrospinal fluid isolations. Studies are missing to specify the most common risk factors associated with infections caused by this type of carbapenemasa. 2019-08-01 06:01:01: Script de automatizacion de embargos. info:eu-repo/date/embargoEnd/2019-07-19 |
| Databáze: | OpenAIRE |
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