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Id: biblio-844782
Autor: Ordóñez Varela, Wendy; Blanco Quirós, Laura.
Título: Primer aislamiento de una cepa de Klebsiella pneumoniae productora de carbapenemasa tipo KPC-1 en el Hospital de San Carlos durante el 2011 / First isolation of a type KPC-1 carbapenemase-producing Klebsiella pneumoniae strain in the San Carlos Hospital during 2011
Fonte: Rev. costarric. salud pública;26(1):69-73, ene.-jun. 2017. tab, ilus.
Idioma: es.
Resumo: ResumenObjetivoDemostrar el aislamiento de una Klebsiella pneumoniae productora de carbapenemasa tipo 1 a partir de una paciente femenina de 1 año con historial de problemas hepáticos e infecciones renales a repetición.MétodosSe realizó la identificación bacteriana y la prueba de resistencia a antibióticos por medio del sistema Vitek 2. La determinación fenotípica de carbapenemasas se realizó por medio de la prueba de ácido borónico y Hodge modificado. La confirmación molecular se hizo utilizando PCR-RT para el gen blaKPC.ResultadosPor la prueba de sensibilidad a antibióticos, se sospecha de una betalactamasa de espectro ampliado con sensibilidad reducida a carbapenémicos (imipenem 4 μg/mL, meropenem 1 μg/mL). Las pruebas de ácido borónico y Hodge modificado sugieren la presencia de carbapenemasas. La confirmación molecular es positiva para carbapenemasas tipo 1.DiscusiónLa emergencia y diseminación de cepas con carbapenemasas constituye un riesgo para pacientes hospitalizados y la comunidad. Estas cepas usualmente son resistentes a múltiples antibióticos y los mecanismos de resistencia diseminan con facilidad. Los hospitales constituyen escenarios que favorecen la diseminación de estas bacterias. Las opciones terapéuticas en estos casos son reducidas, por lo que se insta a un uso consciente de los antibióticos, la higiene intrahospitalaria y vigilancia epidemiológica interdisciplinaria.ConclusionesSe confirma la presencia de Klebsiella pneumoniae KPC-1 como aislamiento de una infección del tracto urinario en una niña con problemas hepáticos. Los lineamientos del Centro Nacional de Referencia en Bacteriología para sospechar de carbapenemasas, las pruebas fenotípicas y la confirmación molecular permitieron corroborar la carbapenemasa.

AbstractObjectiveto demonstrate the finding of a Klebsiella pneumoniae carbapenemase-1 positive, isolated from a 1-year-old female patient with liver illness and kidney recurrent infections.MethodsBacterial identification and antimicrobial susceptibility testing was performed with Vitek 2 systems. Phenotypic determination of carbapenemases was performed using boronic acid test and Hodge modified test. Molecular confirmation was done using PCR-RT for gene blaKPC.ResultsAntimicrobial susceptibility testing suggested an extended spectrum betalactamase with reduced sensitivity to carbapenems (imipenem 4 μg/mL, meropenem 1 μg/mL). Boronic acid test and Hodge modified test were consistent with carbapenemase production. Molecular confirmation was positive for carbapenemase-1.DiscusionThe emergence and spread of carbapenemase-positive strains constitutes a risk for patients and community. These strains are usually resistant to multiple antimicrobials and the resistance mechanisms easily spread. Hospitals are scenarios that favor the spread of these bacteria. Therapeutic options in these cases are reduced, so it is necessary a conscious use of antibiotics, hospital hygiene and interdisciplinary epidemiological surveillance.ConclusionsIt is confirmed the presence of Klebsiella pneumoniae KPC-1, isolated from a girl with urinary tract infection and liver illness. The guidelines of Centro Nacional de Reference en Bacteriology, phenotypic tests and molecular confirmation made possible the confirmation of this finding.
Descritores: Enterobacteriáceas Resistentes a Carbapenêmicos/efeitos dos fármacos
Klebsiella pneumoniae/isolamento & purificação
-Resistência Microbiana a Medicamentos
Costa Rica
Limites: Humanos
Tipo de Publ: Relatos de Casos
Responsável: CR1.1 - BINASSS - Biblioteca Nacional de Salud y Seguridad Social


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Id: biblio-1171786
Autor: Nastro Marcela; Carranza Néstor; Aprigliano Fernando; Saposnik Elsa; Barberis Claudia; García Susana; Vay Carlos; Rodríguez Carlos H; Famiglietti Angela.
Título: Emergencia de la resistencia a colistina en Klebsiella pneumoniae. Caracterización microbiológica y epidemiológica de aislamientos productores y no productores de carbapenemasa de tipo KPC / [Emergence of colistin-resistant Klebsiella pneumoniae. Microbiological and epidemiological characterization of the isolates producing and non-producing KPC-type carbapenemase].
Fonte: Rev. argent. microbiol;45(3):185-90, set. 2013.
Idioma: es.
Resumo: Sixty-four colistin-resistant Klebsiella pneumoniae isolates recovered from clinical specimens from 57 patients admitted to Hospital de Clinicas Jose de San Martin during the period 2010-2012 were studied to describe the microbiological and epidemiological characteristics and factors associated with the emergence of colistin-resistance. Fifty-four colistin-susceptible K. pneumoniae isolates from the same period were also included in the study. The genetic relatedness among the isolates was studied by a PCR assay. Fifty percent of the resistant isolates were KPC-2 producers, 45.3

were ESBL producers and 4.7

only showed resistance to aminopenicilins. All KPC-producers (resistant and susceptible to colistin) were genotipically indistinguishable except for one, whereas the presence of 7 clonal types, which were different from the ones identified in the colistin-susceptible isolates, were detected among ESBL producers. The previous use of colistin was the main factor associated with the acquisition of resistance, and in the case of non-KPC producers the stay in ICU was another significant factor observed. Colistin resistance emerged in our hospital in the year 2010, reaching 3

in nosocomial isolates and maintaining this rate in successive years, due to the selection of resistant subpopulations in the epidemic clonal type in KPC-producers and due to the dispersion of colistin-resistant clonal types in non-KPC producing-isolates.
Descritores: Colistina/farmacologia
Klebsiella pneumoniae/efeitos dos fármacos
Klebsiella pneumoniae/enzimologia
Proteínas de Bactérias/biossíntese
beta-Lactamases/biossíntese
-Farmacorresistência Bacteriana
Feminino
Humanos
Infecções por Klebsiella/epidemiologia
Masculino
Proteínas de Bactérias/classificação
beta-Lactamases/classificação
Tipo de Publ: Resumo em Inglês
Artigo de Revista
Research Support, Non-U.S. Gov't
Research Support, Non-U.S. Gov't
Research Support, Non-U.S. Gov't
Responsável: AR5.1 - Centro de Gestión del Conocimiento y las Comunicaciónes


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Id: biblio-1151747
Autor: Rosa, Tamin Jandrey da; Biegelmeyer, Solange; Lange, Tabata Spellmeier; Bittencourt, Susana Eliane Beck; Picoli, Simone Ulrich.
Título: New Delhi metalobetalactamase (NDM): uma revisão / Metallobetalactamase New Delhi: a review
Fonte: Rev. bras. anal. clin;49(1):36-40, jun.16, 2017.
Idioma: pt.
Resumo: O surgimento da enzima metalobetalactamase "New Delhi" (NDM-1) incrementou a possibilidade das bactérias se tornarem multirresistentes. Esta betalactamase foi relatada pela primeira vez em 2009, em isolados clínicos de Klebsiella pneumoniae e Escherichia coli oriundos de um paciente sueco hospitalizado na Índia. Tendo em vista a ampla resistência desenvolvida por bactérias portadoras do gene blaNDM e seu elevado índice de disseminação, o presente artigo buscou apresentar e discutir aspectos importantes sobre essa metaenzima, como mecanismo de ação, detecção laboratorial, controle de infecção e possibilidades de tratamento.

The emergence of metalobetalactamase enzyme "New Delhi" (NDM-1) increased the chance of bacteria becoming multiresistant. This betalactamase was first reported in 2009 in clinical isolates of Klebsiella pneumoniae and Escherichia coli derived from a Swedish patient hospitalized in India. Given the widespread resistance developed by bacteria carrying the gene blaNDM and its high rate of spread, this paper aims to present and discuss important aspects of this metalobetalactamase as mechanism of action, laboratorial detection, infection control and treatment possibilities
Descritores: Resistência beta-Lactâmica
Enterobacteriaceae
Klebsiella pneumoniae
-Carbapenêmicos
Anti-Infecciosos
Tipo de Publ: Revisão Sistemática
Responsável: BR408.1 - Biblioteca da Faculdade de Medicina - BFM


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Id: biblio-961295
Autor: Espino, Danamirys; Sosa Díaz, Janice; Sosa Díaz, Regina Yamilet.
Título: Klebsiella pneumoniae, un patógeno de alta prioridad para la fabricaciòn de nuevos antibióticos / Klebsiella pneumoniae, a high priority pathogen for producing new antibiotics
Fonte: Rev. medica electron;40(4):1271-1273, jul.-ago. 2018. ilus.
Idioma: es.
Descritores: Klebsiella pneumoniae/patogenicidade
Antibacterianos/farmacologia
-Pacientes
Prática Profissional/normas
Enterobacteriaceae/patogenicidade
Limites: Humanos
Tipo de Publ: Carta
Responsável: CU424.1 - Centro Provincial de Información de Ciencias Médicas


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Id: lil-589364
Autor: Echeverri Toro, Lina María; Atehortúa Muñoz, Santiago León; Robledo Restrepo, Jaime.
Título: K. pneumoniae y betalactamasas: un problema creciente / K. pneumoniae and beta-lactamases: a rising issue
Fonte: Med. U.P.B = Med. UPB;28(2):135-141, jul.-dic. 2009. Ilus.
Idioma: es.
Resumo: El incremento en la resistencia bacteriana es un fenómeno que va en aumento en todo el mundo; Klebsiella pneumoniae esuno de los patógenos más importantes como causa de infección nosocomial y presenta una alta resistencia a los antibióticosbetalactámicos, debido a varios mecanismos. Uno de los más importantes es la producción de enzimas betalactamasas. Los antibióticos ß-lactámicos son los antibióticos más prescritos en todo el mundo; su consumo corresponde aproximadamente al 50% del consumo global, lo que denota la relevancia que tiene el estudio de la resistencia a betalactámicos en Klebsiella pneumoniae. Esta revisión destaca la importancia de este patógeno como patógeno nosocomial en la ciudad, en el país y compara esta situación con otras áreas del mundo. Presenta una descripción de las betalactamasas, su clasificación y sus substratos. Además, se presenta una descripción de los métodos para su detección por el laboratorio clínico.

The increase in bacterial resistance is a rising phenomenon around the world, Klebsiella pneumoniae is one of the most important pathogens causing nosocomial infection being also associated to high resistance to beta-lactam antibiotics, mostly due tothe presence of enzymes known as beta-lactameses. ß-lactam antibiotics are the most prescribed antibiotics throughout the world, its use corresponding to approximately 50% of global use. The following review highlights the importance of the studyand detection of B-lactamases in K. penaumoniae strains. The following paper describes the importance of K. pneumoniae as a nosocomial pathogen in the country and in the city and compares the situation to other areas of the world. A description of B-lactamases, their classification and target substrates is provided. In addition, the methods for detection of these enzymes by the clinical laboratory is also provided.
Descritores: Klebsiella pneumoniae
-beta-Lactamases
beta-Lactamas
Infecções
Antibacterianos
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CO101.1 - BCdeS - Biblioteca Ciencias de la Salud


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Id: biblio-974360
Autor: Tsai, Yi-Wen; Liu, Yu-Hsi; Su, Hsing-Hao.
Título: Bacteriology of peritonsillar abscess: the changing trend and predisposing factors / Bacteriologia do abscesso peritonsilar: tendência de mudança e fatores predisponentes
Fonte: Braz. j. otorhinolaryngol. (Impr.);84(5):532-539, Sept.-Oct. 2018. tab, graf.
Idioma: en.
Resumo: Abstract Introduction: Peritonsillar abscess is the most common deep neck infection. The infectious microorganism may be different according to clinical factors. Objective: To identify the major causative pathogen of peritonsillar abscess and investigate the relationship between the causative pathogen, host clinical factors, and hospitalization duration. Methods: This retrospective study included 415 hospitalized patients diagnosed with peritonsillar abscess who were admitted to a tertiary medical center from June 1990 to June 2013. We collected data by chart review and analyzed variables such as demographic characteristics, underlying systemic disease, smoking, alcoholism, betel nut chewing, bacteriology, and hospitalization duration. Results: A total of 168 patients had positive results for pathogen isolation. Streptococcus viridans (28.57%) and Klebsiella pneumoniae (23.21%) were the most common microorganisms identified through pus culturing. The isolation rate of anaerobes increased to 49.35% in the recent 6 years (p = 0.048). Common anaerobes were Prevotella and Fusobacterium spp. The identification of K. pneumoniae increased among elderly patients (age > 65 years) with an odds ratio (OR) of 2.76 (p = 0.03), and decreased in the hot season (mean temperature > 26 °C) (OR = 0.49, p = 0.04). No specific microorganism was associated with prolonged hospital stay. Conclusion: The most common pathogen identified through pus culturing was S. viridans, followed by K. pneumoniae. The identification of anaerobes was shown to increase in recent years. The antibiotics initially selected should be effective against both aerobes and anaerobes. Bacterial identification may be associated with host clinical factors and environmental factors.

Resumo Introdução: O Abscesso Peritonsilar é a infecção cervical profunda mais comum. O microrganismo infeccioso pode ser diferente de acordo com os fatores clínicos. Objetivo: Identificar o principal agente causador do abscesso peritonsilar e investigar a relação entre o patógeno causador, os fatores clínicos do hospedeiro e a duração da hospitalização. Método: Este estudo retrospectivo incluiu 415 pacientes hospitalizados diagnosticados com abscesso peritonsilar que foram internados em um centro médico terciário de junho de 1990 a junho de 2013. Coletamos dados através da análise dos arquivos médicos dos pacientes e analisamos variáveis como características demográficas, doença sistêmica subjacente, tabagismo, alcoolismo, hábito de mascar noz de betel, bacteriologia e duração da hospitalização. Resultados: Um total de 168 pacientes apresentaram resultados positivos para isolamento de patógenos. Streptococcus viridans (28,57%) e Klebsiella pneumoniae (23,21%) foram os microrganismos mais comuns identificados pela cultura da secreção. A taxa de isolamento de anaeróbios aumentou para 49,35% nos últimos 6 anos (p = 0,048). Os anaeróbios comuns foram Prevotella e Fusobacterium spp. A identificação de K. pneumoniae aumentou em pacientes idosos (idade > 65 anos) com razão de chances (Odds Ratio - OR) de 2,76 (p = 0,03) e diminuiu na estação do calor (temperatura média > 26 °C) (OR = 0,49, p = 0,04). Nenhum microrganismo específico foi associado à hospitalização prolongada. Conclusão: O patógeno mais comumente identificado através da cultura de secreção foi S. viridans, seguido por K. pneumoniae. A identificação de anaeróbios mostrou ter aumentado nos últimos anos. Os antibióticos selecionados inicialmente devem ser efetivos contra aeróbios e anaeróbios. A identificação bacteriana pode estar associada a fatores clínicos e fatores ambientais do hospedeiro.
Descritores: Abscesso Peritonsilar/microbiologia
Infecções por Bactérias Gram-Positivas/microbiologia
Fusobacterium necrophorum/isolamento & purificação
Bactérias Gram-Positivas/isolamento & purificação
-Infecções por Klebsiella
Abscesso Peritonsilar/diagnóstico
Abscesso Peritonsilar/terapia
Estudos Retrospectivos
Fatores de Risco
Infecções por Bactérias Gram-Positivas/terapia
Prevotella
Estreptococos Viridans/isolamento & purificação
Infecções por Fusobacterium/microbiologia
Klebsiella pneumoniae/isolamento & purificação
Antibacterianos/uso terapêutico
Limites: Humanos
Adolescente
Adulto
Pessoa de Meia-Idade
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-1099651
Autor: Morales Urresta, Erika Estefanía; Velasco Polo, Verónica Alexandra; Cárdenas Martínez, Ana Gabriela; Oñate Araque, Ximena Lucia; Núñez Freile, Byron Fabián; Guerrero Toapanta, Fausto Marcos; Reyes Chacón, Jorge Aníbal.
Título: Carbapenemasas y sensibilidad a los antibióticos no ß-lactámicos en Klebsiella pneumoniae resistente a los carbapenémicos en un hospital de tercer nivel de complejidad. Quito ­ Ecuador / Carbapenemases and sensitivity to non-ß-lactam antibiotics in Klebsiella pneumoniae resistant to carbapenems in a third level hospital. Quito - Ecuador
Fonte: Cambios rev. méd;18(2):52-57, 2019/12/27. tabs..
Idioma: es.
Resumo: INTRODUCCIÓN. La resistencia de Klebsiella pneumoniae a carbapenémicos ha aumentado con los años, reduciendo opciones terapéuticas. Puede deberse a dos mecanismos principales, como: la producción de carbapenemasas y alteración de la permeabilidad de la membrana. OBJETIVO. Analizar la frecuencia de Klebsiella pneumoniae resistente a carbapenémicos, junto al mecanismo de resistencia informado por el Laboratorio Nacional de Referencia y la sensibilidad a antibióticos usados para uso terapéutico. MATERIA-LES Y MÉTODOS. Estudio retrospectivo, de población y muestra conocida. Se determinó la sensibilidad/resistencia de Klebsiella pneumoniae: todos los datos aislados de Klebsiella pneumoniae. Se reportaron 11 809 bacilos gram negativos pertenecientes a la familia Enterobacteriaceae. Se utilizó el sistema Whonet 5.6 2017 y BacLink2, así como la revisión de los resultados enviados al Centro Nacional de Referencia para la Resistencia a los Antimicrobianos del Instituto Nacional de Investigación de Salud Pública Izquieta Pérez para investigación de carbapenemasas en el Hospital de Especialidades Carlos Andrade Marín,en el período abril 2016 a mayo 2018. RESULTADOS. El 20,5% (2 421; 11 809) correspondieron a Klebsiella pneumoniae y de estos, 32,9% (797; 2 421) mostraron resistencia a Meropenem. Existió mayor frecuencia en muestra de orina, secreción, sangre y aspirado traqueal. Predominó en varones de más de 61 años. Se clasificó en 15 grupos fenotípicos según los perfiles de resistencia a los antibióticos utilizados como alternativa terapéutica. CONCLUSIÓN. La presencia de Klebsiella pneumoniae produjo una carbapenemasa resistente a los medi-camentos utilizados como tratamiento, llevó a pensar en el uso de otros medicamentos como: fosfomicina o ceftazidima/viabactam; sin embargo, se desarrolló medidas de control y prevención de infecciones, así como programas para el uso de antibióticos.

INTRODUCTION. The resistance of Klebsiella pneumoniae to carbapenems has increased over the years, reducing therapeutic options. It can be due to two main mechanisms, such as: the production of carbapene-mases and alteration of membrane permeability. OBJECTIVE. Analyse the frequency of carbapenem-resistant Klebsiella pneumoniae, along with the resistance mechanism reported by the National Reference Laboratory and sensitivity to antibiotics used for therapeutic use. MATERIALS AND METHODS. Retrospective study, po-pulation and known sample. The sensitivity / resistance of Klebsiella pneumoniae was determined: all isolated were Klebsiella pneumoniae. 11 809 gram negative bacillus belonging to the Enterobacteriaceae family were reported. The Whonet 5.6 2017 and BacLink2 system was used, as well as the review of the results sent to the National Reference Center for the Antimicrobial Resistance of the National Institute of Public Health Research Izquieta Pérez for carbapenemases research at the Carlos Andrade Marín Speciality Hospital, in the period april 2016 to may 2018. RESULTS. 20,5% (2 421; 11 809) were Klebsiella pneumoniae and of these, 32,9% (797; 2 421) showed resistance to Meropenem. There was a higher frequency in urine sample, secretion, blood and tracheal aspiration. Predominance in males over 61 years old. It was classified into 15 phenotypic groups according to antibiotic resistance profiles used as a therapeutic alternative. CONCLUSION. The pre-sence of Klebsiella pneumoniae produced a carbapenemase drug-resistance used as treatment, leading to thought on the use of other medicines such as phosphomycin or ceftazidima/avibactam; however, infection control and prevention measures were developed, as well as programs for the use of antibiotics.
Descritores: Fenótipo
Carbapenêmicos
beta-Lactamas
Enterobacteriaceae
Klebsiella pneumoniae
Antibacterianos
-Terapêutica
Fatores R
Testes de Sensibilidade Microbiana
Gestão de Antimicrobianos
Unidades de Terapia Intensiva
Microbiologia
Limites: Humanos
Masculino
Feminino
Tipo de Publ: Estudo de Validação
Responsável: EC162.1


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Id: biblio-1145877
Autor: Brito, Maria da Penha Silva de; Naue, Carine Rosa.
Título: Demanda de culturas microbiológicas e prevalência de microrganismos em um hospital universitário de Pernambuco / Demand for microbiological cultures and prevalence of microorganisms in a university hospital of Pernambuco / Demanda de culturas microbiológicas y prevalencia de microrganismos en un hospital universitario de Pernambuco
Fonte: Rev. Pesqui. (Univ. Fed. Estado Rio J., Online);13:17-26, jan.-dez. 2021. tab.
Idioma: en; pt.
Resumo: Objetivo: verificar a demanda de hemoculturas, aspirados traqueais e uroculturas realizadas no HU-UNIVASF/ EBSERH e a prevalência dos microrganismos identificados no período de janeiro a junho de 2016. Métodos: estudo retrospectivo documental com abordagem quantitativa. Resultados: o setor de microbiologia realizou 488 hemoculturas, 427 uroculturas e 197 aspirados traqueais. A positividade de hemoculturas mostrou-se entre 10,9 à 25,7%, e o percentual de contaminações variou de 6,8 à 14,0%. Os microrganismos mais prevalência nas hemoculturas foram Staphylococcus epidermidis (23,7%), Staphylococcus aureus (19,3%) e Klebisiella pneumoniae (9,6%). Nas uroculturas foram Klebisiella pneumoniae (23,1%), Candida sp. (13,5%) e Escherichia coli (12,5%). Nos aspirados traqueais foram Acinetobacter baumannii (29,2%), Pseudomonas aeruginosa (26,6%) e Staphylococcus aureus (16,2%). Conclusão: a cultura mais solicitada foi hemocultura. A bactéria mais prevalente nas hemoculturas foi Staphylococcus epidermidis, nos aspirados traqueais Acinetobacter baumannii e nas uroculturas Klebisiella pneumoniae

Objective: the study's purpose has been to verify the demand for blood cultures, tracheal aspirates and urine cultures performed at a University Hospital from the Universidade Federal do Vale do São Francisco (HU-UNIVASF/EBSERH), as well as the predominance of microorganisms identified over the period from January to June 2016. Methods: it is a retrospective documentary study with a quantitative approach. Results: the microbiology sector carried out 488 blood cultures, 427 urine cultures and 197 tracheal aspirates. The positivity of blood cultures was between 10.9 and 25.7%, and the percentage of contaminations ranged from 6.8 to 14.0%. The most prevalent microorganisms in blood cultures were Staphylococcus epidermidis (23.7%), Staphylococcus aureus (19.3%) and Klebsiella pneumoniae (9.6%). In urine cultures were Klebsiella pneumoniae (23.1%), Candida sp. (13.5%) and Escherichia coli (12.5%). In tracheal aspirates were Acinetobacter baumannii (29.2%), Pseudomonas aeruginosa (26.6%) and Staphylococcus aureus (16.2%). Conclusion: the most requested culture was blood culture. The most prevalent bacterium in blood cultures was Staphylococcus epidermidis, in tracheal aspirates was Acinetobacter baumannii, and in urine cultures was Klebsiella pneumoniae

Objetivo: el propósito del trabajo es verificar la demanda de hemocultivos, aspirados traqueales y urocultivos realizados en el Hospital Universitário de la Universidade Federal do Vale do São Francisco (HU-UNIVASF/ EBSERH) y la prevalencia de los microorganismos identificados en el período de enero a junio de 2016. Métodos: este trabajo es un estudio retrospectivo documental con abordaje cuantitativo. Resultados: el sector de microbiología realizó 488 hemocultivos, 427 urocultivos y 197 aspirados traqueales. La positividad de hemocultivos se mostró entre el 10,9 al 25,7%, y el porcentaje de contaminaciones varía de 6,8 a 14,0%. Los microorganismos más prevalentes en los hemocultivos fueron Staphylococcus epidermidis (23,7%), Staphylococcus aureus (19,3%) y Klebsiella pneumoniae (9,6%). En los urocultivos fueron Klebisiella pneumoniae (23,1%), Candida sp. (13,5%) y Escherichia coli (12,5%). En los aspirados traqueales fueron Acinetobacter baumannii (29,2%), Pseudomonas aeruginosa (26,6%) y Staphylococcus aureus (16,2%). Conclusión: la cultura más solicitada fue hemocultivo. La bacteria más prevalente en los hemocultivos fue Staphylococcus epidermidis, en los aspirados traqueales, Acinetobacter baumannii y en los urocultivos, Klebisiella pneumoniae
Descritores: Urina/microbiologia
Infecção Hospitalar/microbiologia
Infecção Hospitalar/epidemiologia
Técnicas Bacteriológicas/métodos
Hemocultura
-Staphylococcus aureus
Staphylococcus epidermidis
Prevalência
Acinetobacter baumannii
Escherichia coli
Hospitais Universitários
Klebsiella pneumoniae
Responsável: BR1208.1 - BSEN - Biblioteca Setorial de Enfermagem e Nutrição


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Id: lil-780802
Autor: Akturk, Hacer; Sutcu, Murat; Somer, Ayper; Aydın, Derya; Cihan, Rukiye; Ozdemir, Aslı; Coban, Asuman; Ince, Zeynep; Citak, Agop; Salman, Nuran.
Título: Carbapenem-resistant Klebsiella pneumoniae colonization in pediatric and neonatal intensive care units: risk factors for progression to infection
Fonte: Braz. j. infect. dis;20(2):134-140, Mar.-Apr. 2016. tab, graf.
Idioma: en.
Resumo: Abstract Background Little is known about factors associated with carbapenem-resistant Klebsiella pneumoniae infections in pediatric patients, who are initally colonized with carbapenem-resistant Klebsiella pneumoniae. Materials and methods A retrospective case–control study was conducted involving pediatric and neonatal intensive care units throughout a five-year period (January 2010–December 2014). Clinical and microbiological data were extracted from Hospital Infection Control Committee reports and patients’ medical records. Risk factors were assessed in carbapenem-resistant Klebsiella pneumoniae colonized patients who developed subsequent systemic infection (cases) and compared to carbapenem-resistant Klebsiella pneumoniae colonized patients who did not develop infection (controls). Results Throughout the study period, 2.6% of patients admitted to neonatal intensive care units and 3.6% of patients admitted to pediatric intensive care units had become colonized with carbapenem-resistant Klebsiella pneumoniae. After a mean of 10.6 ± 1.9 days (median: 7 days, range: 2–38 days) following detection of colonization, 39.0% of the carbapenem-resistant Klebsiella pneumoniae colonized patients in pediatric intensive care units and 18.1% of carbapenem-resistant Klebsiella pneumoniae colonized patients in neonatal intensive care units developed systemic carbapenem-resistant Klebsiella pneumoniae infection. Types of systemic carbapenem-resistant Klebsiella pneumoniae infections included bacteremia (n = 15, 62.5%), ventilator-associated pneumonia (n = 4, 16.6%), ventriculitis (n = 2, 8.3%), intraabdominal infections (n = 2, 8.3%), and urinary tract infection (n = 1, 4.1%). A logistic regression model including parameters found significant in univariate analysis of carbapenem resistant Klebsiella pneumoniae colonization and carbapenem resistant Klebsiella pneumoniae infection groups revealed underlying metabolic disease (OR: 10.1; 95% CI: 2.7–37.2), previous carbapenem use (OR: 10.1; 95% CI: 2.2–40.1), neutropenia (OR: 13.8; 95% CI: 3.1–61.0) and previous surgical procedure (OR: 7.4; 95% CI: 1.9–28.5) as independent risk factors for carbapenem-resistant Klebsiella pneumoniae infection in patients colonized with carbapenem-resistant Klebsiella pneumoniae. Out of 24 patients with carbapenem resistant Klebsiella pneumoniae infection, 4 (16.6%) died of carbapenem-resistant Klebsiella pneumoniae sepsis. Conclusion Asymptomatic colonization with carbapenem-resistant Klebsiella pneumoniae in intensive care units of pediatric departments should alert health care providers about forthcoming carbapenem-resistant Klebsiella pneumoniae infection. Those carbapenem-resistant Klebsiella pneumoniae colonized patients at risk of developing infection due to carbapenem-resistant Klebsiella pneumoniae may be targeted for interventions to reduce subsequent infection occurence and also for timely initiation of empirical carbapenem-resistant Klebsiella pneumoniae active treatment, when necessary.
Descritores: Infecções por Klebsiella/microbiologia
Carbapenêmicos/farmacologia
Infecção Hospitalar/microbiologia
Farmacorresistência Bacteriana
Klebsiella pneumoniae/efeitos dos fármacos
Antibacterianos/farmacologia
-Reto/microbiologia
Infecções por Klebsiella/epidemiologia
Unidades de Terapia Intensiva Neonatal
Infecção Hospitalar/epidemiologia
Métodos Epidemiológicos
Progressão da Doença
Resistência beta-Lactâmica
Testes de Sensibilidade a Antimicrobianos por Disco-Difusão
Klebsiella pneumoniae/isolamento & purificação
Limites: Humanos
Masculino
Feminino
Recém-Nascido
Lactente
Pré-Escolar
Criança
Adolescente
Responsável: BR1.1 - BIREME


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Id: biblio-839191
Autor: Tuon, Felipe F; Graf, Maria Esther; Merlini, Alexandre; Rocha, Jaime L; Stallbaum, Suellen; Arend, Lavinia N; Pecoit-Filho, Roberto.
Título: Risk factors for mortality in patients with ventilator-associated pneumonia caused by carbapenem-resistant Enterobacteriaceae
Fonte: Braz. j. infect. dis;21(1):1-6, Jan.-Feb. 2017. tab, graf.
Idioma: en.
Resumo: Abstract Background: The ideal therapeutic option for ventilator associated pneumonia caused by carbapenem-resistant Enterobacteriaceae is not defined. The aim of this study was to assess mortality-associated risk factors in patients with VAP by CRE and determine the outcome of several treatment options. Methods: This was a retrospective study performed in two tertiary hospitals involving patients with VAP caused by CRE between January 2010 and August 2014. The outcomes were mortality within 30 days of VAP diagnosis and overall mortality during hospital admission. Risk factors for mortality were assessed by comparing variables of survivors and non-survivors. Results: One hundred and twelve patients with CRE-VAP were included, 73 (65%) male, median age 56 years. The 30-day mortality was 57.1% and the overall hospital mortality was 67%. In the binary logistic regression analysis, only age >50 years was independently associated to increased mortality. Polymyxin was the most used drug (47.5%), followed by tigecycline (29.2%) and aminoglycosides (2.4%). Combined therapy with two active drugs was used by 17 patients (20.8%). No therapeutic option was independently associated to survival. However, combined therapy with two active drugs was superior to the therapy with a single active drug when inappropriate therapy was the comparator (p = 0.044). The addition of carbapenem was not associated with increased survival. Conclusion: The best therapeutic option for VAP by CRE is still not completely defined, but the therapy with at least two active drugs was superior in this study.
Descritores: Carbapenêmicos/uso terapêutico
Farmacorresistência Bacteriana
Infecções por Enterobacteriaceae/mortalidade
Pneumonia Associada à Ventilação Mecânica/mortalidade
Antibacterianos/uso terapêutico
-Fatores de Tempo
Modelos Logísticos
Estudos Transversais
Estudos Retrospectivos
Fatores de Risco
Resultado do Tratamento
Mortalidade Hospitalar
Estatísticas não Paramétricas
Enterobacter aerogenes/efeitos dos fármacos
Quimioterapia Combinada/mortalidade
Pneumonia Associada à Ventilação Mecânica/microbiologia
Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico
Klebsiella pneumoniae/efeitos dos fármacos
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Responsável: BR1.1 - BIREME



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