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Bacteriemia por Klebsiella pneumoniae productora de carbapenemasa tipo KPC. Estudio comparativo y evolución en 7 años
INTRODUCTION: Bacteremia caused by Klebsiella pneumoniae carbapenemase-producing strains (Kp-KPC) is associated with high mortality. The hypothesis of our work is that there was an increase in the levels of resistance to different antimicrobials in Kp-KPC isolated from bacteremia MATERIALS AND METHO...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedad Española de Quimioterapia
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372954/ |
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author | Lespada, María Inés Córdova, Ezequiel Roca, Virginia Gómez, Nora Badía, Marcela Rodríguez, Claudia |
author_facet | Lespada, María Inés Córdova, Ezequiel Roca, Virginia Gómez, Nora Badía, Marcela Rodríguez, Claudia |
author_sort | Lespada, María Inés |
collection | PubMed |
description | INTRODUCTION: Bacteremia caused by Klebsiella pneumoniae carbapenemase-producing strains (Kp-KPC) is associated with high mortality. The hypothesis of our work is that there was an increase in the levels of resistance to different antimicrobials in Kp-KPC isolated from bacteremia MATERIALS AND METHODS: Retrospective and descriptive study in two periods: Period 1 (P1) 2010-2014 and period 2 (P2) 2015-2016. We included patients ≥18 years old with bacteremia caused by Kp-KPC in a General Hospital. We defined active drug (AD) if it was in vitro susceptible and in the case of meropenem if it had a MIC ≤ 8 mg/L in combination treatment. RESULTS: Fifty episodes of bacteremia caused by Kp-KPC were analyzed in 45 patients. (P1: 21 and P2: 29). The following variables were similar in both periods: median age (53 vs. 52 years); male sex (45 vs. 62%); site of infection: primary bacteremia (52 vs.45%), bacteremia associated with catheter (24 vs.17%), and other (24 vs. 38%). During P2 there was a significant increase in colistin resistance (28 vs. 69%) (p <0.01), an increase in MIC to meropenem ≥ 16 mg/L (74 and 97%) (p = 0.02), and decrease in tigecycline resistance (29 vs. 4%) (p = 0.02). The overall mortality was 40 in P1 and 32% in P2 (p=0.7). There was not difference in mortality when the definitive treatment was with an active antimicrobial vs. two active antimicrobials, as well as between the different antimicrobials used. CONCLUSIONS: There was a significant increase in bacteremia caused by Kp-KPC and the level of colistin resistance and MIC to meropenem. Overall mortality was high in both periods |
format | Online Article Text |
id | pubmed-6372954 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Sociedad Española de Quimioterapia |
record_format | MEDLINE/PubMed |
spelling | pubmed-63729542019-03-04 Bacteriemia por Klebsiella pneumoniae productora de carbapenemasa tipo KPC. Estudio comparativo y evolución en 7 años Lespada, María Inés Córdova, Ezequiel Roca, Virginia Gómez, Nora Badía, Marcela Rodríguez, Claudia Rev Esp Quimioter Original INTRODUCTION: Bacteremia caused by Klebsiella pneumoniae carbapenemase-producing strains (Kp-KPC) is associated with high mortality. The hypothesis of our work is that there was an increase in the levels of resistance to different antimicrobials in Kp-KPC isolated from bacteremia MATERIALS AND METHODS: Retrospective and descriptive study in two periods: Period 1 (P1) 2010-2014 and period 2 (P2) 2015-2016. We included patients ≥18 years old with bacteremia caused by Kp-KPC in a General Hospital. We defined active drug (AD) if it was in vitro susceptible and in the case of meropenem if it had a MIC ≤ 8 mg/L in combination treatment. RESULTS: Fifty episodes of bacteremia caused by Kp-KPC were analyzed in 45 patients. (P1: 21 and P2: 29). The following variables were similar in both periods: median age (53 vs. 52 years); male sex (45 vs. 62%); site of infection: primary bacteremia (52 vs.45%), bacteremia associated with catheter (24 vs.17%), and other (24 vs. 38%). During P2 there was a significant increase in colistin resistance (28 vs. 69%) (p <0.01), an increase in MIC to meropenem ≥ 16 mg/L (74 and 97%) (p = 0.02), and decrease in tigecycline resistance (29 vs. 4%) (p = 0.02). The overall mortality was 40 in P1 and 32% in P2 (p=0.7). There was not difference in mortality when the definitive treatment was with an active antimicrobial vs. two active antimicrobials, as well as between the different antimicrobials used. CONCLUSIONS: There was a significant increase in bacteremia caused by Kp-KPC and the level of colistin resistance and MIC to meropenem. Overall mortality was high in both periods Sociedad Española de Quimioterapia 2019-02-08 2019-02 /pmc/articles/PMC6372954/ Text en © The Author 2019 https://creativecommons.org/licenses/by-nc/4.0/ The article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/) |
spellingShingle | Original Lespada, María Inés Córdova, Ezequiel Roca, Virginia Gómez, Nora Badía, Marcela Rodríguez, Claudia Bacteriemia por Klebsiella pneumoniae productora de carbapenemasa tipo KPC. Estudio comparativo y evolución en 7 años |
title | Bacteriemia por Klebsiella pneumoniae productora de carbapenemasa tipo KPC. Estudio comparativo y evolución en 7 años |
title_full | Bacteriemia por Klebsiella pneumoniae productora de carbapenemasa tipo KPC. Estudio comparativo y evolución en 7 años |
title_fullStr | Bacteriemia por Klebsiella pneumoniae productora de carbapenemasa tipo KPC. Estudio comparativo y evolución en 7 años |
title_full_unstemmed | Bacteriemia por Klebsiella pneumoniae productora de carbapenemasa tipo KPC. Estudio comparativo y evolución en 7 años |
title_short | Bacteriemia por Klebsiella pneumoniae productora de carbapenemasa tipo KPC. Estudio comparativo y evolución en 7 años |
title_sort | bacteriemia por klebsiella pneumoniae productora de carbapenemasa tipo kpc. estudio comparativo y evolución en 7 años |
topic | Original |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372954/ |
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