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Scand J Infect Dis ; 40(3): 234-40, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-17852898

RESUMEN

The spread of Gram-negative bacilli with acquired metallo-beta-lactamase (MBL) threatens the successful treatment of major nosocomial infections. The objective of this study was to evaluate the differences in the clinical characteristics of bacteremia caused by MBL-producing Acinetobacter species and MBL non-producing isolates. Two retrospective case-control studies were conducted using data on patients with Acinetobacter bacteremia, who were admitted between January 2001 and December 2005 at a 1500-bed, tertiary-care teaching hospital. Case group 1 (n=27) included patients from whom imipenem-resistant Acinetobacter was isolated in blood culture, and case group 2 (n=7) consisted of those patients from group 1 who yielded MBL-producing isolates. The control group (n=41) included patients from whom carbapenem-susceptible Acinetobacter isolates were isolated in blood culture. Multivariate analysis revealed that the independent risk factors for imipenem-resistant Acinetobacter bacteremia were neutropenia and prolonged use of carbapenem. The independent risk factors for MBL-producing Acinetobacter bacteremia were neutropenia and prolonged use of cephalosporins. The results of this study suggest that a prolonged use of cephalosporins may be associated with MBL-producing Acinetobacter bacteremia.


Asunto(s)
Infecciones por Acinetobacter/microbiología , Acinetobacter/efectos de los fármacos , Bacteriemia/microbiología , Farmacorresistencia Bacteriana , beta-Lactamasas/biosíntesis , Acinetobacter/clasificación , Acinetobacter/enzimología , Acinetobacter/aislamiento & purificación , Infecciones por Acinetobacter/tratamiento farmacológico , Infecciones por Acinetobacter/epidemiología , Infecciones por Acinetobacter/fisiopatología , Adulto , Anciano , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Bacteriemia/tratamiento farmacológico , Bacteriemia/epidemiología , Bacteriemia/fisiopatología , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Estudios de Casos y Controles , Cefalosporinas/farmacología , Cefalosporinas/uso terapéutico , Dermatoglifia del ADN , ADN Bacteriano/genética , Electroforesis en Gel de Campo Pulsado , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neutropenia/complicaciones , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
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