RESUMEN
La bacteriemia por Enterococcus adquirió un papel relevante en los últimos años, debido al incremento de casos intrahospitalarios. Nuestro objetivo fue describir los episodios ocurridos en pacientes adultos de nuestro hospital. Entre enero del 2000 y diciembre del 2013 se registraron 117 episodios. El 61% eran varones y el 39% mujeres. La edad promedio fue 68 años. El 91% presentaba condiciones predisponentes. El principal foco fue intraabdominal. Enterococcus faecalis fue responsable del 65% de los casos, Enterococcus faecium del 28% y otras especies del 7%. El 34% fueron bacteriemias polimicrobianas. Todas las cepas de E. faecalis fueron sensibles a ampicilina y vancomicina. El 88% de los aislamientos de E. faecium fue resistente a ampicilina y el 54% a vancomicina y teicoplanina. En nuestro hospital, el enterococo es el sexto patógeno causante de bacteriemia intrahospitalaria y predomina E. faecium resistente a ampicilina y vancomicina.
Enterococcal bacteremia has acquired considerable importance in recent years, mainly due to an increased number of cases that occur during hospital admission. We describe the episodes of enterococcal bacteremia in adult patients recorded at our hospital. Between January 2000 and December 2013, 117 episodes were analyzed. Sixty one percent (61%) of the patients were male and 39% female. The mean age was 68. Predisposing factors were present in 91% of patients. The primary source of infection was intraabdominal. Enterococcus faecalis was responsible for 65% of the cases; E. faecium for 28%; and other species for 7%. Thirty four percent (34%) of cases were polymicrobial bacteremia. All E. faecalis isolates were susceptible to ampicillin and vancomycin. Eighty eight percent (88%) of E. faecium were resistant to ampicillin and 54% to vancomycin and teicoplanin. In our hospital, Enterococcus is the sixth pathogen causing nosocomial bacteremia, with high incidence of ampicillin and vancomycin-resistant E. faecium.
Asunto(s)
Humanos , Masculino , Femenino , Bacteriemia/microbiología , Bacteriemia/tratamiento farmacológico , Bacteriemia/epidemiología , Enterococcus faecium/efectos de los fármacos , Enterococcus faecalis/efectos de los fármacos , Antiinfecciosos/uso terapéuticoRESUMEN
Enterococcal bacteremia has acquired considerable importance in recent years, mainly due to an increased number of cases that occur during hospital admission. We describe the episodes of enterococcal bacteremia in adult patients recorded at our hospital. Between January 2000 and December 2013, 117 episodes were analyzed. Sixty one percent (61%) of the patients were male and 39% female. The mean age was 68. Predisposing factors were present in 91% of patients. The primary source of infection was intraabdominal. Enterococcus faecalis was responsible for 65% of the cases; E. faecium for 28%; and other species for 7%. Thirty four percent (34%) of cases were polymicrobial bacteremia. All E. faecalis isolates were susceptible to ampicillin and vancomycin. Eighty eight percent (88%) of E. faecium were resistant to ampicillin and 54% to vancomycin and teicoplanin. In our hospital, Enterococcus is the sixth pathogen causing nosocomial bacteremia, with high incidence of ampicillin and vancomycin-resistant E. faecium.
Asunto(s)
Bacteriemia/microbiología , Enterococcus/aislamiento & purificación , Infecciones por Bacterias Grampositivas/microbiología , Adulto , Anciano , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Argentina/epidemiología , Bacteriemia/tratamiento farmacológico , Bacteriemia/epidemiología , Coinfección , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Comorbilidad , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Susceptibilidad a Enfermedades , Farmacorresistencia Bacteriana Múltiple , Enterococcus/efectos de los fármacos , Enterococcus faecalis/efectos de los fármacos , Enterococcus faecalis/aislamiento & purificación , Enterococcus faecium/efectos de los fármacos , Enterococcus faecium/aislamiento & purificación , Femenino , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Infecciones por Bacterias Grampositivas/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Infecciones Urinarias/epidemiología , Infecciones Urinarias/microbiologíaRESUMEN
Bacteremia is an important cause of morbimortality. This study describes the episodes of communityacquired bacteremia in adult patients registered at our hospital. Between January 2005 and December 2013, 645 episodes were studied. A total of 51% of patients were male and 49% female. The mean age was 67. The most frequent comorbidities were: diabetes (18%), neoplasia (15%), heart disease (10%) and HIV infection (6%). The focus was: urinary (22%), respiratory (18%), cutaneous (15%), abdominal (13%), and others (4%). Gram-negative bacteria prevailed (51.88%). The most frequent microorganisms were Escherichia coli (30.29%), Streptococcus pneumoniae (15.51%), y Staphylococcus aureus (14.06%). Bacteremia was polymicrobial in 7.14% of the cases. Forty percent of E. coli isolates were resistant to ciprofloxacin and 6% to ceftazidime. Fifteen percent of S. aureus strains were resistant to methicillin whereas only 7% of S. pneumoniae expressed high resistance to penicillin with MICs = 2 µg/ mL, according to meningitis breakpoints.