Carriers of multiresistant bacteria of clinical importance in critical areas (ICU - INCU) from a Hospital at north of Peru
DOI:
https://doi.org/10.24265/horizmed.2016.v16n3.08Keywords:
Bacterial drug resistance, Carrier state, Healthcare personnelAbstract
Objective: To determine the frequency of multiresistant bacteria Carriers (BM) and its profile of resistance in critical areas (ICU-INCU) in a public hospital in northern Peru (HRL). Material and methods: A cross-sectional observational study was conducted during February to May 2015, in 48 patients and 32 healthcare staff. 4 anatomical regions for sampling were considered and supplemented instruments with antibiotics were used for primary isolation of BM. The resistance phenotype was confirmed by Jailer's test, Modified Hodge and susceptibility to cefoxitin. Results: The frequencies of BM in patients and healthcare staff were 79.1% and 3.1% respectively; also 89.5% of patients were already carriers at the time of admission mainly from Emergency Service, being anorectal region the principal source of isolates with 75.0%. It also was determined that production of extended spectrum beta-lactamase (ESBL) was the principal resistance phenotype with 77.65%, followed by the production of carbapenemases and methicillin resistance with 14.2% and 8.24% respectively. Conclusions: This study reveals the high frequency of multiresistant bacteria carriers in patients in critical areas of HRL and that most of these already were colonized in the anorectal region.
Downloads
References
Aguilar-Gamboa FR, Valiente JN, Mantilla MM. Portadores Nasofaríngeos de Staphylococcus aureus y Streptococcus pneumoniae en personal de Salud del Hospital Provincial Docente Belén de Lambayeque [Internet]. Revista Experiencia en Medicina del Hospital Regional Lambayeque. 2015 [cited 2016 Feb 6]. Available from: http://rem.hrlamb.gob.pe/index.php/REM/article/view/17
López MJ, Cortés JA. Colonización e infección de la vía urinaria en el paciente críticamente enfermo. Med Intensiva [Internet]. Elsevier España, S.L.; [cited 2016 Feb 6];36(2):143–51. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0210-56912012000200008&lng=es&nrm=iso&tlng=es
Olaechea PM, Insausti J, Blanco A, Luque P. Epidemiología e impacto de las infecciones nosocomiales. Med Intensiva [Internet]. Elsevier España, S.L.; 2010 [cited 2014 Dec 3];34(4):256–67. Available from: http://scielo.isciii.es/ scielo.php?script=sci_arttext&pid=S0210-56912010000400006&lng=es&nrm=iso&tlng=es
Custovic A, Smajlovic J, Hadzic S, Ahmetagic S, Tihic N, Hadzagic H. Epidemiological surveillance of bacterial nosocomial infections in the surgical intensive care unit. Mater Sociomed [Internet]. 2014 Feb [cited 2014 Nov 26];26(1):7–11. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3990379&tool=pmcentrez&rendertype=abstract
Geffers C, Gastmeier P. Nosocomial infections and multidrugresistant organisms in Germany: epidemiological data from KISS (the Hospital Infection Surveillance System). Dtsch Arztebl Int [Internet]. 2011 Feb [cited 2014 Nov 24];108(6):87–93. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3047718&tool=pmcentrez&re ndertype=abstract
Moura JP de, Pimenta FC, Hayashida M, Cruz ED de A, Canini SRM da S, Gir E. Colonization of nursing professionals by Staphylococcus aureus. Rev Lat Am Enfermagem. Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo; 2011 Apr;19(2):325–31.
Eliecer Cano M, Ángeles Domínguez M., Ezpeleta C, Padilla B, Ramírez de Arellano E, Martínez-Martínez L. Cultivos de vigilancia epidemiológica de bacterias resistentes a los antimicrobianos de interés nosocomial. Enferm Infecc Microbiol Clin. 2008;26(4):220–9.
Del Castillo MC, López-Cerezo L, Casal M, Pascual A. Evaluation of chromID ESBL medium for detecting carriers of extendedspectrum beta-lactamase-producing enterobacteriaceae. Enferm Infecc Microbiol Clin. Elsevier; 2011 Jan;29(6):471–2.
CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement. M100-S24. Clinical and Laboratory Standards Institute. wayne, PA; 2014.
Kumar D, Singh AK, Ali MR, Chander Y. Antimicrobial Susceptibility Profile of Extended Spectrum β-Lactamase (ESBL) Producing Escherichia coli from Various Clinical Samples. Infect Dis (Auckl). 2014 Jan;7:1–8.
Piersigilli AL, Enrico MC, Bongiovanni ME, Bilbao LE, Martínez G, Ledesma EM. Aislados clínicos de Pseudomonas aeruginosa productores de ß-lactamasa de espectro extendido en un centro privado de Córdoba. Rev Chil infectología. Sociedad Chilena de Infectología; 2009 Aug;26(4):331–5.
Pasteran F, Veliz O, Rapoport M, Guerriero L, Corso A. Sensitive and specific modified Hodge test for KPC and metallo-betalactamase detection in Pseudomonas aeruginosa by use of a novel indicator strain, Klebsiella pneumoniae ATCC 700603. J Clin Microbiol. 2011 Dec;49(12):4301–3.
Rojas DDVM. Betalactamasas tipo AmpC: generalidades y métodos para detección fenotípica. Rev la Soc Venez Microbiol. Sociedad Venezolana de Microbiología; 2009;29(2):78–83.
JV Schaal, Pasquier P, Delacour H, Salvadori A, Jarrassier A, Renner JR, et al. Prevalence of colonization by multiresistant bacteria on admission to the ICU in the French military hospital in Kabul, Afghanistan. Critical Care. BioMed Central; 2013. P78.
Yazgi H, Ertek M, Ozbek A, Kadanali A. [Nasal carriage of Staphylococcus aureus in hospital personnel and the normal population and antibiotic resistance of the isolates]. Mikrobiyol Bul. Jan;37(2-3):137–42.
Trindade JP de A, Goulart Rodrigues É, de Sousa TK, Prado Palos MA, Vieira dos Santos S de L. Trabajadores del área de salud de un hospital oncológico colonizados por microorganismos multidroga resistentes. Enfermería Glob. Universidad de Murcia; 13(33):227–39.
Sękowska A, Gospodarek E, Kusza K. The prevalence of infections and colonisation with Klebsiella pneumoniae strains isolated in ICU patients. Anaesthesiol Intensive Ther. Jan;46(4):280–3.
Kim J, Lee JY, Kim S Il, Song W, Kim J-S, Jung S, et al. Rates of fecal transmission of extended-spectrum β-lactamaseproducing and carbapenem-resistant Enterobacteriaceae among patients in intensive care units in Korea. Ann Lab Med. 2014 Jan;34(1):20–5.
Bakır Saygan S, Yaşar H, Eras Z, Cesur S, Irmak H, Dilmen U, et al. Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus carriage rates in a neonatal intensive care unit. Mikrobiyol Bul. 2010 Jul;44(3):529–31.
Silvestri L, Solidoro A, Milanese M, Van Saene HKF, Fontana F, Gregori D, et al. Topical oropharyngeal vancomycin to control methicillin-resistant Staphylococcus aureus lower airway infection in ventilated patients. Minerva Anestesiol. 2010 Mar;76(3):193–202.
Colquechagua Aliaga F, Sevilla Andrade C, Gonzales Escalante E. Enterobacterias productoras de Betalactamasas de espectro extendido en muestras fecales en el Instituto Nacional de Salud del Niño, Perú [Internet]. Revista Peruana de Medicina Experimental y Salud Pública. 2015 [cited 2015 Jun 28]. Available from: http://www.rpmesp.ins.gob.pe:8080/index.php/rpmesp/article/view/5228
Martínez Buitrago E, Hernández C, Pallares C, Pacheco R, Hurtado K, Recalde M. Frecuencia de aislamientos microbiológicos y perfil de resistencia bacteriana en 13 clínicas y hospitales de alta complejidad en Santiago de Cali - Colombia. Infectio. Elsevier; 2014 Mar;18(01):3–11.
Sales V, Oliveira E, Célia R, Gonçalves F, Melo C. Microbiological analysis of inanimate surfaces in an Intensive Care Unit and patient safety. Rev Enferm Ref. Escola Superior de Enfermagem de Coimbra - Unidade de Investigação em Ciências da Saúde - Enfermagem; 2014 Dec;IV (3):45–53.
Medell Gago M, Hart Casares M, Mora Diaz I. Acinetobacter baumannii versus Pseudomonas aeruginosa. Comportamiento en pacientes críticos con ventilación mecánica. Rev Cubana Med. 1999, Editorial Ciencias Médicas; 51(3):239–46.
Paz Rojas EL, de León Pandolfi DP, Ramírez Ponce R. Resistencia bacteriana en cuidados intensivos y tendencia actual: Departamento de Cuidados Críticos, Servicio de Cuidados Intensivos del Hospital Nacional Guillermo Almenara Irigoyen, Essalud, Lima, Perú, 2004-2006. Acta Médica Peru. Colegio Médico del Perú; 25(3):140–7.
Hernández-Gómez C, Blanco VM, Motoa G, Correa A, Maya JJ, De la Cadena E, et al. Evolución de la resistencia antimicrobiana de bacilos Gram negativos en unidades de cuidados intensivos en Colombia. Biomédica [Internet]. 2013 Nov 5 [cited 2015 Jun 28];34:91. Available from: http://www.revistabiomedica.org/index.php/biomedica/article/view/1667/2490
Trujillo Rodríguez Y, Fernández Alfonso JM, González Lorenzo A, López García I, Delgado Pérez L. Resistencia microbiana de gérmenes aislados en pacientes de las unidades de cuidados intensivos e intermedios. Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez. 2010. Rev Médica Electrónica. 1997, Centro Provincial de Información de Ciencias Médicas de Matanzas--FCMM; 34(5):509–20.
Benner KW, Prabhakaran P, Lowros AS. Epidemiology of infections due to extended-spectrum Beta-lactamaseproducing bacteria in a pediatric intensive care unit. J Pediatr Pharmacol Ther [Internet]. 2014 Apr [cited 2016 Feb 6];19(2):83–90. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4093669&tool=pmcentrez&rendertype=abstract
DalBen MF, Basso M, Garcia CP, Costa SF, Toscano CM, Jarvis WR, et al. Colonization pressure as a risk factor for colonization by multiresistant Acinetobacter spp and carbapenem-resistant Pseudomonas aeruginosa in an intensive care unit. Clinics (Sao Paulo) [Internet]. 2013 Jan [cited 2014 Nov 26];68(8):1128–33. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3752633&tool=pmcentrez&rendertype=abstract
Nastro M, Montoto Piazza L, Saposnik E, García S, Barberis C, Vay C, et al. Resistencia a cefalosporinas de espectro extendido en enterobacterias sin AmpC inducible: Evaluación de los nuevos puntos de corte. Rev Argent Microbiol. Asociación Argentina de Microbiología; 44(1):30–5.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2016 Horizonte Médico (Lima)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Horizonte Médico (Lima) (Horiz. Med.) journal’s research outputs are published free of charge and are freely available to download under the open access model, aimed at disseminating works and experiences developed in biomedical and public health areas, both nationally and internationally, and promoting research in the different fields of human medicine. All manuscripts accepted and published in the journal are distributed free of charge under the terms of a Creative Commons license – Attribution 4.0 International (CC BY 4.0).
