Ayala-Gaytán JJ, Alemán-Bocanegra MC, Guajardo-Lara CE, Valdovinos-Chávez SB

Idioma: Español
Referencias bibliográficas: 21
Paginas: 140-145
Archivo PDF: 505.81 Kb.

RESUMEN

Antecedentes: el punto de corte de susceptibilidad de S. aureus con vancomicina recientemente se redujo de 4 a 2 µg/mL por mala respuesta, ahora se cuestiona si debe reducirse aún más.
Objetivo: revisar la frecuencia de aislamientos de cepas de S. aureus resistente a meticilina y vancomicina.
Material y método: estudio retrospectivo, transversal y descriptivo. Durante tres años se aislaron las cepas de S. aureus y con el sistema MicroScan (Dade-Behring, de Sacramento, CA) se obtuvo la concentración mínima inhibitoria (CIM) a vancomicina de acuerdo con el Clinical and Laboratory Standards Institute.
Resultados: 7 (13.2%) de las 53 cepas de S. aureus susceptibles a meticilina y 17 (19.1%) de las 89 cepas de S. aureus resistentes a meticilina tuvieron una concentración mínima inhibitoria a vancomicina de 2 µg/ mL. En ningún caso la CIM fue mayor. De estas 24 muestras, 10 (41.6%) provenían de abscesos subcutáneos, 8 (33.3%) de lavados bronquiales, 4 de hemocultivos y 2 de la cavidad articular.
Conclusiones: la resistencia de nuestros aislados de S. aureus a meticilina es alta e importante la coexistencia de SARM y de SASM con la concentración mínima inhibitoria a vancomicina de 2 μg/mL. No encontramos cepas con CIM de 4 o mayor. El laboratorio debe estar al tanto de las cepas con CIM a vancomicina de ≥ 2 µg/mL, información que debe confirmarse en casos de infecciones severas.

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