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Instituto Nacional de Salud Pública

2015, Número 5

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salud publica mex 2015; 57 (5)


Factores de riesgo en infecciones de vías urinarias causadas por Escherichia coli productora de β-lactamasas de espectro extendido en un hospital de tercer nivel

Alcántar-Curiel MD, Alpuche-Aranda CM, Héctor Javier Varona-Bobadilla HJ, Gayosso-Vázquez C, Jarillo-Quijada MD, Frías-Mendivil M, Sanjuan-Padrón L, Santos-Preciado JI

Idioma: Español
Referencias bibliográficas: 33
Paginas: 412-418
Archivo PDF: 267.85 Kb.


RESUMEN

Objetivo. Evaluar los factores de riesgo en infecciones de vías urinarias (IVUs) causadas por E. coli productora de Beta-Lactamasas de espectro extendido (BLEEs) y caracterizar las BLEEs. Material y métodos. Estudio de casos y controles en pacientes consecutivos con IVUs causadas por E. coli productoras o no de BLEEs en un hospital de referencia. Resultados. E. coli productora de BLEEs se aisló en 22/70 (31%) pacientes con IVUs por E. coli durante un periodo de tres meses. Todos los aislamientos fueron resistentes a cefalosporinas y quinolonas, pero susceptibles a carbapenemes, amikacina y nitrofurantoina. Factores de riesgo significativos incluyeron tratamiento previo con más de dos familias de antibióticos (OR=6.86; IC95% 1.06-157.70; p=0.028), IVUs sintomáticas recurrentes (OR=5.60; IC95% 1.88-17.87; p=0.001) y hospitalizaciones previas (OR=5.06; IC95% 1.64-17.69; p=0.002). Dieciséis aislamientos presentaron el gen betalactamasas (bla)CTX-M-15 y cinco el gen blaTEM-1. Conclusiones. Uno de cada tres pacientes presentó IVU con E. coli resistente a beta-lactámicos, fluoroquinolonas y productora de BLEEs. En estos casos, los factores de riesgo y patrones de resistencia deberían tomarse en cuenta para recomendar tratamiento.


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