Aguilera‑Alonso D, Escosa‑García L, Goycochea‑Valdivia WA, Soler‑Palacín P, Saavedra‑Lozano J, Rodrigo C, Cercenado E,  Ramos JT, Baquero‑Artigao F

Idioma: Español
Referencias bibliográficas: 25
Paginas: 7-18
Archivo PDF: 334.68 Kb.

RESUMEN

En los últimos años se ha evidenciado un incremento en la incidencia de infecciones por bacterias multirresistentes. Las principales amenazas son los bacilos gramnegativos productores de β-lactamasas de espectro extendido (BLEE), AmpC o carbapenemasas, Staphylococcus aureus resistente a la meticilina y Enterococcus faecium resistente a la vancomicina. Para hacer frente a este problema es fundamental establecer programas de optimización en el uso de antimicrobianos (PROA) específicos para pediatría, realizar una vigilancia epidemiológica activa y desarrollar una adecuada política de control de infecciones. Su abordaje terapéutico es, a menudo, complejo y multidisciplinar, precisando frecuentemente el uso de antibióticos con menor experiencia. En este documento de posicionamiento, elaborado por la Asociación Española de Pediatría y la Sociedad Española de Infectología Pediátrica, se revisa la epidemiología y el tratamiento de estas infecciones siguiendo la mejor evidencia disponible.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Cassini A, Högberg LD, Plachouras D, Quattrocchi A, Hoxha A, Simonsen GS et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis. 2019; 19: 56-66.

2. Rodríguez-Baño J, Gutiérrez-Gutiérrez B, Machuca I, Pascual A. Treatment of infections caused by Extended-Spectrum-Beta-Lactamase-, Ampc-, and Carbapenemase-producing Enterobacteriaceae. Clin Microbiol Rev. 2018; 31 (2). pii: e00079-17.

3. Gutierrez-Gutiérrez B, Rodríguez-Baño J. Current options for the treatment of infections due to extended-spectrum beta-lactamase-producing Enterobacteriaceae in different groups of patients. Clin Microbiol Infect. 2019; 25 (8): 932-942.

4. McMullan BJ, Andresen D, Blyth CC, Avent ML, Bowen AC, Britton PN et al. Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines. Lancet Infect Dis. 2016; 16: e139-e152.

5. Turner NA, Sharma-Kuinkel BK, Maskarinec SA, Eichenberger EM, Shah PP, Carugati M et al. Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research. Nat Rev Microbiol. 2019; 17: 203-218.

6. Ara Montojo MF, Aguilera-Alonso D, Del Rosal T, Sanz Santaeufemia FJ, Berzosa A, Soto Sánchez ATB. High rate of methillin resistance among Staphylococcus aureus isolates from Spanish children with community-acquired pneumoniale. In: 37th Annual Meeting of the European Society for Paediatric Infectious Diseases. 2019.

7. Ariza J, Cobo J, Baraia-Etxaburu J, Benito N, Bori G, Cabo J et al. Executive summary of management of prosthetic joint infections. Clinical practice guidelines by the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC). Enferm Infecc Microbiol Clin. 2017; 35: 189-195.

8. Cosimi RA, Beik N, Kubiak DW, Johnson JA. Ceftaroline for severe methicillin-resistant Staphylococcus aureus infections: a systematic review. Open Forum Infect Dis. 2017; 4: ofx084.

9. Cercenado E. Enterococcus: phenotype and genotype resistance and epidemiology in Spain. Enferm Infecc Microbiol Clin. 2011; 29: 59-65.

10. Bielicki JA, Lundin R, Sharland M, ARPEC Project. Antibiotic Resistance Prevalence in Routine Bloodstream Isolates from Children’s Hospitals Varies Substantially from Adult Surveillance Data in Europe. Pediatr Infect Dis J. 2015; 34: 734-741.

11. Yim J, Smith JR, Rybak MJ. Role of combination antimicrobial therapy for vancomycin-resistant enterococcus faecium infections: review of the current evidence. Pharmacother J Hum Pharmacol Drug Ther. 2017; 37: 579-592.

12. Flokas ME, Karanika S, Alevizakos M, Mylonakis E. Prevalence of ESBL-Producing Enterobacteriaceae in pediatric bloodstream infections: a systematic review and meta-analysis. PLoS One. 2017; 12: e0171216.

13. Yanhong Jessika Hu, Anju Ogyu, Benjamin J Cowling, Keiji Fukuda HHP. Available evidence of antibiotic resistance from extended-spectrum β-lactamase-producing Enterobacteriaceae in paediatric patients in 20 countries: a systematic review and meta-analysis. Bull World Health Organ. 2019; 1: 486-501B.

14. Tamma PD, Doi Y, Bonomo RA, Johnson JK, Simner PJ; Antibacterial Resistance Leadership Group. A primer on AmpC β-Lactamases: necessary knowledge for an increasingly multidrug-resistant world. Clin Infect Dis. 2019; 69 (8): 1446-1455.

15. Cheng MP, Lee RS, Cheng AP, De L’étoile-Morel S, Demir K, Yansouni CP et al. Beta-Lactam/beta-lactamase inhibitor therapy for potential AmpC-Producing organisms: a systematic review and meta-analysis. Open Forum Infect Dis. 2019; 6 (7). pii: ofz248.

16. Gudiol C, Aguilar-Guisado M, Azanza JR, Candel FJ, Cantón R, Carratalà J et al. Executive summary of the consensus document of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Network for Research in Infectious Diseases (REIPI) and the Spanish Society of Haematology and Haemotherapy (SEHH) on the management of febrile neutropenia in patients with hematological malignancies. Enferm Infecc Microbiol Clin. 2019; pii: S0213-005X(19)30130-2.

17. Logan LK, Renschler JP, Gandra S, Weinstein RA, Laxminarayan R; Centers for Disease Control; Prevention Epicenters Program. Carbapenem-resistant enterobacteriaceae in children, United States, 1999-2012. Emerg Infect Dis. 2015; 21: 2014-2021.

18. Logan LK, Gandra S, Mandal S, Klein EY, Levinson J, Weinstein RA et al. Multidrug- and carbapenem-resistant Pseudomonas aeruginosa in Children, United States, 1999-2012. J Pediatric Infect Dis Soc. 2016; 6: 352-359.

19. Chiotos K, Tamma PD, Flett KB, Karandikar MV, Nemati K, Bilker WB et al. Increased 30-day mortality associated with carbapenem-resistant enterobacteriaceae in children. Open Forum Infect Dis. 2018; 5: ofy222.

20. Chiotos K, Tamma PD, Flett KB, Naumann M, Karandikar MV, Bilker WB et al. Multicenter study of the risk factors for colonization or infection with carbapenem-resistant enterobacteriaceae in children. Antimicrob Agents Chemother. 2017 Dec; 61 (12): e01440-01417.

21. Gutiérrez-Gutiérrez B, Salamanca E, de Cueto M, Hsueh PR, Viale P, Paño-Pardo JR et al. Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT): a retrospective cohort study. Lancet Infect Dis. 2017; 17: 726-734.

22. Cies JJ, Moore WS, Enache A, Chopra A, Chopra A. Population pharmacokinetics and pharmacodynamic target attainment of meropenem in critically ill young children. J Pediatr Pharmacol Ther. 2017; 22: 276-285.

23. Daikos GL, Markogiannakis A. Carbapenemase-producing Klebsiella pneumoniae: (when) might we still consider treating with carbapenems? Clin Microbiol Infect. 2011; 17: 1135-1141.

24. Nabarro LEB, Shankar C, Pragasam AK, Mathew G, Jeyaseelan V, Veeraraghavan B et al. Clinical and bacterial risk factors for mortality in children with carbapenem-resistant Enterobacteriaceae bloodstream infections in India. Pediatr Infect Dis J. 2017; 36: e161-e166.

25. Hsu AJ, Tamma PD. Treatment of multidrug-resistant gram-negative infections in children. Clin Infect Dis. 2014; 58: 1439-1448.