medigraphic.com
Colegio de Medicina Interna de México.

2006, Number 4

<< Back Next >>

Med Int Mex 2006; 22 (4)

Bacteremias: incidence and antimicrobial resistance, trends over 15 years follow-up

Ayala GJJ, Ríos MHA, Velarde PPA, Arzola GCY, Guajardo LCE

Language: Spanish
References: 20
Page: 263-268
PDF size: 170.67 Kb.


ABSTRACT

Objective: To describe the incidence in the major pathogens causing bacteremia and their trends in antimicrobial resistance in a tertiary care teaching hospital.
Methods: Blood culture isolates collected by the laboratory of microbiology were analyzed from January 1st 1990 to December 31st 2004.
Results: The incidence of bacteremia doubled during the second five-year period and on average it reached 7.1/1000 patients discharged. S. aureus and S. epidermidis were the major pathogens isolated and they comprised 39.1% of isolates followed by P. aeruginosa and E. coli. There was a 4-fold increase in the number of isolates of E. coli that surpassed P. aeruginosa isolates in the last five-year period. S. pneumoniae, Enterococcus spp, Klebsiella spp and Enterobacter spp were isolated less frequently. Oxacilin resistance among S. aureus and S. epidermidis remained high and stable. P. aeruginosa showed a remarkable increase in the antimicrobial resistance even to carbapenems. There was not ciprofloxacin resistance among E. coli at the beginning but it was up to 53% when the study concluded. The remaining pathogens were isolated in a few occasions and therefore it was not possible to determine their trends in antimicrobial resistance.
Conclusion: The incidence of bacteremia and the predominance of gram-positive bacteria correspond to the type of hospital of short-stay and to the reports of nosocomial infections. There currently is a progressive increase in antimicrobial resistance. It is necessary to establish policies to guide the use of antibiotics and to reinforce the measures of isolation of the infected patient.


REFERENCES

  1. Mandell LA, Peterson LR, Wise R, et al. The battle against emergin antibiotic resistance: should fluoroquinolonas be used to treat children. Clin Infect Dis 2002;35:721-7.

  2. Jones RN. Global epidemiology of antimicrobial resistance among community-acquired and nosocomial pathogens: A five-year summary from the SENTRY antimicrobial surveillance program (1997-2001). Semm Respir Crit Care Med 2003;24:121-33.

  3. Critchley IA, Karlowsky JA. Optimal use of antibiotic resistance surveillance systems. Clin Microbiol Infect 2004;10:502-11.

  4. Reynolds R, Potz N, Colman M, et al. Antimicrobial susceptibility of the pathogens of bacteremia in the UK and Ireland 2001-2002: The BSAC bacteremia resistance surveillance programme. J Antimicrob Chemother 2004;53:1018-32.

  5. Yinnon AM, Schlesinger Y, Gabbay D, Rudensky B. Analysis of 5 years of bacteraemias: importance of stratification of microbial susceptibilities by source of patients. J Infect 1997;35:17-23.

  6. Performance standards for antimicrobial susceptibility testing. Jan 2004,vol 24(1);M100-S14:1-159. National Committee for Clinical Laboratory Standards.

  7. Scheckler WE, Bobula JA, Beamsley MB, Hadden ST. Bloodstream infection in a community hospital: a 25-year follow-up. Infect Control Hosp Epidemiol 2003;24:936-41.

  8. Kato-Maeda M, Bautista-Alavez A, Rolón-Montes de Oca AL, et al. Tendencia en el incremento de la resistencia antimicrobiana en organismos causantes de bacteremia en un hospital de tercer nivel: 1995-2000. Rev Invest Clin 2003;55:600-5.

  9. Martin GS, Mannino DM, Eaton S, Moss M. The empidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003;348:1546-54.

  10. Sifuentes-Osornio J, Guerrero-Almeida MC, Ponce de León-Garduño A, Guerrero-Almeida ML. Tendencia de las bacteremias y factores de riesgo de muerte en un hospital de tercer nivel de la Ciudad de México, 1981 a 1992. Gac Med Mex 2001;137:191-202.

  11. Wisplinghoff H, Bischoff T, Tallent SM, et al. Nosocomial bloodstream infection in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 2004;39:309-17.

  12. Kaye KS, Engemann JJ, Fraimow HS, Abrutyn E. Pathogens resistant to antimicrobial agents: Epidemiology, molecular mechanisms, and clinical management. Infect Dis Clin North Am 2004;18:467-511.

  13. Jones RN. Resistance patterns among nosocomial pathogens. Trends over the past few years. Chest 2001;119:397s-404s.

  14. Shannon KP, French GL. Increasing resistance to antimicrobial agents of Gram-negative organisms isolated at a London teaching hospital, 1995-2000. J Antimicrobial Chemother 2004;53:818-25.

  15. Colodner R. Extended-spectrum B-lactamases: A challenge for clinical microbiologist and infection control specialists. Am J Infect Control 2005;33:104-7.

  16. Senda K, Arakawa Y, Ichiyama S, et al. PCR detection of metallo-B-lactamase gene (blaIMP) in gram-negative rods resistant to broad-spectrum B-lactams. J Clin Microbiol 1996;34:2909-13.

  17. Garau J, Xercavins M, Rodríguez-Carballeira M, et.al. Emergence and dissemination of quinolone-resistant Escherichia coli in the community. J Antimicrob Chemoter 1999;43:2736-41.

  18. Nema S, Premchandani P, Asolkar MV, Chitnis DS. Emerging bacterial drug resistance in hospital practice. Indian J Med Sci 1997;51:275-80.

  19. Goossens H, Ferech M, Vander RS, Elseviers M. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet 2005;365:579-87.

  20. Peterson LR, Brossette SE. Hunting health care-associated infections from the clinical microbiology laboratory: passive, active, and virtual surveillance. J Clin Microbiol 2002;40:1-4.




2020     |     www.medigraphic.com