Characterization of infections in adults due to methicillin-resistant staphylococcus aureus(MRSA) in an IV level health institution, Barranquilla 2016
DOI:
https://doi.org/10.18041/2390-0512/bioc..2.2291Keywords:
infections in adults, methicillin-resistant staphylococcus aureus, infectionsAbstract
Objective: To determine the epidemiological, microbiological and clinical characteristics of infections caused by methicillin-resistant Staphylococcus aureus in adult patients hospitalized in an institution of IV level of complexity in 2016. Method: Obtaining data was done by using the base of data from the microbiology laboratory and the review of systematized clinical records of patients who were hospitalized in the period January to December 2016 with positive culture report for methicillin-resistant Staphylococcus aureus, at the University Hospital ESE Cari. Results: When we related the variables age, sex, presence of comorbidities, qSOFA, hospital stay and days with antibiotic, it was found that there were statistically significant differences between qSOFA and mortality (Fisher <0.05), and although in the rest of the cases the differences were not significant (largely due to the sample size since only 6 subjects died), the fact is highlighted that all those who presented at least one comorbidity died, and that this was greater in women, in those who had hospital stays longer and more days with antibiotics. Conclusion: The results of the present study show a high number of cases of S. Aureus MR. Most of them were young adults, with variable hospital stays, in which combined therapy was used.
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References
Lowy F. Staphylococcus Aureus Infections. The New England Journal of Medicine. 1998; Volumen 339(Numero 8):520-532.
Deurenberg RStobberingh E. The evolution of Staphylococcus aureus. Infection, Genetics and Evolution. 2008;8(6):747-763.
Leal A, Eslava J, Álvarez C, Buitrago G, Méndez M, Grebo. Canales endémicos y marcadores de resistencia bacteriana, en instituciones de tercer nivel de Bogotá, Colombia. Rev Salud Pública. 2006;8(Supl 1):59-70.
Lowy F. Staphylococcus Aureus Infections. The New England Journal of Medicine. 1998; Volumen 339(Numero 8):520-532.
Suárez C, Kattán J, Guzmán A, Villegas M. Mecanismos de resistencia a carbapenems en P. aeruginosa, Acinetobacter y Enterobacteriaceae y estrategias para su prevención y control. Infectio. 2006;10:85-93.
Lucet J, Chevret S, Decré D, Vanjak D, Macrez A, Bédos J, et al. Outbreak of multiply resistant Enterobacteriaceae in an intensive care unit: epidemiology and risk factors for acquisition. Clin Infect Dis. 1996;22:430-6.
Organización Panamericana de la Salud. Estrategia mundial de la OMS para contener la resistencia a los antimicrobianos. Revista Panamericana de Salud Pública. 2001;10(4):284- 293.
Espinosa C, Castillo JS, Cortés JA, Leal AL. Cúal es el perfil de resistencia de Cocos Gram positivos aislados en los hospitales en Colombia, 2001-2007. Acta Med Colomb 2008;33:1.
Grupo GREBO. Boletín Informativo Número 8, Bogotá, 2016, ISSN. Bogotá: GREBO; 2016.
Sopena N, Sabrià M. Staphylococcus aureus resistente a la meticilina. Medicina Clínica. 2002;118(17):671-676.
Espinosa C, Cortés J, Castillo J, Leal A. Revisión sistemática de la resistencia antimicrobiana en cocos Gram positivos intrahospitalarios en Colombia. Biomédica. 2011;31(1):27.
Harbarth S, Rutschmann O, Sudre P, Pittet D. Impact of methicillin resistance on the outcome of patients with bacteremia caused by Staphylococcus aureus. Arch Intern Med. 1998;158:182- 9.
Londoño JF, Ortiz GM, Gaviria AM. Prevalencia de Staphylococcus aureus resistente a meticilina en personal de la unidad de terapia intensiva de la Clínica Universitaria Bolivariana, Medellín. Infectio. 2006;10:160-6.
Whitby M, McLaws ML, Berry G. Risk of death from methicillin-resistant Staphylococcus aureus bacteraemia: A meta-analysis. Med J Aust. 2001;175:264-7.
Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y. Comparison of mortality associated with methicillinresistant and methicillin-susceptible Staphylococcus aureus bacteremia: A meta-analysis. Clin Infect Dis. 2003;36:53-9.
Haessler S, Mackenzie T, Kirkland KB. Long-term outcomes following infection with meticillin-resistant or meticillin-susceptible Staphylococcus aureus. J Hosp Infect. 2008;69:39-45.
Leal AL, Eslava-Schmalbach J, Álvarez C, Buitrago G, Méndez M. Endemic tendencies and bacterial resistance markers in thirdlevel hospitals in Bogota, Colombia. Rev Salud Pública (Bogotá). 2006;8(Suppl.1):59-70.
Granados G, Londoño H, Vargas M, Arango J, Benítez F, Barciela E, et al. Epidemiología de la bacteriemia asociada a catéteres endovasculares en 35 unidades de cuidados intensivos de Colombia. Acta Colombiana de Cuidados Intesivos. 2009; 9 (1): 36-42.
Gomes A, Sanches I, Aires de Sousa M, Castaneda E, de Lencastre H. Molecular epidemiology of methicillinresistant Staphylococcus aureus in Colombian hospitals: dominance of a single unique multidrug–resistant clone. Microb Drug Resist 2001; 7: 23–32.
Cruz C, Moreno J, Renzoni A, Hidalgo M, Reyes J, Schrenzel J, et al. Tracking methicillin– resistant Staphylococcus aureus clones in Colombian hospitals over 7 years (1996–2003): emergence of a new dominant clone. Int J Antimicrob Agents 2005; 26: 457–462.
Alvarez C, Barrientos O, Leal A, Contreras G, Barrero L, Rincón S, et al. Community associated methicillin resistant Staphylococcus aureus, Colombia. Emerg Infect Dis 2006; 12: 2000–2001.
Cortés J, Gómez C, Cuervo S, Leal A, GREBO. Implicaciones en salud Pública de Staphylococcus aureus meticilino resistente adquirido en la comunidad en Bogotá, Colombia. Rev Salud Pública. 2007; 9:448–454.
Buitrago G, Cortés JA, Castillo JS, Leal AL, Sánchez R, Alvarez CA. Emergencia de Staphylococcus aureus resistente a meticilina con perfil comunitario en hospitales de Bogotá. Infectio. 2008;12:64.
Escobar J, Moreno J, Díaz P, Castro B, Leal A, Vanegas N. Caracterización molecular de Staphylococcus aureus resistente a meticilina adquirido en la comunidad (SARM–AC) en Colombia. Infectio 2008; 12: 72.
Vesga O, Toro JM. Sepsis por Staphyloccoccus aureus: estudio descriptivo de 61 casos. Acta Med Colomb. 1994; 19: 116–124.
Jiménez JN, Correa M, Rúa A, Zapata M, Riaño R, Báez P, et al. Detección molecular de Staphylococcus aureus resistente a meticilina (MRSA) colonizando manos de individuos de la población general. Infectio. 2008; 12: 73.
Ospina S. Comunicación personal. Hospital Universitario San Vicente de Paúl, 2008.
Zuazo JL. El recurso microbiológico en el diagnóstico de las enfermedades infecciosas. En: Llop A, Valdés M, Zuazo J. Microbiología y Parasitología Médicas. La Habana: ECIMED; 2001. p. 571 – 80.
Castillo JS, Leal AL, Cortés JA, Álvarez CA, Sánchez R, Buitrago G, et al. Mortality among critically ill patients with methicillin-resistant Staphylococcus aureus bacteremia: A multicenter cohort study in Colombia. Rev Panam Salud Pública. 2012;32:343-50.
Barrero, Liliana I. Castillo, Juan S. Leal, Aura L. Sánchez, Ricardo, Cortés, Jorge A. Álvarez, Carlos A. González Andrés L. Impacto económico de la resistencia a la meticilina en pacientes con bacteriemia por Staphylococcus aureus en hospitales de Bogotá. Biomédica 2014;34:345- 53.
Que Y, Moreillon P. Staphylococcus aureus (incluido el síndrome del shock tóxico). En: Mandell, Douglas, Bennett. Enfermedades infecciosas Principios y práctica. Vol.1. Octava edición. España: Elsevier España, S.L.U. 2016. p. 2356 – 2392.
Lowy F. Staphylococcus Aureus Infections. The New England Journal of Medicine. 1998; Volumen 339(Numero 8):520 - 532.
Deurenberg R, Stobberingh E. The evolution of Staphylococcus aureus. Infection, Genetics and Evolution. 2008;8(6):747-763.
Cadena J, Thinwa J, Walter E, et al. Risk factors for the development of active methicillin- resistant Staphylococcus aureus (MRSA) infection in patients colonized with MRSA at hospital admission. American Journal of Infection Control 2016; 44:1617-21.
Aires de Sousa M, de Lencastre H. Bridges from hospitals to the laboratory: genetic portraits of methicillin–resistant Staphylococcus aureus clones. FEMS Immunol Med Microbiol 2004; 40:101–111.
Cadena J, Thinwa J, Walter E, et al. Risk factors for the development of active methicillin- resistant Staphylococcus aureus (MRSA) infection in patients colonized with MRSA at hospital admission. American Journal of Infection Control 2016; 44:1617-21.
Liu C, Bayer A, Cosgrove S, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections in Adults and Children. Infectious Diseases in Clinical Practice. 2011;19(3):207- 209
Tiwari H K, Sapkota D, Sen M R. High prevalence of multidrug-resistant MRSA in a tertiary care hospital of northern India. Infection and Drug Resistance 2008;1: 57–61.
Rajaduraipandi K, Mani KR, Panneerselvam K,M Mani, M Bhaskar, P Manikandan. Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus: A multicentre study. Ind J Med Microbiol 2006; 24:34–8
Assadullah S, Kakru DK, Thoker MA, Bhat F A, Hussain N, Shah A. Emergence of low level vancomycin resistance in MRSA. Indian J Med Microbiol 2003; 21:196–8.
Moran G, Krishnadasan A, Gorwitz R, Fosheim G, McDougal L, Carey R et al. Methicillin- ResistantS. aureusInfections among Patients in the Emergency Department. New England Journal of Medicine. 2006;355(7):666-674.
Yilmaz G, Aydin K, Iskender S, Caylan R, Koksal I. Detection and prevalence of inducible clindamycin resistance in staphylococci. J Med Microbiol 2007; 56: 342-5.
Haq E, Shahriar, M., Haq, A., Gomes, B. C., Hossain, M. M., Razzak, M. A et al. Prevalence of β-lactamaseproducing and non-producing methicillin resistant Staphylococcus aureus in clinical samples in Bangladesh. Journal of Microbiology and Antimicrobials 2011; 3(5):112- 8.
Talan D, Krishnadasan A, Gorwitz R, Fosheim G, Limbago B, Albrecht V et al. Comparison of Staphylococcus aureus From Skin and Soft-Tissue Infections in US Emergency Department Patients, 2004 and 2008. Clinical Infectious Diseases. 2011;53(2):144-149.
Haydar S, Spanier M, Weems P, Wood S, Strout T. Comparison of qSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis. The American Journal of Emergency Medicine. 2017.
Deurenberg RStobberingh E. The evolution of Staphylococcus aureus. Infection, Genetics and Evolution. 2008;8(6):747-763.
Leal A, Eslava J, Álvarez C, Buitrago G, Méndez M, Grebo. Canales endémicos y marcadores de resistencia bacteriana, en instituciones de tercer nivel de Bogotá, Colombia. Rev Salud Pública. 2006;8(Supl 1):59-70.
Lowy F. Staphylococcus Aureus Infections. The New England Journal of Medicine. 1998; Volumen 339(Numero 8):520-532.
Suárez C, Kattán J, Guzmán A, Villegas M. Mecanismos de resistencia a carbapenems en P. aeruginosa, Acinetobacter y Enterobacteriaceae y estrategias para su prevención y control. Infectio. 2006;10:85-93.
Lucet J, Chevret S, Decré D, Vanjak D, Macrez A, Bédos J, et al. Outbreak of multiply resistant Enterobacteriaceae in an intensive care unit: epidemiology and risk factors for acquisition. Clin Infect Dis. 1996;22:430-6.
Organización Panamericana de la Salud. Estrategia mundial de la OMS para contener la resistencia a los antimicrobianos. Revista Panamericana de Salud Pública. 2001;10(4):284- 293.
Espinosa C, Castillo JS, Cortés JA, Leal AL. Cúal es el perfil de resistencia de Cocos Gram positivos aislados en los hospitales en Colombia, 2001-2007. Acta Med Colomb 2008;33:1.
Grupo GREBO. Boletín Informativo Número 8, Bogotá, 2016, ISSN. Bogotá: GREBO; 2016.
Sopena N, Sabrià M. Staphylococcus aureus resistente a la meticilina. Medicina Clínica. 2002;118(17):671-676.
Espinosa C, Cortés J, Castillo J, Leal A. Revisión sistemática de la resistencia antimicrobiana en cocos Gram positivos intrahospitalarios en Colombia. Biomédica. 2011;31(1):27.
Harbarth S, Rutschmann O, Sudre P, Pittet D. Impact of methicillin resistance on the outcome of patients with bacteremia caused by Staphylococcus aureus. Arch Intern Med. 1998;158:182- 9.
Londoño JF, Ortiz GM, Gaviria AM. Prevalencia de Staphylococcus aureus resistente a meticilina en personal de la unidad de terapia intensiva de la Clínica Universitaria Bolivariana, Medellín. Infectio. 2006;10:160-6.
Whitby M, McLaws ML, Berry G. Risk of death from methicillin-resistant Staphylococcus aureus bacteraemia: A meta-analysis. Med J Aust. 2001;175:264-7.
Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y. Comparison of mortality associated with methicillinresistant and methicillin-susceptible Staphylococcus aureus bacteremia: A meta-analysis. Clin Infect Dis. 2003;36:53-9.
Haessler S, Mackenzie T, Kirkland KB. Long-term outcomes following infection with meticillin-resistant or meticillin-susceptible Staphylococcus aureus. J Hosp Infect. 2008;69:39-45.
Leal AL, Eslava-Schmalbach J, Álvarez C, Buitrago G, Méndez M. Endemic tendencies and bacterial resistance markers in thirdlevel hospitals in Bogota, Colombia. Rev Salud Pública (Bogotá). 2006;8(Suppl.1):59-70.
Granados G, Londoño H, Vargas M, Arango J, Benítez F, Barciela E, et al. Epidemiología de la bacteriemia asociada a catéteres endovasculares en 35 unidades de cuidados intensivos de Colombia. Acta Colombiana de Cuidados Intesivos. 2009; 9 (1): 36-42.
Gomes A, Sanches I, Aires de Sousa M, Castaneda E, de Lencastre H. Molecular epidemiology of methicillinresistant Staphylococcus aureus in Colombian hospitals: dominance of a single unique multidrug–resistant clone. Microb Drug Resist 2001; 7: 23–32.
Cruz C, Moreno J, Renzoni A, Hidalgo M, Reyes J, Schrenzel J, et al. Tracking methicillin– resistant Staphylococcus aureus clones in Colombian hospitals over 7 years (1996–2003): emergence of a new dominant clone. Int J Antimicrob Agents 2005; 26: 457–462.
Alvarez C, Barrientos O, Leal A, Contreras G, Barrero L, Rincón S, et al. Community associated methicillin resistant Staphylococcus aureus, Colombia. Emerg Infect Dis 2006; 12: 2000–2001.
Cortés J, Gómez C, Cuervo S, Leal A, GREBO. Implicaciones en salud Pública de Staphylococcus aureus meticilino resistente adquirido en la comunidad en Bogotá, Colombia. Rev Salud Pública. 2007; 9:448–454.
Buitrago G, Cortés JA, Castillo JS, Leal AL, Sánchez R, Alvarez CA. Emergencia de Staphylococcus aureus resistente a meticilina con perfil comunitario en hospitales de Bogotá. Infectio. 2008;12:64.
Escobar J, Moreno J, Díaz P, Castro B, Leal A, Vanegas N. Caracterización molecular de Staphylococcus aureus resistente a meticilina adquirido en la comunidad (SARM–AC) en Colombia. Infectio 2008; 12: 72.
Vesga O, Toro JM. Sepsis por Staphyloccoccus aureus: estudio descriptivo de 61 casos. Acta Med Colomb. 1994; 19: 116–124.
Jiménez JN, Correa M, Rúa A, Zapata M, Riaño R, Báez P, et al. Detección molecular de Staphylococcus aureus resistente a meticilina (MRSA) colonizando manos de individuos de la población general. Infectio. 2008; 12: 73.
Ospina S. Comunicación personal. Hospital Universitario San Vicente de Paúl, 2008.
Zuazo JL. El recurso microbiológico en el diagnóstico de las enfermedades infecciosas. En: Llop A, Valdés M, Zuazo J. Microbiología y Parasitología Médicas. La Habana: ECIMED; 2001. p. 571 – 80.
Castillo JS, Leal AL, Cortés JA, Álvarez CA, Sánchez R, Buitrago G, et al. Mortality among critically ill patients with methicillin-resistant Staphylococcus aureus bacteremia: A multicenter cohort study in Colombia. Rev Panam Salud Pública. 2012;32:343-50.
Barrero, Liliana I. Castillo, Juan S. Leal, Aura L. Sánchez, Ricardo, Cortés, Jorge A. Álvarez, Carlos A. González Andrés L. Impacto económico de la resistencia a la meticilina en pacientes con bacteriemia por Staphylococcus aureus en hospitales de Bogotá. Biomédica 2014;34:345- 53.
Que Y, Moreillon P. Staphylococcus aureus (incluido el síndrome del shock tóxico). En: Mandell, Douglas, Bennett. Enfermedades infecciosas Principios y práctica. Vol.1. Octava edición. España: Elsevier España, S.L.U. 2016. p. 2356 – 2392.
Lowy F. Staphylococcus Aureus Infections. The New England Journal of Medicine. 1998; Volumen 339(Numero 8):520 - 532.
Deurenberg R, Stobberingh E. The evolution of Staphylococcus aureus. Infection, Genetics and Evolution. 2008;8(6):747-763.
Cadena J, Thinwa J, Walter E, et al. Risk factors for the development of active methicillin- resistant Staphylococcus aureus (MRSA) infection in patients colonized with MRSA at hospital admission. American Journal of Infection Control 2016; 44:1617-21.
Aires de Sousa M, de Lencastre H. Bridges from hospitals to the laboratory: genetic portraits of methicillin–resistant Staphylococcus aureus clones. FEMS Immunol Med Microbiol 2004; 40:101–111.
Cadena J, Thinwa J, Walter E, et al. Risk factors for the development of active methicillin- resistant Staphylococcus aureus (MRSA) infection in patients colonized with MRSA at hospital admission. American Journal of Infection Control 2016; 44:1617-21.
Liu C, Bayer A, Cosgrove S, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections in Adults and Children. Infectious Diseases in Clinical Practice. 2011;19(3):207- 209
Tiwari H K, Sapkota D, Sen M R. High prevalence of multidrug-resistant MRSA in a tertiary care hospital of northern India. Infection and Drug Resistance 2008;1: 57–61.
Rajaduraipandi K, Mani KR, Panneerselvam K,M Mani, M Bhaskar, P Manikandan. Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus: A multicentre study. Ind J Med Microbiol 2006; 24:34–8
Assadullah S, Kakru DK, Thoker MA, Bhat F A, Hussain N, Shah A. Emergence of low level vancomycin resistance in MRSA. Indian J Med Microbiol 2003; 21:196–8.
Moran G, Krishnadasan A, Gorwitz R, Fosheim G, McDougal L, Carey R et al. Methicillin- ResistantS. aureusInfections among Patients in the Emergency Department. New England Journal of Medicine. 2006;355(7):666-674.
Yilmaz G, Aydin K, Iskender S, Caylan R, Koksal I. Detection and prevalence of inducible clindamycin resistance in staphylococci. J Med Microbiol 2007; 56: 342-5.
Haq E, Shahriar, M., Haq, A., Gomes, B. C., Hossain, M. M., Razzak, M. A et al. Prevalence of β-lactamaseproducing and non-producing methicillin resistant Staphylococcus aureus in clinical samples in Bangladesh. Journal of Microbiology and Antimicrobials 2011; 3(5):112- 8.
Talan D, Krishnadasan A, Gorwitz R, Fosheim G, Limbago B, Albrecht V et al. Comparison of Staphylococcus aureus From Skin and Soft-Tissue Infections in US Emergency Department Patients, 2004 and 2008. Clinical Infectious Diseases. 2011;53(2):144-149.
Haydar S, Spanier M, Weems P, Wood S, Strout T. Comparison of qSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis. The American Journal of Emergency Medicine. 2017.
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2017-06-25
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