Enterococcus faecium resistente a vancomicina

B, Jacqueline Marovac; Campos, M. Isabel

doi:10.4067/s0034-98872000000600018

Cited by 9 publications

(4 citation statements)

References 23 publications

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“…En Chile, gracias a estudios de vigilancia liderados por la Sociedad Chilena de Infectología, se pudo identificar los primeros casos de portación intestinal de ERV hacia fines de los años 90, detectándose la existencia de cepas con susceptibilidad intermedia 3 . El primer reporte publicado en Chile sobre un aislado de ERV data del año 2000, correspondiendo a un caso de portación intestinal 8 . Posterior-mente, otros dos casos de colonización fueron reportados por Mella y cols 9 .…”

Section: Discussionunclassified

Emergencia de infecciones por Enterococcus sp resistente a vancomicina en un hospital universitario en Chile

Bilbao

et al. 2007

Rev. chil. infectol.

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Emergency of vancomycin-resistant Enterococcus infections in a teaching hospital in Chile An active surveillance of vancomycin-resistant enterococci (VRE) intestinal colonization in selected group of patients has been developed in Chile since year 2000. Nevertheless, no reports of clinical cases have been published. Aim. To describe main clinical and microbiological features of patients infected by VRE in a tertiary-level teaching Hospital. Patients and methods. Intestinal and clinical samples positive to VRE were provided by laboratory, and a retrospective analysis of potential risk factors, clinical features, treatment and outcomes was performed. Study encompassed years 2001 to 2006. Main results. 23 cases of infections were identified, all cases occurring during 2005 and 2006. Incidence rate was 0.07 and 0.09 cases per 1000 occupied bed-days, respectively. The mean age was 62.0 ± 17 years. A significant proportion of patients had cancer (39.1%), recent surgical procedures (54.1%), were on dialysis (26.1%), or were using steroids (26.1%). Most patients had received 2 or more antimicrobial (87%), almost a third represented transfers from other hospitals and an additional 22% readmissions before 30 days of latest discharge. Patients were mainly hospitalized in the ICU (60.9%) but nearly 30% were associated exclusively to nephrological or onco-hematological wards. Clinical manifestations included bacteremia (30.4%), surgical site infections or abscesses (26.1%), urinary tract infections (26.1%) and others.. Three patients (13%) did not have symptoms. After identification was possible, all isolates were identified as E. faecium (82.6% of total), the rest as Enterococcus sp. Most strains showed intermediate susceptibility to vancomycin (66.7%). For 14 strains studied both with vancomycin and teicoplanin, , phenotype Van B was predominant (85.7%), followed by VanA (7.1%) and VanB/VanD type (7.1%). No molecular studies were performed. Fifteen patients (65.4%) received a surgical and/or medical treatment. A favorable response was observed in 80% of these cases. Eight patients were not treated (34.8%), in 2 cases because of a rapidly-fatal infection. The global risk-fatality ratio for VRE infections was 13% and increased to 42.9% in patients with bacteremia. Microbiological eradication was documented in 52.2%.

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Section: Discussionunclassified

Emergencia de infecciones por Enterococcus sp resistente a vancomicina en un hospital universitario en Chile

Bilbao

et al. 2007

Rev. chil. infectol.

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“…In spite of the great epidemiological relevance of S. aureus in Latin American nations, cases of infection due to VRE are reported in hospitals in Argentina 43 , Chile 44 , and Perú 45 . Among Gram-positive bacteria, those most frequently reported causing nosocomial infections correspond to ESβL producing E. coli in Chile, Argentina, Brazil 46 , Perú, and Bolivia 47 .…”

Section: Vol 42 Nº 1 2011 (Enero-marzo)mentioning

confidence: 99%

Epidemiology of nosocomial bacteria resistant to antimicrobials

Cabrera¹,

Gómez²,

Zúñiga³

et al. 2011

Colomb Med

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Nosocomial infections are a major challenge for public health because of the high rates of morbidity and mortality generated. It was considered that the excessive or inappropriate use of antibiotics triggers the emergence of resistant strains. Among the clinically important bacteria that most commonly cause nososcomial infections, Gram positive multiresistant pathogens stand out such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus spp (VRE), and the Gram negative strains of Klebsiella pneumoniae, Escherichia coli, Pseudomonas spp. and Acinetobacter baumannii producing expanded spectrum b-lactamases (ESbL). This review describes the behavior of the main bacterial pathogens resistant to antibiotics that cause infections in Europe, United States, and Latin America, emphasizing studies of molecular epidemiology on a global scale, including the major epidemiological studies in Colombia. The genetic structure of S. aureus and Enterococcus spp strains shows a clonal characteristic favored by the predominance of a small number of clones with the capacity to spread globally, due probably to cross-infection. However, the introduction of MRSA strains from the community encourages genetic diversity, tending to establish a genetic polyclonal endemic structure in places like the United States. In Gram negative bacteria, the high genetic diversity among isolates, mainly in Latin American countries, indicates that the polyclonal spread is influenced by horizontal transfer of plasmids, by excessive exposure to antibiotics, and prolonged hospital stays. In Colombia, there is information on nosocomial resistant pathogens, but molecular epidemiological information is still scarce.

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“…En Chile se ha documentado progresivamente la resistencia antimicrobiana en ambientes comunitarios que involucra aislados de Escherichia coli asociados a infección urinaria, Neisseria gonorrhoeae o Streptococcus pneumoniae resistente a penicilina, cepas de Haemophilus influenzae o Moraxella catarrhalis resistentes a amoxicilina y aislados de Shigella resistentes a diferentes compuestos [1][2][3][4][5][6] . La situación es más desastrosa en ambientes nosocomiales, siendo frecuente o progresiva en Chile la presencia de enterobacterias portadoras de β-lactamasas de espectro extendido, Pseudomonas aeruginosa hiperproductoras de β-lactamasas cromosomales y Staphylococcus aureus resistente a cloxacilina o Enterococcus resistente a vancomicina [7][8][9] . Para contener la emergencia de la resistencia antimicrobiana en la comunidad y en el hospital, se han delineado diferentes estrategias de intervención y que Cumplimiento sobre las recomendaciones de uso y evaluación del impacto económico de un programa de uso restringido de imipenem-cilastatina Infecciones Intrahospitalarias incluyen capacitación médica, restricción al uso de antimicrobianos, autorización previa, remoción de compuestos, formularios de solicitud, detenciones automáticas, educación de los pacientes, rotación cíclica de compuestos, desarrollo de guías clínicas y la omisión de susceptibilidades específicas en el informe de laboratorio [10][11][12][13] .…”

Section: Introductionunclassified

Cumplimiento sobre las recomendaciones de uso y evaluación del impacto económico de un programa de uso restringido de imipenem-cilastatina

et al. 2006

Rev. chil. infectol.

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Enterococcus faecium resistente a vancomicina

Cited by 9 publications

References 23 publications

Emergencia de infecciones por Enterococcus sp resistente a vancomicina en un hospital universitario en Chile

Emergencia de infecciones por Enterococcus sp resistente a vancomicina en un hospital universitario en Chile

Epidemiology of nosocomial bacteria resistant to antimicrobials

Cumplimiento sobre las recomendaciones de uso y evaluación del impacto económico de un programa de uso restringido de imipenem-cilastatina

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