Multirresistencia microbiana a los antibióticos en sepsis neonatal en el Area de UCIN del Hospital Guayaquil período 2014 a 2015
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
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Se realizó el estudio de multirresistencia a los antibióticos de las cepas bacterianas aisladas de pacientes con septicemia neonatal en un hospital ABEL GILBERT PONTONI en el período 2014-2015 y evaluar el valor predictivo del método del “tablero de damas” (checkerboard) para seleccionar el tratamiento con combinaciones de antibióticos en pacientes graves. Se estudió 100 casos de septicemia neonatos, por diferentes mecanismos a quienes se les extrajo sangre para hemocultivo y estudios de sensibilidad a antimicrobianos El estudio de la susceptibilidad de las cepas se realizó por el método de microdilución en caldo y se utilizó el tablero de damas en bandejas de caldo para evaluar la eficacia del tratamiento antimicrobiano combinado. El estudio de la susceptibilidad de las cepas se realizó por el método de microdilución en caldo y se utilizó el tablero de damas en bandejas de caldo para evaluar la eficacia del tratamiento antimicrobiano combinado.
De ellas, 94,5% resultaron resistentes a varios antibióticos. Cuatro cepas de Staphylococcus spp. Coagulasa-negativas y una de Enterococcus faecium fueron resistentes a la vancomicina (concentración mínima inhibidora = 128 g/ml). Se observó una alta probabilidad de eficacia clínica (P < 0,01) con combinaciones de antibióticos que mostraron un efecto sinérgico in vitro, mientras que las reacciones antagónicas se correspondieron con la probabilidad altamente significativa de fracaso terapéutico clínico.
Cincuenta por ciento de las cepas aisladas de Staphylococcus spp. Coagulasanegativas y 37% de las cepas de S. Aureus, principales agentes causales de sepsis neonatal, fueron resistentes a la primera línea terapéutica que se administra en el area de ucin que es ampicilina 250 miligramos más gentamicina 5 miligramos
The study was conducted of multidrug resistance to antibiotics of bacterial strains isolated from patients with neonatal sepsis in a hospital ABEL GILBERT PONTONI in the period 2014-2015 and assess the predictive value of the "checkerboard" method (checkerboard) to select the treatment with combinations of antibiotics in critically ill patients. 100 cases of neonatal sepsis was studied by different mechanisms who bled for blood culture and sensitivity studies to antimicrobials The study of the susceptibility of the strains was performed by the method of microdilution broth and Checkerboard was used in trays broth to evaluate the efficacy of combination antimicrobial therapy. The study of the susceptibility of the strains was performed by the broth microdilution method and chequerboard trays used in broth to evaluate the efficacy of combination antimicrobial therapy. Of these, 94.5% were resistant to several antibiotics. Four strains of Staphylococcus spp. Coagulase-negative and one of Enterococcus faecium were resistant to vancomycin (minimal inhibitory concentration = 128 g / ml). a high probability of clinical efficacy (P <0.01) was observed with combinations of antibiotics that showed a synergistic effect in vitro, while antagonistic reactions were consistent with highly significant probability of clinical therapeutic failure. Fifty percent of the isolates of Staphylococcus spp. Coagulasanegativas and 37% of strains of S. aureus, main causative agents of neonatal sepsis, were resistant to first-line therapy that is administered in the NICU area is 250 milligrams ampicillin plus gentamicin
The study was conducted of multidrug resistance to antibiotics of bacterial strains isolated from patients with neonatal sepsis in a hospital ABEL GILBERT PONTONI in the period 2014-2015 and assess the predictive value of the "checkerboard" method (checkerboard) to select the treatment with combinations of antibiotics in critically ill patients. 100 cases of neonatal sepsis was studied by different mechanisms who bled for blood culture and sensitivity studies to antimicrobials The study of the susceptibility of the strains was performed by the method of microdilution broth and Checkerboard was used in trays broth to evaluate the efficacy of combination antimicrobial therapy. The study of the susceptibility of the strains was performed by the broth microdilution method and chequerboard trays used in broth to evaluate the efficacy of combination antimicrobial therapy. Of these, 94.5% were resistant to several antibiotics. Four strains of Staphylococcus spp. Coagulase-negative and one of Enterococcus faecium were resistant to vancomycin (minimal inhibitory concentration = 128 g / ml). a high probability of clinical efficacy (P <0.01) was observed with combinations of antibiotics that showed a synergistic effect in vitro, while antagonistic reactions were consistent with highly significant probability of clinical therapeutic failure. Fifty percent of the isolates of Staphylococcus spp. Coagulasanegativas and 37% of strains of S. aureus, main causative agents of neonatal sepsis, were resistant to first-line therapy that is administered in the NICU area is 250 milligrams ampicillin plus gentamicin
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SEPSIS NEONATAL, RESISTENCIA A MEDICAMENTOS, HOSPITAL DE ESPECIALIDADES GUAYAQUIL DR. ABEL GILBERT PONTON, CANTON GUAYAQUIL, ECUADOR, UNIDADES DE CUIDADO INTENSIVO NEONATAL, FACTORES DE RIESGO, COMPLICACIONES NEONATALES