Evolución de la resistencia de bacilos Gramnegativos a íŸ- Lactámicos: un estudio de seis años.
Abstract
Los antibióticos íŸ-lactámicos son los antimicrobianos más frecuentemente prescritos en el mundo; por lo tanto, no resulta sorprendente que la resistencia de las bacterias a estas drogas .constituya un problema de salud pública. Se analiza un total de 1.868 cepas de bacilos Gram- negativo,distribuidas de la siguiente forma; Escherichia coli (735), Klebsiella pneumoniae (358), Enterobacter cloacae (138), Proteus mirabilis (121), Pseudomonas aeruginosa (334), Acinetobacter sp. (182); recolectados consecutivamente entre 1992 y 1997, a partir de pacientes ambulatorios. El método de difusión en agar se utiliza para determinar los patrones de susceptibilidad a diversos íŸ-lactámicos. La resistencia promedio para cada bacteria es la siguiente; E. coli, ampicilina (AMP) 52%, carbenicilina (CB) 50%, ampicilina-sulbactam (SAM) 29%, cefalosporinas, de primera generación (CF) 16%, cefamandol (MA) 8%, cefoxitina (FQX), ceftriazona (CRO), ceftazidima (CAZ) y aztreonam (AZT) 3% para cada uno, cefotaxima (CTX) 2% y cefoperazona (CFP) 4%. K. pneumoniae: AMP y CB 97% , SAM 15%, CF 12%, MA 10%, FOX y CFP 5%, CTX, CRO y CAZ 4%, AZT 7%. E. cloacae: AMP 95%, CB 30%, CF 87%, MA 19%, FOX 67%, CTX y CFP 8%, CRO 5%, CAZ y AZT 3%. P. mirabilis: AMP 27%, CB 12%, CF 19%, MA y FOX 4%, CTX 2%, CFP, CRO, CAZ y AZT 0% en cada caso. Sólo imipenem (IMP) es 100% activo para las enterobacterias aisladas. Ps. aeruginosa: CB 28%, CTX 47%, CFP 4%, CRO 54%, CAZ e IMP 1%, AZT 9%. Acinetobecter sp.: AMP 72%, CB 36%, CF 80%, MA 56%, FOX 61%, CTX 34%, OFP 36%, CRO 40%, CAZ 21%, IMP 6% y AZT 42%. La resistencia a íŸ-lactámicos es uno de los riesgos entre aislamientos de bacilos Gramnegativo, y sólo a través de un uso nacional de estas drogas es posible preservar su utilidad en la quimioterapia de infecciones bacterianas.Copyright (c) 2019 M Ginestre, A Martínez, S Romero, B Harris, G Rincón

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