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      Perfil de Sensibilidad y Resistencia Antimicrobiana de Acinetobacter spp. en el Hospital Municipal Boliviano Holandés Translated title: Sensitivity profile and antimicrobial resistance of Acinetobacter spp. in the Bolivian Dutch Municipal Hospital

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          Abstract

          Objetivo: Observar el perfil de sensibilidad y resistencia antimicrobiana de Acinetobacter spp., aislado en pacientes hospitalizados en el Hospital Municipal Boliviano Holandés durante el año 2010 al 2014. Material y métodos: Se revisaron un total de 167 cultivos positivos de Acinetobacter spp. Se realizó un estudio observacional no experimental, descriptivo, retrospectivo, de corte transversal. Resultados: En el antibiograma de los cultivos positivos de Acinetobacter spp. se utilizaron ocho antimicrobianos y se identificó la siguiente sensibilidad y resistencia: a) amikacina, sensibilidad de 25%, sensibilidad intermedia de 2% y resistencia 73%; b) ampicilina más sulbactam, sensibilidad de 22%, intermedia de 8% y resistencia 70%; c) ceftazidime, sensibilidad de 9%, intermedia de 4% y resistencia 87%; d) ciprofloxacina sensibilidad 19%, intermedia 1% y resistencia 80%; e) gentamicina, sensibilidad de 21%, intermedia 0% y resistencia 79%; f) SMX-TMP, sensibilidad de 14%, intermedia de 1% y resistencia 85%; g) imipenem sensibilidad de 61%, intermedia de 1% y resistencia 38%; h) meropenem con sensibilidad de 57%, intermedia 4% y resistencia 39%. Se observó una resistencia absoluta a 6 antimicrobianos. La multidrogoresistencia se identificó en el 41%, la misma que se incrementó progresivamente en los últimos años. Así, en el 2010 se encontró solo 3% de multidrogoresistencia, el 2011 6%, el 2012 y 2013 19% y en el año 2014 53%. Conclusiones: La incidencia de infecciones por Acinetobacter spp., un agente nosocomial de gran importancia clínica, se incrementó de manera progresiva en los últimos años en nuestro hospital al igual que su resistencia. Por ello, se aconseja un uso racional de antimicrobianos y mejorar las medidas de bioseguridad en nuestro nosocomio y en el personal de salud.

          Translated abstract

          Objective: To observe the sensitivity profile and antimicrobial resistance of Acinetobacter spp, isolated from patients hospitalized in the Bolivian Dutch Municipal Hospital during 2010 to 2014. Material and Methods: A total of 167 positive cultures of Acinetobacter spp were reviewed a non-experimental, descriptive, retrospective, observational cross-sectional study was conducted. Results: In the susceptibility testing of positive cultures of Acinetobacter spp. eight antimicrobials were used and the following sensitivity and resistance was identified: a) amikacin, sensitivity of 25%, 2% intermediate sensitivity and resistance 73%; b) ampicillin-sulbactam, sensitivity of 22%, 8% and intermediate resistance 70%; c) ceftazidime, sensitivity of 9%, 4% and intermediate resistance 87%; d) Ciprofloxacin sensitivity 19%, 1% and intermediate resistance 80%; e) gentamicin, sensitivity of 21%, intermediate resistance 0% and resistance 79%; f) TMP-SMX, sensitivity of 14%, intermediate 1% and resistance 85%; g) 61% sensitivity imipenem, intermediate 1% and resistance 38%; h) meropenem with sensitivity of 57%, intermediate resistance and 4% resistance 39%, absolute resistance to 6 antimicrobials was observed. multidrug resistense identified in 41%, the same as it was progressively increased in recentyears. Thus, in 2010 he found only 3% of multidrug, 6% in 2011,2012 and 2013 19% and in 2014 53%. Conclusions. The incidence of infections Acinetobacter spp, a nosocomial agent of great clinical importance, gradually increased in recent years in our hospital as their resistance. Therefore, it is advisable rational use of antimicrobials and improves bio-security measures in our hospital and health personnel.

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          Most cited references30

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          Acinetobacter baumannii: epidemiology, antimicrobial resistance, and treatment options.

          Multidrug-resistant Acinetobacter baumannii is recognized to be among the most difficult antimicrobial-resistant gram-negative bacilli to control and treat. Increasing antimicrobial resistance among Acinetobacter isolates has been documented, although definitions of multidrug resistance vary in the literature. A. baumannii survives for prolonged periods under a wide range of environmental conditions. The organism causes outbreaks of infection and health care-associated infections, including bacteremia, pneumonia, meningitis, urinary tract infection, and wound infection. Antimicrobial resistance greatly limits the therapeutic options for patients who are infected with this organism, especially if isolates are resistant to the carbapenem class of antimicrobial agents. Because therapeutic options are limited for multidrug-resistant Acinetobacter infection, the development or discovery of new therapies, well-controlled clinical trials of existing antimicrobial regimens and combinations, and greater emphasis on the prevention of health care-associated transmission of multidrug-resistant Acinetobacter infection are essential.
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            Antimicrobial resistance among Gram-negative bacilli isolated from Latin America: results from SENTRY Antimicrobial Surveillance Program (Latin America, 2008-2010).

            This study updates the frequency and resistance rates of Gram-negative bacilli isolated from Latin American medical centers enrolled in the SENTRY Antimicrobial Surveillance Program. A total of 12,811 bacterial organisms, including 5704 Gram-negative bacilli (44.5%), were consecutively collected (1 per patient) between January 2008 and December 2010 from 10 Latin American medical centers located in Argentina, Brazil, Chile, and Mexico. Antimicrobial susceptibility testing was performed and interpreted by the Clinical and Laboratory Standards Institute broth microdilution method at a central laboratory. All Gram-negative organisms with reduced susceptibility to imipenem or meropenem (MIC, ≥ 2 μg/mL) were screened for carbapenemase production by the modified Hodge test and by polymerase chain reaction. ESBL rates were 18.1%, 12.8%, 23.8%, and 48.4% among Escherichia coli and 60.4%, 49.9%, 59.2%, and 33.3% among Klebsiella spp. from Argentina, Brazil, Chile, and Mexico, respectively. Meropenem-nonsusceptible Klebsiella spp. rate was highest in Brazil (11.1%), followed by Argentina (8.2%), Chile (5.0%), and Mexico (0.8%). Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae was not detected in 2008, but emerged in 2009 (10 strains) and increased significantly in 2010 (44; P 77% overall coverage against the 5 most frequently isolated Gram-negative bacilli from Latin American Medical centers participating in the SENTRY Program. Copyright © 2012 Elsevier Inc. All rights reserved.
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              Biofilm formation in Acinetobacter baumannii.

              Acinetobacter baumannii has received much attention in recent years because of its increasing involvement in a number of severe infections and outbreaks occurring in clinical settings, and presumably related to its ability to survive and persist in hospital environments. The treatment of infections caused by A. baumannii nosocomial strains has become increasingly problematic, due to their intrinsic and/or acquired resistance to multiple classes of antibiotics. Furthermore, the demonstrated ability of nosocomial strains to grow as biofilm is believed to play a significant role in their persistence and antibiotic resistance. This review summarises current knowledge on A. baumannii biofilm formation and its clinical significance, as well as the related genetic determinants and the regulation of this process.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                rbp
                Revista de la Sociedad Boliviana de Pediatría
                Rev. bol. ped.
                Sociedad Boliviana de Pediatría (La Paz, , Bolivia )
                1024-0675
                2016
                : 55
                : 1
                : 3-10
                Affiliations
                [01] orgnameHospital Municipal Boliviano Holandés
                Article
                S1024-06752016000100002
                2992f396-c30f-4986-8b00-6eb91cb5232a

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 01 March 2016
                : 01 January 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 8
                Product

                SciELO Bolivia


                Acinetobacter baumanni,sensibilidad antimicrobiana,infecciones hospitalarias,antimicrobial resistance,hospital infections

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