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      Métodos fenotípicos para la detección de betalactamasas de espectro extendido en cepas de Escherichia coli y Klebsiella pneumoniae. Translated title: Phenotypic methods for detection of extended spectrum betalactamases in Escherichia coli and Klebsiella pneumoniae strains.

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          Abstract

          La producción de BLEE por cepas de Escherichia coli y Klebsiella pneumoniae es un grave problema de salud pública, ya que causa la pérdida de la eficacia terapéutica a los antibióticos ß-lactámicos. En este trabajo se utilizaron cinco métodos para la detección fenotípica de BLEE. Se estudiaron 130 cepas de E. coli y 67 de K. pneumoniae, aisladas de los cultivos bacteriológicos realizados en el CRB-SAHUM. Los métodos de descarte y confirmatorios del NCCLS mostraron ser muy efectivos en la detección de cepas BLEE positivas, especialmente los métodos basados en la CIM. Adicionalmente se utilizó el método del doble disco. Éste demostró ser tan sensible y específico como los métodos estandarizados del NCCLS, ya que los resultados no demostraron diferencias significativas. Todos los métodos empleados tuvieron un desempeño parecido; se recomienda ampliamente el empleo del método de doble disco, por ser de bajo costo y de fácil aplicación en la rutina diaria de un laboratorio de Bacteriología.

          Translated abstract

          Escherichia coli and Klebsiella pneumoniae ESBL producer strains are a serious public health problem since cause therapeutic effectiveness loss to the betalactam antibiotics. In this study five methods were used to detect phenotypic ESBL production. 130 E. coli and 67 K. pneumoniae, isolated from bacteriological cultures carried out in the CRB-SAHUM, were studied. The screening and confirmatory NCCLS methods showed to be very good in the detection of ESBL positive strains, especially the methods based on the MIC. Additionally it was used the double disk method, this it demonstrated to be so sensitive and specific as the standardized methods of the NCCLS, since the results did not demonstrate significant differences. All the used methods had a similar performance; it is highly recommended the use of the double disk method, to be of low cost and easy of application in the daily routine of a bacteriology laboratory.

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          Outcome of cephalosporin treatment for serious infections due to apparently susceptible organisms producing extended-spectrum beta-lactamases: implications for the clinical microbiology laboratory.

          Although extended-spectrum beta-lactamases (ESBLs) hydrolyze cephalosporin antibiotics, some ESBL-producing organisms are not resistant to all cephalosporins when tested in vitro. Some authors have suggested that screening klebsiellae or Escherichia coli for ESBL production is not clinically necessary, and when most recently surveyed the majority of American clinical microbiology laboratories did not make efforts to detect ESBLs. We performed a prospective, multinational study of Klebsiella pneumoniae bacteremia and identified 10 patients who were treated for ESBL-producing K. pneumoniae bacteremia with cephalosporins and whose infecting organisms were not resistant in vitro to the utilized cephalosporin. In addition, we reviewed 26 similar cases of severe infections which had previously been reported. Of these 36 patients, 4 had to be excluded from analysis. Of the remaining 32 patients, 100% (4 of 4) patients experienced clinical failure when MICs of the cephalosporin used for treatment were in the intermediate range and 54% (15 of 28) experienced failure when MICs of the cephalosporin used for treatment were in the susceptible range. Thus, it is clinically important to detect ESBL production by klebsiellae or E. coli even when cephalosporin MICs are in the susceptible range (
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            Multiple antibiotic-resistant bacteria in long-term-care facilities: An emerging problem in the practice of infectious diseases.

            Long-term-care facilities (LTCFs) are becoming a major component of the health care delivery system. The management of infections with antibiotic-resistant bacteria in elderly patients in LTCFs is presenting new challenges to our current therapeutic armamentarium. Among the enteric bacilli, resistance to ceftazidime, beta-lactam/beta-lactamase-inhibitor combinations, and trimethoprim-sulfamethoxazole present the foremost problems. Quinolone-resistant gram-negative and gram-positive bacteria are increasing in frequency because of the widespread use of these agents in empirical treatment. Among the resistant gram-positive organisms, methicillin-resistant Staphylococcus aureus, penicillin-resistant pneumococci, and vancomycin-resistant enterococci are the most feared pathogens. Education, antibiotic control measures, and fundamental epidemiological and scientific research are advocated as important preventive measures.
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              Evolution and Dissemination of β-Lactamases Accelerated by Generations of β-Lactam Antibiotics

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                Author and article information

                Journal
                rsvm
                Revista de la Sociedad Venezolana de Microbiología
                Rev. Soc. Ven. Microbiol.
                Organo Oficial de la Sociedad Venezolana de Microbiología. (Caracas, DF, Venezuela )
                1315-2556
                January 2004
                : 24
                : 1-2
                : 98-103
                Affiliations
                [01] orgnameUniversidad del Zulia, orgdiv1Escuela de Bioanalisis, Laboratorio de Bacteriologia,
                [02] Maracaibo orgnameUniversidad del Zulia orgdiv1Escuela de Bioanalisis, Catedra de Practica Profesional de Bacteriologia Venezuela
                [03] Maracaibo orgnameUniversidad del Zulia, orgdiv1Escuela de Bioanalisis, Catedra de Bacteriologia General, Venezuela
                Article
                S1315-25562004000100018 S1315-2556(04)02400118
                2069f917-17d6-47c0-b458-43848180b2ab

                http://creativecommons.org/licenses/by/4.0/

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 43, Pages: 6
                Product

                SciELO Venezuela

                Categories
                Resistencia Bacteriana en Venezuela

                betalactamasas de espectro extendido (BLEE).,Klebsiella pneumoniae,Escherichia coli,extended spectrum betalactamases.

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