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      Cambios en la resistencia de Staphylococcus aureus a los antimicrobianos en centros clínicos del Area Metropolitana de Caracas, Venezuela. Período 1995-2002. Translated title: Changes in the resistance of Staphylococcus aureus to antimicrobials in clinical centers of Metropolitan Area of Caracas, Venezuela. Period 1995-2002.

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          Abstract

          El objetivo de este trabajo fue estudiar los cambios en la resistencia a los antimicrobianos de aislados de Staphylococcus aureus (SA) provenientes de muestras clínicas recuperadas en tres centros de salud del área metropolitana de Caracas durante el período 1995-2002. Los datos se obtuvieron de los Servicios de Bacteriología del Hospital Vargas (HV), Hospital Clínico Universitario (HCU) y Centro Médico (CM), participantes del Grupo Venezolano de Vigilancia de la Resistencia Bacteriana a los Antimicrobianos (GVRB). Analizamos 6.291 cepas de S. aureus mediante pruebas de sensibilidad a los antimicrobianos por el método de difusión en agar. Los rangos de resistencia registrados fueron: HV: oxacilina (Ox) 9 a 33%, vancomicina (Van) 0 a 1%, gentamicina (Gen) 2 a 16%, ciprofloxacina (Cip) 1 a 13%, eritromicina (E)10 a 25% y trimetoprim-sulfametoxazol (SXT) 2 a 13%. HUC: Ox 3 a 18%, Van 0 a 2%, Gen 5 a 33%, Cip 3 a 14%, E 10 a 30% y SXT 1 a 10%. CM: Ox 4 a 20%, Van 0%, Gen 5 a 10, Cip 2 a 14%, E 16 a 29% y SXT 1 a 6%. Los porcentajes de resistencia de este patógeno en estos centros, en general, reflejan una tendencia al aumento, especialmente ciprofloxacina, eritromicina y trimetoprim-sulfametoxazol. Sin embargo, los valores reportados para oxacilina son inferiores a los hallados en países asiáticos, Europa, EE UU y otros países de América Latina.

          Translated abstract

          We studied the changes in antimicrobial resistance of Staphylococcus aureus (SA) isolates from three Health Institutions from the metropolitan area of Caracas during the period between 1995-2002. SA isolates were recuperated from the Bacteriology Services from Hospital Vargas (HV), Hospital Clínico Universitario (HCU) and Centro Médico (CM) participants of the venezuelan group for the surveillance of bacterial antimicrobial resistance (GVRB). The sensibility to antimicrobials of 6,291 isolates of SA was analyzed by the agar diffusion method. Percentages of resistance found were as follows: HV: oxacillin (Ox) reported values between 9 and 33%, vancomycin (Van) 0 to 1%, gentamicin (Gen) 2 to 16%, ciprofloxacin (Cip) 1 to 13%, erytromycin (E) 10 to 25% and trimethoprim-sulfamethoxazole (SXT) 2 to 13%. HUC: Ox 3 to 18%, Van 0 to 2%, Gen 5 to 33%, Cip 3 to 14%, E 10 to 30% and SXT 1 to 10%, and in CM: Ox 4 to 20%, Van 0%, Gen 5 to 10, Cip 2 to 14%, E 16 to 29% and SXT 1 to 6%. The percentages of antimicrobial resistance for these isolates, in general, show tendency to increase, specially for Cip, E and SXT. Notwithstanding, the values found are lower than those reported in countries of Asia, Europe, USA and other Latinamerican countries.

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          Most cited references61

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          Nosocomial bloodstream infections in United States hospitals: a three-year analysis.

          Nosocomial bloodstream infections are important causes of morbidity and mortality. In this study, concurrent surveillance for nosocomial bloodstream infections at 49 hospitals over a 3-year period detected >10,000 infections. Gram-positive organisms accounted for 64% of cases, gram-negative organisms accounted for 27%, and 8% were caused by fungi. The most common organisms were coagulase-negative staphylococci (32%), Staphylococcus aureus (16%), and enterococci (11%). Enterobacter, Serratia, coagulase-negative staphylococci, and Candida were more likely to cause infections in patients in critical care units. In patients with neutropenia, viridans streptococci were significantly more common. Coagulase-negative staphylococci were the most common pathogens on all clinical services except obstetrics, where Escherichia coli was most common. Methicillin resistance was detected in 29% of S. aureus isolates and 80% of coagulase-negative staphylococci. Vancomycin resistance in enterococci was species-dependent--3% of Enterococcus faecalis strains and 50% of Enterococcus faecium isolates displayed resistance. These data may allow clinicians to better target empirical therapy for hospital-acquired cases of bacteremia.
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            Staphylococcus aureus resistant to vancomycin--United States, 2002.

            (2002)
            Staphylococcus aureus is a cause of hospital- and community-acquired infections. In 1996, the first clinical isolate of S. aureus with reduced susceptibility to vancomycin was reported from Japan. The vancomycin minimum inhibitory concentration (MIC) result reported for this isolate was in the intermediate range (vancomycin MIC=8 microg/mL) using interpretive criteria defined by the National Committee for Clinical Laboratory Standards. As of June 2002, eight patients with clinical infections caused by vancomycin-intermediate S. aureus (VISA) have been confirmed in the United States. This report describes the first documented case of infection caused by vancomycin-resistant S. aureus (VRSA) (vancomycin MIC > or = 32 microg/mL) in a patient in the United States. The emergence of VRSA underscores the need for programs to prevent the spread of antimicrobial-resistant microorganisms and control the use of antimicrobial drugs in health-care settings.
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              Methicillin-resistant staphylococci.

              Eighteen strains of Staph. pyogenes (nine penicillin-sensitive and nine penicillin-destroying) were passaged 40 to 50 times on Celbenin(1) ditch plates. All strains developed an increase in resistance to Celbenin and eight strains (four penicillin-sensitive and four penicillin-destroying) were able to grow in 100 mug/ml. or more Celbenin. Resistance was of the drug-tolerant type and none of the cultures inactivated Celbenin. There was an associated increase in tolerance to benzyl penicillin. The highly Celbenin-resistant cultures isolated from penicillin-destroying staphylococci were in sharp contrast to those from penicillin-sensitive strains, as well as to penicillin G-tolerant staphylococci isolated in vitro, because they retained the cultural characteristics, coagulase and haemolytic activity, and mouse virulence of the parent strains, and the degree of resistance remained stable after repeated passage in the absence of Celbenin. Three naturally occurring Celbenin-resistant strains of Staph. pyogenes isolated from infective processes were also studied. All three strains grew luxuriantly in concentrations of Celbenin up to 12.5 mug/ml. but very poorly in higher concentrations. The possible significance of these findings is discussed.
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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
                July 2003
                : 23
                : 2
                : 190-195
                Affiliations
                [02] orgnameUCV orgdiv1Catedra de Microbiologia de la Escuela J M Vargas
                [01] Caracas orgnameUCV orgdiv1Escuela de Enfermeria orgdiv2Catedra de Microbiologia
                [03] orgnameGrupo Venezolano de Vigilancia de la Resistencia Bacteriana a los Antimicrobianos
                Article
                S1315-25562003000200017 S1315-2556(03)02300217
                3fd0c529-81ae-4710-92e8-d743d9f5aed1

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

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 50, Pages: 6
                Product

                SciELO Venezuela

                Categories
                Resistencia Bacteriana en Venezuela

                resistencia a los antimicrobianos,Staphylococcus aureus

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