Resumen de Cepas E-ESKAPE multidrogorresistentes aisladas en hemocultivos de pacientes con cáncer

Consuelo Velázquez Acosta, Patricia Cornejo Juárez, Patricia Volkow Fernández

• español

  Objetivo. Describir la tendencia de cepas multidrogorre- sistentes (MDR) aisladas en hemocultivos de pacientes con cáncer durante el periodo de 2005 a 2015. Material y métodos. Análisis retrospectivo en el que se procesaron 33 127 hemocultivos. La identificación y la sensibilidad antimicro- bianas se realizaron a través de métodos automatizados WaLK away (Siemens Laboratory Diagnostics) y BD Phoenix (Becton, Dickinson and Company). Se determinaron cepas resistentes de acuerdo con la concentración mínima inhibitoria, según los pa- rámetros del Clinical and Laboratory Standards Institute (CLSI).

  Resultados. 5 604 (16.9%) aislamientos fueron positivos, con 6 397 aislamientos, 3 732 (58.4%) bacilos gramnegativos, 2 355 (36.9%) cocos grampositivos, 179 (2.7%) levaduras y 126 (1.9%) bacilos grampositivos. Escherichia coli (n=1 591, 24.5%) fue la bacteria más frecuente, 652 (41%) productoras de beta-lactamasas de espectro-extendido (BLEE); Enterococcus faecium 143 (2.1%), 45 (31.5%) resistente a vancomicina;

  Staphylococcus aureus 571 (8.7%), 121 (21.2%) resistentes a meticilina (SARM); Klebsiella pneumoniae 367 (5.6%), 41 (11.2%) BLEE, Acinetobacter baumannii 96 (1.4%), 23 (24%) MDR; Pseudomonas aeruginosa 384 (5.6%), 43 (11.2%) MDR. Las cepas MDR se aislaron más frecuentemente en pacientes con neoplasias hematológicas en comparación con tumores sólidos; SARM (RM=4.48, IC95% 2.9-6.8); E.

  coli BLEE (RM=1.3, IC95% 1.10-1.65) y A. baumannii-MDR (RM=3.2, IC95% 1.2-8.3). Conclusiones. Se observó un aislamiento significativamente mayor de cepas E-ESKAPE MDR en pacientes con neoplasias hematológicas.

• English

  Objective. To describe the trend of multidrug resistant (MDR) strains isolated from blood in patients with cancer from 2005 to 2015. Materials and methods. 33 127 blood cultures were processed by retrospective analysis.

  Identification and antimicrobial sensitivity were performed through automated methods: WaLK away (Siemens Labora- tory Diagnostics) and BD Phoenix (Becton, Dickinson and Company). Resistant strains were determined according to the minimum inhibitory concentration, following the parame- ters of the Clinical and Laboratory Standards Institute (CLSI). Results. Of 6 397 isolates, 5 604 (16.9%) were positive; 3 732 (58.4%) Gram- bacilli; 2 355 (36.9%) Gram+ cocci; 179 (2.7%) yeasts, and 126 (1.9%) Gram+ bacilli. Escherichia coli (n=1 591, 24.5%) was the most frequent bacteria, with 652 (41%) strains being extended-spectrum beta-lactamases producers (ESBL); of Enterococcus faecium (n=143, 2.1%), 45 (31.5%) were vancomycin resistant; of Staphylococcus aureus (n=571, 8.7%), 121 (21.2%) methicillin resistant (MRSA); of Klebsiella pneumoniae (n=367, 5.6%), 41 (11.2%) ESBL; of Acinetobacter baumanii (n=96, 1.4%), 23 (24%) MDR, and of Pseudomonas aeruginosa (n=384, 5.6%), 43 (11.2%) MDR.

  MDR strains were significantly more frequent in patients with hematological malignancies, compared to those with solid tumors: MRSA (OR=4.48, 95%CI 2.9-6.8), ESBL E. coli (OR=1.3, 95%CI 1.10-1.65) and MDR Acinetobacter baumanii (OR=3.2, 95%CI 1.2-8.3).Conclusions. We observed significantly higher isolations of E-ESPAKE MDR strains in patients with hematological malignancies.