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Revista Colombia Médica
Universidad del Valle - Facultad de Salud
ISSN: 0120-8322
EISSN: 1657-9534
Vol. 34, No. 4, 2003, pp. 196-205
Bioline Code: rc03030
Full paper language: Spanish
Document type: Research Article
Document available free of charge

Revista Colombia Médica, Vol. 34, No. 4, 2003, pp. 196-205

 en
Pedro Martínez, Máximo Mercado Salim Máttar

Abstract

Objective. The objectives of this study were to establish the extended spectrum β-lactamases (ESBL), in nosocomial bacilli Gram negative and to compare three methods for the detection of ESBL.
Materials and methods. 201 microorganisms were studied isolated of patients with nosocomial infections at the Hospital San Jerónimo (HSJ) of Montería during the years 2001 and 2002. To detect the presence of ESBL was taking account the hydrolytic activity upon ceftazidime, that measured the synergism of the clavulanic acid in combination with ceftazidime. To compare the methods of detection of ESBL, were used those proposed by the National Committee for Clinical Laboratory Standards (NCCLS) disk diffusion, the Minimal inhibitory Concentration (MIC90) and the combination disk method of Jarlier.
Results. The results showed that 86 (43%) of 201 germs were ESBL producers. ESBL were observed in 24 (63%) of 38 Acinetobacter baumannii check for this species in other resources , 11 (61%) of 18 Enterobacter check for this species in other resources spp, 17 (46%) of 37 Klebsiella pneumoniae check for this species in other resources , 22 (38%) of 58 Pseudomonas aeruginosa check for this species in other resources , 5 (31%) of 16 Proteus mirabilis check for this species in other resources and 7 (20.5%) of 34 Escherichia coli check for this species in other resources . The comparison of the detection methods did not show differences between them (p>0.05). The results show a high prevalence of ESBL (43%) in the nosocomial bacilli Gram negative at the HSJ of Montería.
Conclusions. The study was able to show the importance of the methods for detection of ESBL as support to establish the correct antimicrobial therapy in nosocomial germs and upon this base to suggest the implementation of measures of surveillance that prevent and to reduce the dissemination of ESBL at this hospital.

Keywords
ESBL. Nosocomial. Córdoba. Colombia. Prevalence. Methods

 
 es Determinación de β-lactamasas de espectro extendido en gérmenes nosocomiales del Hospital San Jerónimo, Montería
Pedro Martínez, Máximo Mercado Salim Máttar

Resumen

Objetivo: Este estudio tuvo como objetivos establecer la prevalencia de β-lactamasas de espectro extendido (BLEE) en bacilos Gram negativos nosocomiales y comparar tres métodos para su identificación.
Materiales y métodos: Se estudiaron en el Hospital San Jerónimo (HSJ) de Montería durante los años 2001 y 2002, 201 microorganismos aislados de pacientes con infección nosocomial. Para identificar la presencia de BLEE se tuvo en cuenta la actividad hidrolítica sobre la ceftazidima que midió el sinergismo del ácido clavulánico en combinación con ceftazidima. Para comparar los métodos de identificación de BLEE, se utilizaron los propuestos por el National Committee for Clinical Laboratory Standards (NCCLS) difusión de disco, la concentración mínima inhibitoria (CMI90) y el método de combinación de disco de Jarlier.
Resultados: Los resultados mostraron que 86 (43%) de 201 gérmenes fueron productores de BLEE. Se presentaron BLEE en 24 (63%) de 38 Acinetobacter baumannii check for this species in other resources , 11 (61%) de 18 Enterobacter check for this species in other resources spp, 17 (46%) de 37 Klebsiella pneumoniae check for this species in other resources , 22 (38%) de 58 Pseudomonas aeruginosa check for this species in other resources , 5 (31%) de 16 Proteus mirabilis check for this species in other resources y 7 (20.5%) de 34 Escherichia coli check for this species in other resources . Al comparar los métodos de identificación no se presentaron diferencias entre si (p>0.05). Los resultados muestran una prevalencia alta de BLEE (43%) en los bacilos Gram negativos nosocomiales del HSJ de Montería.
Conclusiones: El estudio logró demostrar la importancia de los métodos de identificación de BLEE como apoyo para la correcta instauración de la terapia antimicrobiana en gérmenes nosocomiales y sobre esta base sugerir la implementación de medidas de vigilancia que prevengan y disminuyan la diseminación de BLEE en este hospital.

Palabras-clave
b-lactamasas espectro extendido. Hospital. Prevalencia. Enterobacteriaceae. No-fermentadores. Montería

 
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Alternative site location: http://colombiamedica.univalle.edu.co

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