Antimicrobial susceptibility of bacteria isolated from vascular access sepsis. Institute of Nephrology, 2019
Keywords:
Hemodialysis, catheter, vascular access, antimicrobial resistance, Cuba.Abstract
Introduction: The vascular access in hemodialysis is essential for the renal patient both for its associated morbidity and mortality as well as for its impact on quality of life. Although arteriovenous fistula, hemodialysis catheters or vascular prostheses have gradually evolved toward improvement, they are prone to infections primarily due to bacteria on the skin and mucosal microbiota.
Objective: To characterize the antimicrobial susceptibility of bacteria isolated from patients with vascular access sepsis in the hemodialysis service of the Institute of Nephrology.
Material and Methods: A cross-sectional study was conducted in the period January-December 2019. The universe consisted of all 112 isolates obtained from blood culture samples, secretions and catheter tips from patients with bacteremia, sepsis or discharge at the site of catheter insertion or vascular access.
Results: The results show that 72.3% of the samples studied were blood cultures. Also, 38.3% of Staphylococcus aureus isolates, which were totally sensitive to vancomycin, were obtained. On the other hand, 68.1% of Escherichia coli strains were extended spectrum beta-lactamases (ESBL) producers with sensitivity to aminoglycosides and carbapenems greater than 60%. Pseudomonas strains exhibited a similar pattern of sensitivity, however, 100% were resistant to cephalosporins.
Conclusions: No resistance to vancomycin was reported in this study. Gram-negative isolates showed high resistance to cephalosporins and good sensitivity to aminoglycosides and carbapenems.
Downloads
References
1. Sociedad Española de Nefrología. Guías de acceso vascular en hemodiálisis [Internet]. España: Sociedad Española de Nefrología; 2017 [Citado 18/06/2020]. Disponible en: https://revistanefrologia.com/es-guia-clinica-espanola-del-acceso-vascular-hemodialisis-articulo-S0211699517302175
2. Vivek S, Moore CL, Lalathakasha K, Yee J. Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies. Int J Nephrol Renovasc Dis [Internet]. 2016 [Citado 18/06/2020];9:95-103. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846073/
3. Golestaneh L, Mokrzycki MH. Prevention of hemodialysis catheter infections: Ointments, dressings, locks, and catheter hub devices. Hemodialysis International [Internet]. 2018 [Citado 19/06/2020];22(Supl. 2):S75-S82. Disponible en: https://onlinelibrary.wiley.com/doi/pdf/10.1111/hdi.12703
4. Pérez MM, Herrera N, Pérez E. Mortality of the adult in chronic hemodialysis. AMC [Internet].2017 Feb [Citado 25/04/2020];21(1):773-86. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S102502552017000100004&lng=es
5. Assa S, Hummel YM, Voors AA, Kuipers J, Westerhuis R, Groen H, et al. Hemodialysis-induced regional left ventricular systolic dysfunction and inflammation: a cross-sectional study. Am J Kidney Dis [Internet]. 2014 [Citado 25/04/2020];64:265-73. Disponible en: https://europepmc.org/article/med/24364893
6. Castrejón MI, Resendiz Albor AA, Ynga MA, Arciniega IM, Orellana VI, Garcia CA, et al. Dialyzable Leukocyte Extract (Transferon+) Administration in Sepsis: Experience from a Single Referral. Pediatric Intensive Care Unit [Internet]. 2019;143:1-10. Disponible en: https://doi.org/10.1155/2019/898050
7. Organización Mundial de la Salud. Farmacoresistencia [Internet]. Ginebra: OMS; 2020 [Citado 25/04/2020]. Disponible en: https://www.who.int/drugresistance/AMR_Importance/es/
8. Yu H, Han X, Quiñones Pérez D. La humanidad enfrenta un desastre: la resistencia antimicrobiana. Rev haban cienc méd [Internet]. 2021 [Citado 25/04/2020];20(3):[Aprox. 2 p.]. Disponible en: http://www.revhabanera.sld.cu/index.php/rhab/article/view/3850
9. Koneman E, Allen S, Dowell VR, Sommers H. Diagnóstico Microbiológico [Internet]. Buenos Aires: Editorial Médica Panamericana; 2006 [Citado 18/06/2020]. Disponible en: https://pdf.zlibcdn.com/dtoken/b0b4e5d4e3aba8fe83f5bbb6dcccd75d/Diagn%C3%B3stico_microbiol%C3%B3gico__Texto_y_atlas_color_b_1310633_(z-lib.org).pdf
10. National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial susceptibility testing; fifteent informational supplement. 2019 M100-S15 (25) [Internet]. New York: National Committee for Clinical Laboratory Standards; 2019 [Citado 25/04/2020]. Disponible en: https://clsi.org/standards/products/microbiology/documents/m100/
11.Jarlier V, Nicolás M, Fournier G, Philippon A. Extended broad-spectrum β-lactamases conferring transferable resistance to newer β-lactam agents in Enterobacteriaceae: hospital prevalence and susceptibility pattern. Rev Infect Dis [Internet]. 1988 [Citado 25/04/2020];10(4):867-78. Disponible en: https://pubmed.ncbi.nlm.nih.gov/3263690/
12. Vento Valdés I, Toraño Peraza G, Del Sol González AC, Piquero Lazo EM. Bacteriemia relacionada con catéter por Staphylococcus aureus resistente a meticilina en pacientes con enfermedad renal crónica avanzada. Rev Cubana Med Tropical [Internet]. 2019 [Citado 25/04/2020];71(2):[Aprox. 1 p.]. Disponible en: http://www.revmedtropical.sld.cu/index.php/medtropical/article/view/427
13. Ramírez G, Amaya LIY, Turrubiartes EA, Velarde LT, Álvarez QD, Fragoso LE. Etiología infecciosa y resistencia antimicrobiana en pacientes de Hemodiálisis, San Luis Potosí, México. Nefrología, diálisis y trasplante [Internet].2009 [Citado 15/06/2020];29(3):111-4. Disponible en: https://pdfs.semanticscholar.org/c365/7886250ef75130e6fc87eabf3cf0a73e4c2f.pdf
14. Crespo Garrido M, Ruiz Parrado MC, Gómez Pozo M, Crespo Montero R. Las bacteriemias relacionadas con el catéter tunelizado de hemodiálisis y cuidados de enfermería. Enferm Nefrol [Internet]. 2017 [Citado 15/06/2020];20(4):353-65. Disponible en: http://scielo.isciii.es/pdf/enefro/v20n4/2255-3517-enefro-20-04-353.pdf
15. Galindo Méndez M. Caracterización molecular y patrón de susceptibilidad antimicrobiana de Escherichia coli productorade β-lactamasas de espectro extendido en infección del tracto urinario adquirida en la comunidad. Rev Chilena Infectol [Internet].2018;35(1):29-35. Disponible en: http://dx.doi.org/10.4067/s0716-10182018000100029
16. Monté L, Martínez R. Escherichia coli y Klebsiella pneumoniae productoras de betalactamasas de espectro extendido en un hospital de La Habana. Rev Cubana Hig Epidemiol [Internet]. 2021 [Citado 24/04/2021];58(1):[Aprox. 1 p.]. Disponible en: http://www.revepidemiologia.sld.cu/index.php/hie/article/view/412
17. Hernández A. Infecciones nosocomiales por Pseudomonas aeruginosa multiresistente incluido carbapenémicos: factores predictivos y pronósticos. Estudio prospectivo 2016-2017. Rev Esp Quimioter [Internet]. 2018 [Citado 18/06/2020];31(2):123-6. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159385/
18. Molin C. Detección Fenotípica de Carbapenemasas en Pseudomonas aeruginosa en Pacientes que acudieron al Hospital de Clínicas San Lorenzo de febrero a julio 2013. Mem Inst Investig Cienc Salud [Internet]. 2016 [Citado 18/06/2020];14(1):25-31. Disponible en: http://dx.doi.org/10.18004/Mem.iics/1812-9528/2016.014(01)25-031
Download PDF
