RESUMEN
Surveillance programs have been reporting decreasing rates of carbapenem-sensitivity in Serratia marcescens, leading to a concern regarding the few remaining therapeutic options to treat these multidrug-resistant (MDR) organisms. Here, we describe a case series of 11 stem cell hematopoietic transplantation patients infected (N = 6) or colonized (N = 5) by carbapenem-resistant S marcescens (CrSm) from 2010 to 2013. The comorbidities found were acute renal insufficiency (3/11), neutropenia (7/11), and mucositis (8/11), and the mortality rate was 64%. KPC was the most prevalent carbapenemase detected (8/11) and tigecycline and gentamicin were the antimicrobials used as treatment.
Asunto(s)
Bacteriemia , Trasplante de Células Madre Hematopoyéticas , Antibacterianos/uso terapéutico , Bacteriemia/tratamiento farmacológico , Bacteriemia/epidemiología , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Serratia marcescens , beta-LactamasasRESUMEN
Fifty consecutive MRSA blood isolates were evaluated: 30(60%) carried SCCmec type II (single PFGE clone; sequence type 5 or ST105); 12 (26%), IV; 5 (10%), III; 3 (6%), I. Brazilian endemic clone, carrying SCCmec type III, has been the main nosocomial clone in Brazil; however, this study showed that a clone carrying type II predominated.
Asunto(s)
Bacteriemia/microbiología , Infección Hospitalaria/microbiología , ADN Bacteriano/genética , Secuencias Repetitivas Esparcidas , Staphylococcus aureus Resistente a Meticilina/genética , Infecciones Estafilocócicas/microbiología , Antibacterianos/uso terapéutico , Bacteriemia/diagnóstico , Bacteriemia/tratamiento farmacológico , Técnicas de Tipificación Bacteriana , Células Clonales , Infección Hospitalaria/diagnóstico , Infección Hospitalaria/tratamiento farmacológico , ADN Bacteriano/clasificación , Electroforesis en Gel de Campo Pulsado , Humanos , Staphylococcus aureus Resistente a Meticilina/clasificación , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/tratamiento farmacológicoRESUMEN
We compared 41 patients who received colistimethate with 41 who received polymyxin B for the treatment of serious infections caused by carbapenem-resistant Acinetobacter spp. and found both polymyxins have similar efficacy and toxicity.