RESUMEN
OBJETIVO: Describir el perfil de multirresistencia (MDR), resistencia extendida (XDR) y panresistencia (PDR) a antibacterianos en aislados de muestras de pacientes de un hospital privado de tercer nivel en el norte de México. MÉTODO: Se realizó un estudio retrospectivo durante el periodo comprendido de febrero de 2016 a abril de 2019. A partir de 156 muestras clínicas de orina, heridas, sangre, expectoración y otros fluidos se aislaron 166 bacterias; 10 de las muestras incluyeron dos microorganismos. Los microrganismos aislados se clasificaron en MDR, XDR o PDR. RESULTADOS: El 78% de los aislados gramnegativos y el 69% de los aislados grampositivos mostraron MDR, XDR o PDR. Staphylococcus epidermidis fue la bacteria grampositiva con multirresistencia más frecuentemente aislada. Escherichia coli y Klebsiella sp. se encontraron entre los gramnegativos MDR más frecuentes. En dos casos, los aislados clínicos de Pseudomonas aeruginosa procedentes de la unidad de cuidados intensivos neonatales mostraron PDR. CONCLUSIÓN: Los servicios de terapia intensiva, cirugía y unidad de cuidados intensivos neonatales merecen especial atención por la alta proporción de aislados MDR y la presencia de PDR a causa de P. aeruginosa. OBJECTIVE: To describe the profile of multidrug-resistance (MDR), extensively resistance (XDR) and pandrug-resistance (PDR) to antibacterial drugs in isolates from patient samples from a third level private hospital in the North of Mexico. METHOD: A retrospective study was carried out during the period from February 2016 to April 2019. From 156 clinical samples of urine, wounds, blood, expectoration and other fluids, 166 bacteria were isolated; 10 samples included two microorganisms. Isolated microorganisms were classified into MDR, XDR or PDR. RESULTS: 78% of the Gram negative and 69% of the Gram positive isolates showed MDR, XDR or PDR. Staphylococcus epidermidis was the most frequently isolated MDR Gram positive bacteria. Escherichia coli and Klebsiella sp. were among the most frequent MDR Gram negative. In two cases, the clinical isolates of Pseudomonas aeruginosa from the neonatal intensive care unit showed PDR. CONCLUSIONS: The intensive care, surgery and neonatal intensive care unit services deserve special attention due to the high proportion of MDR isolates and the presence of PDR due to P. aeruginosa.
Asunto(s)
Estudios Retrospectivos , Humanos , Recién Nacido , MéxicoRESUMEN
From January 2005 to December 2010, we conducted a prospective cohort surveillance study on surgical site infections (SSIs) in five hospitals, all of which were members of the International Nosocomial Infection Control Consortium (INICC) in four cities in Mexico. Data were recorded from hospitalized patients using the methods and definitions of the Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC-NHSN) for SSIs. Surgical procedures (SPs) were classified into 11 types according to the ICD-9 criteria. We documented 312 SSIs, associated with 5063 SPs (5.5%; CI, 5.5-6.9). SSI rates per type of SP in these Mexican hospitals compared with the INICC and CDC-NHSN reports, respectively, include: 18.4% for ventricular shunt (vs. 12.9% vs. 5.6%); 10% for spleen surgery (vs. 5.6% vs. 2.3%); 7.3% for cardiac surgery (vs. 5.6% vs. 1.3%); 6.4% for open reduction of fracture (vs. 4.2% vs. 1.7%); 5.2% for exploratory abdominal surgery (vs. 4.1% vs. 2.0%), and 5.1% for hip prosthesis (vs. 2.6% vs. 1.3%). Compared with the CDC-NHSN, our SSIs rates were higher in 73% and similar in 27% of the analyzed types of SPs, whereas compared with INICC, rates were similar in 55% and higher in 45% of SPs. There are no data on SSI rates by surgical procedure in Mexico. Therefore, this paper represents an important advance in the knowledge of epidemiology of SSIs in Mexico that will allow us to introduce targeted interventions. This study also demonstrates that the INICC is a valuable international benchmarking tool, in addition to the CDC-NSHN, the participating hospitals of which enjoy factual advantages.
Asunto(s)
Infección de la Herida Quirúrgica/epidemiología , Ciudades , Estudios de Cohortes , Países en Desarrollo , Hospitales , Humanos , México/epidemiología , Estudios ProspectivosRESUMEN
OBJECTIVE: To report the results of a surveillance study on surgical site infections (SSIs) conducted by the International Nosocomial Infection Control Consortium (INICC). DESIGN: Cohort prospective multinational multicenter surveillance study. SETTING: Eighty-two hospitals of 66 cities in 30 countries (Argentina, Brazil, Colombia, Cuba, Dominican Republic, Egypt, Greece, India, Kosovo, Lebanon, Lithuania, Macedonia, Malaysia, Mexico, Morocco, Pakistan, Panama, Peru, Philippines, Poland, Salvador, Saudi Arabia, Serbia, Singapore, Slovakia, Sudan, Thailand, Turkey, Uruguay, and Vietnam) from 4 continents (America, Asia, Africa, and Europe). PATIENTS: Patients undergoing surgical procedures (SPs) from January 2005 to December 2010. METHODS: Data were gathered and recorded from patients hospitalized in INICC member hospitals by using the methods and definitions of the Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) for SSI. SPs were classified into 31 types according to International Classification of Diseases, Ninth Revision, criteria. RESULTS: We gathered data from 7,523 SSIs associated with 260,973 SPs. SSI rates were significantly higher for most SPs in INICC hospitals compared with CDC-NHSN data, including the rates of SSI after hip prosthesis (2.6% vs. 1.3%; relative risk [RR], 2.06 [95% confidence interval (CI), 1.8-2.4]; P < .001), coronary bypass with chest and donor incision (4.5% vs. 2.9%; RR, 1.52 [95% CI, 1.4-1.6]; [P < .001); abdominal hysterectomy (2.7% vs. 1.6%; RR, 1.66 [95% CI, 1.4-2.0]; P < .001); exploratory abdominal surgery (4.1% vs. 2.0%; RR, 2.05 [95% CI, 1.6-2.6]; P < .001); ventricular shunt, 12.9% vs. 5.6% (RR, 2.3 [95% CI, 1.9-2.6]; P < .001, and others. CONCLUSIONS: SSI rates were higher for most SPs in INICC hospitals compared with CDC-NHSN data.
