Epidemiología y caracterización molecular de bacilos Gram negativos multirresistentes productores de sepsis intrahospitalaria en pacientes adultos

Abstract

This study describes the epidemiological and microbiological profile of 66 patients with sepsis hospitalized in the adult emergence of the University Hospital of Los Andes (IAHULA), Mérida, Venezuela, from January to July 2015. Also, Gram negative bacilli producers of this infection were characterized. Clinical and epidemiological data were analyzed according to their distribution and frequency. Microbiological processing of blood cultures were performed by conventional and automated methods. The broad spectrum β-lactamases (ESBL) and carbapenemases were phenotypically detected and the presence of bla genes and their variants were confirmed by molecular assays. 54. 5% of patients were males with an average age of 50. 9 years (= 20. 1). Pneumonia (37. 9%; 25/66) was the largest primary source of infection and chronic kidney disease (34. 9%; 23/66) was the most frequent comorbidity. Mortality was recorded in 56. 1% of patients. Only in 6 cases (9. 1%), the microorganisms producing sepsis were identified. Enterococcus species were resistant to ampicillin. E. faecium showed a vanA phenotype and S. aureus was oxacillin-resistant. Enterobacteria were producing several ESBLs (TEMP-1, SHV-2, SHV-5, CTX-M-8 and CTX-M-15) and P. aeruginosa carried genes encoding a VIM-2 type metallo-β- lactamase. Our results indicate that sepsis has a major impact as a cause of morbidity and mortality in adult patients in HULA. These findings are useful to improve the quality of healthcare and also empirical therapeutic approaches for the treatment of sepsis.