Staphylococcus aureus Resistente a Meticilina: Estudio de Porcentaje de Aislamientos y Perfil de Resistencia entre los años 2016-2019 en el Hospital San Vicente de Paúl
Fecha
2021-12
Tipo
tesis
Autores
Salvador Zúñiga, Gonzalo Alberto
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Resumen
Staphylococcus aureus es considerado en la actualidad como uno de los patógenos más importantes en los establecimientos de salud, gracias a su constante evolución, lo cual le permite adaptarse a las condiciones ambientales en las que se encuentra de forma muy rápida. Esto debido a que cuenta con una amplia variedad de factores de virulencia, bioquímicos y estructurales, que le permiten colonizar, invadir y diseminarse; así como la posibilidad de cambiar la sensibilidad a los antimicrobianos que se utilizan para su tratamiento.
En el presente trabajo se determinó el porcentaje de aislamientos de Staphylococcus aureus resistentes a meticilina, en los años 2016 al 2019, así como el perfil de resistencia de estas cepas a 5 familias de antimicrobianos (aminoglucósidos, macrólidos, lincosamidas, estreptograminas y tetraciclinas). Así mismo, se determinó la distribución según el valor de la CIM a vancomicina.
Se encontró que el porcentaje de aislamientos de SARM en el periodo de estudio oscila entre el 54.4% y el 63.1%, presentándose una diferencia significativa entre entre cepas SARM y SASM, únicamente en el año 2016. Posterior a este año, el porcentaje bajó y no ha aumentado de forma significativa.
En cuanto a los perfiles de resistencia, se encontró que los mayores porcentajes de resistencia se presentan en los macrólidos, que oscilan entre 48.6% y 62.2%, aspecto que se mantiene en el periodo de estudio. Por otro lado, el menor porcentaje de resistencia se presentó en la tetraciclinas, el cual varía entre 15.4% y 22.9%. Los porcentajes de resistencia a aminoglucósidos, quinolona y lincosamidas, oscilan entre el 30% y 40%, sin que hayan aumentado en el tiempo.
La CIM a vancomicina demostró en promedio, el 29.8% de las cepas presentan un valor de 0.5 µg/ml, mientras que el 68.2% de las cepas presentan un valor de 1 µg/ml. Los valores de CIM de 2 µg/ml y 4 µg/ml, presentaron los porcentajes más bajos.
Staphylococcus aureus is currently considered one of the most important pathogens in health facilities, thanks to its constant evolution, which allows it to adapt to the environmental conditions in which it is found very quickly. This is since it has a wide variety of virulence, biochemical and structural factors that allow it to colonize, invade and spread; as well as the possibility of changing the sensitivity to antimicrobials used for its treatment. In the present work, the percentage of isolates of Staphylococcus aureus resistant to methicillin, in the years 2016 to 2019, as well as the resistance profile of these strains to 5 families of antimicrobials (aminoglycosides, macrolides, lincosamides, streptogramins and tetracyclines) was determined. Likewise, the distribution according to the MIC value of vancomycin was determined. It was found that the percentage of MRSA isolates in the study period ranges between 54.4% and 63.1%, presenting a significant difference between MRSA and SASM strains, only in 2016. After this year, the percentage decreased, and it has not increased significantly. Regarding the resistance profiles, it was found that the highest percentages of resistance occur in the macrolides, which range between 48.6% and 62.2%, an aspect that is maintained in the study period. On the other hand, the lowest percentage of resistance was presented in tetracyclines, which varies between 15.4% and 22.9%. The percentages of resistance to aminoglycosides, quinolone and lincosamides range between 30% and 40%, without increasing over time. The vancomycin MIC showed on average, 29.8% of the strains present a value of 0.5 µg/ml, while 68.2% of the strains present a value of 1 µg/ml. The MIC values of 2 µg/ml and 4 µg/ml presented the lowest percentages.
Staphylococcus aureus is currently considered one of the most important pathogens in health facilities, thanks to its constant evolution, which allows it to adapt to the environmental conditions in which it is found very quickly. This is since it has a wide variety of virulence, biochemical and structural factors that allow it to colonize, invade and spread; as well as the possibility of changing the sensitivity to antimicrobials used for its treatment. In the present work, the percentage of isolates of Staphylococcus aureus resistant to methicillin, in the years 2016 to 2019, as well as the resistance profile of these strains to 5 families of antimicrobials (aminoglycosides, macrolides, lincosamides, streptogramins and tetracyclines) was determined. Likewise, the distribution according to the MIC value of vancomycin was determined. It was found that the percentage of MRSA isolates in the study period ranges between 54.4% and 63.1%, presenting a significant difference between MRSA and SASM strains, only in 2016. After this year, the percentage decreased, and it has not increased significantly. Regarding the resistance profiles, it was found that the highest percentages of resistance occur in the macrolides, which range between 48.6% and 62.2%, an aspect that is maintained in the study period. On the other hand, the lowest percentage of resistance was presented in tetracyclines, which varies between 15.4% and 22.9%. The percentages of resistance to aminoglycosides, quinolone and lincosamides range between 30% and 40%, without increasing over time. The vancomycin MIC showed on average, 29.8% of the strains present a value of 0.5 µg/ml, while 68.2% of the strains present a value of 1 µg/ml. The MIC values of 2 µg/ml and 4 µg/ml presented the lowest percentages.
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Palabras clave
Staphylococcus aureus Resistente a Meticilina, SARM, Aislamientos SARM, Perfil de Resistencia SARM