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Rev Esp Anestesiol Reanim ; 64(9): 490-498, 2017 Nov.
Article in English, Spanish | MEDLINE | ID: mdl-28434558

ABSTRACT

OBJECTIVE: The presence of resistant microorganisms is a major cause of failure in initial empirical antimicrobial therapy. The objectives of this study are to determine the resistance profile of microorganisms that cause bacteraemia of abdominal origin and to identify whether the previous use of antibiotics and the place of acquisition of bacteraemia are risk factors associated with the presence of resistant organisms. MATERIAL AND METHODS: A clinical, observational, epidemiological, retrospective cohort study was conducted with all the adult patients admitted to a university hospital from 2011-2013. Antimicrobial resistance profiles were described and a 95% confidence interval chi-square test was used to determine whether the variables studied were risk factors in the isolation of resistant microorganisms. RESULTS: Of the 1245 patients with bacteraemia, 212 (17%) presented bacteraemia of abdominal origin. The resistance profile highlights the incidence of methicillin resistant Staphylococcus aureus (50%), coagulase-negative staphylococci resistant to linezolid (20.58%), enterococci resistant to vancomycin (3.12%), Escherichia coli resistant to third-generation cephalosporins (9.9%) and fluoroquinolones (35.64%), Klebsiella pneumoniae resistant to third-generation cephalosporins (8.33%), Pseudomonas aeruginosa resistant to fluoroquinolones and carbapenem (25% and 25% respectively) and Acinetobacter baumanii resistant to fluoroquinolones and carbapenem (100% and 100% respectively), Candida albicans resistant to fluconazole (11.11%), single Candida krusei isolate resistant to fluconazole and Candida parapsilosis resistant to echinocandins (12.5%). In our study, previous use of antibiotics had a statistically significant association with the isolation of resistant microorganisms (P=.013) but not the place of acquisition of bacteraemia (P=.239). CONCLUSION: Establishing the incidence of resistant organisms can improve empirical antimicrobial therapy in patients with bacteraemia of abdominal origin. Previous use of antibiotics was statistically significantly related to the isolation of resistant microorganisms.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Bacteria/drug effects , Digestive System Diseases/microbiology , Drug Resistance, Microbial , Adult , Aged , Anti-Bacterial Agents/adverse effects , Bacteremia/epidemiology , Bacteremia/microbiology , Bacteria/isolation & purification , Candidemia/drug therapy , Candidemia/epidemiology , Candidemia/microbiology , Community-Acquired Infections/drug therapy , Community-Acquired Infections/epidemiology , Community-Acquired Infections/microbiology , Comorbidity , Cross Infection/drug therapy , Cross Infection/microbiology , Digestive System Diseases/complications , Drug Resistance, Fungal , Drug Resistance, Multiple, Bacterial , Female , Hospitals, University/statistics & numerical data , Humans , Male , Middle Aged , Postoperative Complications/drug therapy , Postoperative Complications/microbiology , Retrospective Studies , Risk Factors , Sepsis/epidemiology , Sepsis/microbiology , Spain/epidemiology , Young Adult
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