RESUMO
Introduction: In the past few years, an increase in methicillin resistant-not multiresistant Staphylococcus aureus was observed in Uruguay among children with community acquired infections. Recommendations for empiric antibiotic treatment required adjustments and new national guidelines were recommended in July 2004. Adherence to these guidelines was indirectly performed by monitoring antibiotic consumption and antimicrobial susceptibility patterns in Uruguay. Objective: To describe and compare antibiotic consumption and antimicrobial susceptibility of Staphylococcus aureus in a Pediatric Hospital of the Centro Hospitalario Pereira Rossell (PH-CHPR) between 2001 and 2006. Methods: Antibiotic consumption in hospitalized children was calculated using the Defined Daily Dose per 100 bed-days (DDD/100). Reference valúes were obtained from the World Health Organization Collaborating Center for Drug Statistics Methodology of. Consumption. Data were obtained using the WinPharma programme of the Pharmacy Department of CHPR. The fraction of annual occupancy of hospital beds was obtained from the Statistic División of CHPR. Antibiotic consumption was evaluated netween 2001 and 2006 and expressed as DDD/100 and percent change. Antimicrobial susceptibility was evaluated using CHPR's Microbiology Laboratory data during the same time period. Results: After 2003 a significant increase in consumption of clindamycin, ceftriaxone, trimethoprim-sulphamethoxazole, cefuroxime, vancomycin and gentamycin was observed, except for cephradine. Consumption of clindamycin, ceftriaxone and trimethoprim-sulphamethoxazole showed the highest increase (6.15 percent; 1.44 percent and 1.17 percent respectively). Detection of Staphylococcus aureus increased significantly mostly from skin and soft tissue infections. Oxacillin susceptibility of S aureus strains obtained from different sites had a significant and persistent decrease after 2003 (from 81 percent during year ...
Introducción: En Uruguay, Staphylococcus aureus resistente a meticilina no multi-resistente se instaló como patógeno en las infecciones comunitarias del niño. Objetivo: Describir la evolución de la susceptibilidad in vitro de S. aureus y su relación con el consumo de antimicrobianos en el Centro Hospitalario Pereira Rossell (CHPR) entre 2001-2006. Metodología: Se estimó el consumo de antimicrobianos mediante el cálculo de la Dosis Diaria Definida por 100 camas-día. Los valores de referencia fueron obtenidos del Collaborating Centre for Drug Statistics Methodology of World Health Organiza-tion. Los datos de consumo fueron extraídos del programa WinFarma del Dpto de Farmacia de CHPR. El porcentaje de ocupación de camas/año se obtuvo de la División de Estadísticas del CHPR. Se analizó la susceptibilidad antimicrobiana de S. aureus de aislados de piel, tejidos blandos y sitios normalmente estériles. Se analizó la evolución del consumo y la susceptibilidad in vitro en el período 2001-2006. Resultados: Desde el año 2003, el consumo de clindamicina, ceftriaxona y cotrimoxazol aumentó y la susceptibilidad a oxacilina disminuyó significativamente. Entre 2004 y 2006 el "efecto D" disminuyó su frecuencia desde 28 a 21 por ciento. No se observaron diferencias en el patrón de susceptibilidad antimicrobiana en función del sitio de aislamiento. Conclusiones: Staphylococcus aureus resistente a meticilina no multi-resistente se ha introducido en forma significativa como un patógeno causante de infecciones en la comunidad en niños uruguayos. La vigilancia del consumo de antimicrobianos y de la epidemiología local es indispensable para actualizar las guías de antibioterapia empírica.