Evaluación del tratamiento de erradicación de Staphylococcus aureus meticilino resistentes de portadores asintomáticos
Abstract
Introduction: The MRSA are resistant microorganisms to a wide range of beta-Iactam antibiotics, which produce infections in outpatients and hospitalized, associated with the character of nasopharyngeal carrier and increasing morbidity and mortality in critical areas of health-care, such as intensive care and hemodialysis. Objective: To assess long-term implementation of a treatment to eradicate the character of nasopharyngeal carrier of MRSA in hemodialysis unit patients of IMSS HGZ No. 1. 2006-2008. Methods: It is a descriptive study on age, sex and concomitant disease of patients with methicillin-resistant staphylococcus. Analytical on the eradication short and longterm nature of these microorganisms. Results: In the long-term assessment of all patients admitted with MRSA, the bearing was eradicated in 100% (16), p<0.05. Of those that MRCNS were originally isolated (57), the long-term eradication was 85.96% (49) (p<0.001). Conclusions: In this study long-term bearering of MRSA was eradicated by applying a prophylactic rifampin and trimethoprim/sulfamethoxazole based treatment, on the CNS carriers of methicillin-resistant, the number of strains decreased on a high percentage, with statistically significant results for both.References
Organización Mundial de la Salud. La contención de la resistencia a los antimicrobianos [Internet]. (Perspectivas Políticas de la OMS sobre Medicamentos; no. 10). Ginebra: OMS, 2005. Disponible en: http://apps.who.int/medicinedocs/pdf/s7922s/s7922s.pdf (Consulta: 10/07/2008).
Lu PL, Chin LC, Peng CF, Chiang YH, Chen TP, Ma L, et al. Risk factors and molecular analysis of community methicillin-resistant Staphylococcus aureus carriage. J Clin Microbiol. 2005;43(1):132-9.
Mainous AG 3rd, Hueston WJ, Everett CJ, Diaz VA. Nasal carriage of Staphylococcus aureus and methicillin-resistant S aureus in the United States, 2001-2002. Ann Fam Med. 2006;4(2):132-7.
Delaney JA, Schneider-Lindner V, Brassard P, Suissa S. Mortality after infection with methicillin-resistant Staphylococcus aureus (MRSA) diagnosed in the community. BMC Med. 2008;6:2.
Echevarria Zarate J, Iglesias Quilca D. Estafilococo Meticilino resistente, un problema actual en la emergencia de resistencia entre los Gram positivos. Rev Med Hered. 2003;14(4):195-203.
Bustos Martínez JA, Hamdan Partida A, Gutiérrez Cárdenas M. Staphylococcus aureus: la reemergencia de un patógeno en la comunidad. Rev Biomed. 2006;17(4):287-305.
Chow JW, Yu VL. Staphylococcus aureus nasal carriage in hemodialysis patients. Its role in infection and approaches to prophylaxis. Arch Intern Med. 1989;149(6):1258-62.
Yu VL, Goetz A, Wagener M, Smith PB, Rihs JD, Hanchett J, et al. Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis. N Engl J Med. 1986;315(2):91-6.
Boelaert JR, De Smedt RA, De Baere YA, Godard CA, Matthys EG, Schurgers ML, et al. The influence of calcium mupirocin nasal ointment on the incidence of Staphylococcus aureus infections in haemodialysis patients. Nephrol Dial Transplant. 1989;4(4):278-81.
Ramírez-Vázquez G. Importancia del diagnóstico microbiológico en el tratamiento de pacientes con patología infecciosa sometidos a procedimientos de hemodiálisis. Tesis de Licenciatura, Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, México, jun. 2007.
Waldvogel FA, Bisno AL. Infections associated with indwelling medical devices. 3rd ed. Washington, DC: ASM Press, 2000, p. 345-65.
Selvey LA, Whitby M, Johnson B. Nosocomial methicillin-resistant Staphylococcus aureus bacteremia: is it any worse than nosocomial methicillin-sensitive Staphylococcus aureus bacteremia? Infect Control Hosp Epidemiol. 2000;21(10):645-8.
Durán-Varela BR, Rivera-Chavira B, Franco-Gallegos E. Apego al tratamiento farmacológico en pacientes con diagnóstico de diabetes mellitus tipo 2. Salud Pública Méx. 2001;43(3):233-6.
Sopena Galindo N. Evolución de un brote epidémico por Staphylococcus Aureus resistente a la meticilina (SARM).Tesis doctoral, Universitat Autónoma de Barcelona, 2002, p. 44-69.