Enterobacterias con resistencias emergentes : caracterización feno y genotípica y evaluación de la actividad de viejos y nuevos antimicrobianos
Enterobacteriaceae isolates from patients admitted at Hospital de Clínicas "José de San Martin" were studied during the period 2009-2013. The CTX-M type ESBL represents the main mechanism of resistance to extended spectrum cephalosporins although we observed a change in the epidemiology gi...
Guardado en:
| Autor principal: | |
|---|---|
| Otros Autores: | |
| Formato: | Tesis doctoral acceptedVersion |
| Lenguaje: | Español |
| Publicado: |
Facultad de Farmacia y Bioquímica
2016
|
| Materias: | |
| Acceso en línea: | http://repositoriouba.sisbi.uba.ar/gsdl/cgi-bin/library.cgi?a=d&c=posgraafa&cl=CL1&d=HWA_1327 http://repositoriouba.sisbi.uba.ar/gsdl/collect/posgraafa/index/assoc/HWA_1327.dir/1327.PDF |
| Aporte de: |
| Sumario: | Enterobacteriaceae isolates from patients admitted at Hospital de Clínicas "José de San Martin" were studied during the period 2009-2013. The CTX-M type ESBL represents the main mechanism of resistance to extended spectrum cephalosporins although we observed a change in the epidemiology given by the higher prevalence of enzymes belonging to the CTX-M-1 group causing a polyclonal spread. The presence of KPC-type carbapenemase represents the most prevalent resistance to carbapenems. K. pneumoniae- KPC- producing isolates emerged sporadically and the caused a monoclonal dissemination associated to ST258. In the last years the resistance spread to other Enterobacteriaceae and also to other STs in K. pneumoniae. Colistin- resistance emerged in KPC-producing K. pneumoniae due to the selection of resistant subpopulations; and in the KPC- negative isolates associated to a dispersion of resistant clones. The previous use of colistin represents the main risk factor for the acquisition and would facilitate the selection of resistant subpopulations. The colistin/rifampicin association was the most active in vitro combination in isolates susceptible and resistant to colistin and was used in same patients with good results. |
|---|