Letter to the Editor
Ventilator-associated pneumonia by Chryseobacterium indologenes
Neumonía por Chryseobacterium indologenes asociada a ventilación mecánica
Luis Chiscano-Camón
, Juan Carlos Ruiz-Rodríguez, Rosa Alcaraz, Ricard Ferrer
Corresponding author
Servicio de Medicina Intensiva, Hospital Universitari Vall d’Hebron, Barcelona, Spain
Read
2
Timeswas read the article
0
Total PDF
2
Total HTML
Share statistics
array:24 [ "pii" => "S2387020616303849" "issn" => "23870206" "doi" => "10.1016/j.medcle.2015.11.030" "estado" => "S300" "fechaPublicacion" => "2016-06-03" "aid" => "3457" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2015" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2016;146:e61-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775315006417" "issn" => "00257753" "doi" => "10.1016/j.medcli.2015.11.015" "estado" => "S300" "fechaPublicacion" => "2016-06-03" "aid" => "3457" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2016;146:e61-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 18 "formatos" => array:2 [ "HTML" => 11 "PDF" => 7 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Neumonía por <span class="elsevierStyleItalic">Chryseobacterium indologenes</span> asociada a ventilación mecánica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e61" "paginaFinal" => "e62" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Ventilator-associated pneumonia by <span class="elsevierStyleItalic">Chryseobacterium indologenes</span>" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Chiscano-Camón, Juan Carlos Ruiz-Rodríguez, Rosa Alcaraz, Ricard Ferrer" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Luis" "apellidos" => "Chiscano-Camón" ] 1 => array:2 [ "nombre" => "Juan Carlos" "apellidos" => "Ruiz-Rodríguez" ] 2 => array:2 [ "nombre" => "Rosa" "apellidos" => "Alcaraz" ] 3 => array:2 [ "nombre" => "Ricard" "apellidos" => "Ferrer" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020616303849" "doi" => "10.1016/j.medcle.2015.11.030" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616303849?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775315006417?idApp=UINPBA00004N" "url" => "/00257753/0000014600000011/v1_201605180055/S0025775315006417/v1_201605180055/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020616303758" "issn" => "23870206" "doi" => "10.1016/j.medcle.2016.07.005" "estado" => "S300" "fechaPublicacion" => "2016-06-03" "aid" => "3507" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2016;146:e63-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Schnitzler syndrome: Report of 3 cases" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e63" "paginaFinal" => "e65" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de Schnitzler: descripción de 3 casos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Gerardo Rodríguez-Lobato, Pilar Iranzo, Juan I. Aróstegui, Carlos Fernández de Larrea" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Luis Gerardo" "apellidos" => "Rodríguez-Lobato" ] 1 => array:2 [ "nombre" => "Pilar" "apellidos" => "Iranzo" ] 2 => array:2 [ "nombre" => "Juan I." "apellidos" => "Aróstegui" ] 3 => array:2 [ "nombre" => "Carlos" "apellidos" => "Fernández de Larrea" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S002577531600018X" "doi" => "10.1016/j.medcli.2015.12.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577531600018X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616303758?idApp=UINPBA00004N" "url" => "/23870206/0000014600000011/v1_201609250103/S2387020616303758/v1_201609250103/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020616303825" "issn" => "23870206" "doi" => "10.1016/j.medcle.2015.11.028" "estado" => "S300" "fechaPublicacion" => "2016-06-03" "aid" => "3466" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2016;146:516-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Charles Bonnet syndrome secondary to intravitreal ranibizumab in a patient with exudative age-related macular degeneration" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "516" "paginaFinal" => "517" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de Charles Bonnet secundario a ranibizumab intravítreo en un paciente con degeneración macular asociada a la edad" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pilar Cifuentes-Canorea, Nestor Ventura-Abreu, Julián García-Feijoo, Enrique Santos-Bueso" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Pilar" "apellidos" => "Cifuentes-Canorea" ] 1 => array:2 [ "nombre" => "Nestor" "apellidos" => "Ventura-Abreu" ] 2 => array:2 [ "nombre" => "Julián" "apellidos" => "García-Feijoo" ] 3 => array:2 [ "nombre" => "Enrique" "apellidos" => "Santos-Bueso" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775315006508" "doi" => "10.1016/j.medcli.2015.11.024" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775315006508?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616303825?idApp=UINPBA00004N" "url" => "/23870206/0000014600000011/v1_201609250103/S2387020616303825/v1_201609250103/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Ventilator-associated pneumonia by <span class="elsevierStyleItalic">Chryseobacterium indologenes</span>" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e61" "paginaFinal" => "e62" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Luis Chiscano-Camón, Juan Carlos Ruiz-Rodríguez, Rosa Alcaraz, Ricard Ferrer" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Luis" "apellidos" => "Chiscano-Camón" "email" => array:1 [ 0 => "lchiscano@vhebron.net" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Juan Carlos" "apellidos" => "Ruiz-Rodríguez" ] 2 => array:2 [ "nombre" => "Rosa" "apellidos" => "Alcaraz" ] 3 => array:2 [ "nombre" => "Ricard" "apellidos" => "Ferrer" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Intensiva, Hospital Universitari Vall d’Hebron, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neumonía por <span class="elsevierStyleItalic">Chryseobacterium indologenes</span> asociada a ventilación mecánica" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Chryseobacterium indologenes (C. indologenes)</span>, previously known as <span class="elsevierStyleItalic">Flavobacterium indologenes</span>, is a glucose non-fermenting, non-motile, aerobic gram-negative bacillus, positive for oxidase, indole and catalase.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> It is able to survive in a hospital environment, colonizing elements such as ventilators, intubation tubes, humidifiers, incubators or elements related with chlorinated water systems; in short, elements containing fluids.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Thus, it can cause various types of infections such as bacteraemia, meningitis and infections associated with connectors (for example, mechanical ventilation elements, causing pneumonia associated with mechanical ventilation<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>), especially in those patients with long periods of hospitalization, treated with broad-spectrum antibiotics and elderly.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> It has also been associated with pyelonephritis, biliary tract infections, peritonitis, lumboperitoneal shunt infections, eye infections and endocarditis. We report a case of <span class="elsevierStyleItalic">C. indologenes</span> ventilator-associated pneumonia.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 67-year-old male, admitted to the Intensive Care Unit (ICU) due to multi-organ failure in the postoperative period of elective surgery for an infrarenal abdominal aortic aneurysm. The patient had acute respiratory failure requiring endotracheal intubation and mechanical ventilation, acute renal failure and <span class="elsevierStyleItalic">shock</span>. The patient had been receiving selective digestive decontamination with polymyxin, amphotericin and tobramycin as solution via nasogastric tube, and also, topically, polymyxin, amphotericin, tobramycin and vancomycin on gums. He was initially treated with piperacillin-tazobactam, which was maintained for 11 days. After 12 days of endotracheal intubation, a percutaneous tracheostomy was performed using the <span class="elsevierStyleItalic">Seldinger</span> method. In the following hours he presented continuous bleeding at the point of incision, controlled by local measures, and required tracheobronchial aspiration repeatedly. 48<span class="elsevierStyleHsp" style=""></span>h after the tracheostomy, he had fever, respiratory deterioration and right basal pulmonary condensation. Tracheal aspirate was <span class="elsevierStyleItalic">C. indologenes</span> positive. Empirical treatment was started with piperacillin-tazobactam and after four days it was replaced by ciprofloxacin according to susceptibility testing. <span class="elsevierStyleItalic">C. indologenes</span> was resistant to aztreonam, imipenem, meropenem, gentamicin, tobramycin and colistin, and sensitive to piperacillin-tazobactam, ceftazidime, cefepime and ciprofloxacin. The patient progressed satisfactorily, with resolution of pneumonia. The patient was transferred to a ward 39 days after admission to the ICU and was discharged from hospital after 54 days of hospital admission.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The pattern of susceptibility of this microorganism to antimicrobials is not fully established because it is a rarely isolated pathogen.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleItalic">C. indologenes</span> presents constituent metallo-beta-lactamases and is often resistant to aminoglycosides, penicillin, aztreonam, cephalosporins (first, second and third generation, except ceftazidime), chloramphenicol and erythromycin. It is also resistant to imipenem and meropenem due to the production of class B carbapenemases.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> The most effective antibiotics are quinolones (garenoxacin, gatifloxacin and levofloxacin), cotrimoxazole, rifampicin, piperacillin, piperacillin-tazobactam and cefepime,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> although the best clinical results have been obtained with minocycline, fluoroquinolones and rifampicin.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Kirby et al.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> concluded that the new quinolones represent the most appropriate treatment.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Reports show that the formation of a <span class="elsevierStyleItalic">biofilm</span> on devices could be a pathogenic and colonization pathway,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> and that the different decontamination strategies do not prevent the formation of the same.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> This phenomenon could be especially important in critically ill patients on mechanical ventilation, in which the aspirations of the tracheobronchial secretions can favour the development of <span class="elsevierStyleItalic">C. indologenes</span> ventilator-associated pneumonia by breaking the <span class="elsevierStyleItalic">biofilm</span> and allowing dissemination through the bronchial tree.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Our case coincides with other cases reported<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,4,6,7,9,10</span></a> in terms of presence of advanced age, prior use of broad-spectrum antibiotic treatment, the inability of selective digestive decontamination to prevent the growth of <span class="elsevierStyleItalic">C. indologenes</span> and a pattern of antimicrobial resistance. In the patient described, the possible route of acquisition may be related to the colonization of the tubing and/or connections used in mechanical ventilation. C. <span class="elsevierStyleItalic">Indologenes</span> should be included in the differential diagnosis of ventilator-associated pneumonias, and, if isolation is confirmed, contamination of the devices associated with the ventilator should be ruled out.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Chiscano-Camón L, Ruiz-Rodríguez JC, Alcaraz R, Ferrer R. Neumonía por <span class="elsevierStyleItalic">Chryseobacterium indologenes</span> asociada a ventilación mecánica. Med Clin (Barc). 2016;146:e61–e62.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Flavobacterium indologenes bacteremia: clinical and microbiological characteristics" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.R. Hsue" 1 => "T.R. Hsue" 2 => "J.J. Wu" 3 => "L.J. Teng" 4 => "S.W. Ho" 5 => "W.C. Hsieh" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "1996" "volumen" => "23" "paginaInicial" => "550" "paginaFinal" => "555" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8879779" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and microbiological characteristics of <span class="elsevierStyleItalic">Flavobacterium indologenes</span> infections associated with indwelling devices" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P.R. Hsue" 1 => "L.J. Teng" 2 => "S.W. Ho" 3 => "W.C. Hsieh" 4 => "K.T. Luh" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "1996" "volumen" => "34" "paginaInicial" => "1908" "paginaFinal" => "1913" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8818879" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neumonía asociada a ventilación mecánica por Chryseobacterium indologenes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Y. Peñasco" 1 => "J. Duerto" 2 => "A. González-Castro" 3 => "M.J. Domínguez" 4 => "J.C. Rodríguez-Borregan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2015.01.005" "Revista" => array:2 [ "tituloSerie" => "Med Intensiva" "fecha" => "2015" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and epidemiological features of <span class="elsevierStyleItalic">Chryseobacterium indologenes</span> infections: analysis of 215 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F.L. Chen" 1 => "G.C. Wang" 2 => "S.O. Teng" 3 => "T.Y. Ou" 4 => "F.L. Yu" 5 => "W.S. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jmii.2012.08.007" "Revista" => array:6 [ "tituloSerie" => "J Microbiol Immunol Infect" "fecha" => "2013" "volumen" => "46" "paginaInicial" => "425" "paginaFinal" => "432" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23022462" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of healthcare associated pneumonia caused by <span class="elsevierStyleItalic">Chryseobacterium indologenes</span> in an immunocompetent patient" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.N. Salih" 1 => "D. Tuna" 2 => "U. Serap" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2015/483923" "Revista" => array:5 [ "tituloSerie" => "Case Rep Infect Dis" "fecha" => "2015" "volumen" => "2015" "paginaInicial" => "483923" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25628903" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Characterization of CIA-1, an Ambler class A extended-spectrum β-lactamase from <span class="elsevierStyleItalic">Chryseobacterium indologenes</span>" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Matsumoto" 1 => "M. Nagata" 2 => "N. Ishimine" 3 => "K. Kawasaki" 4 => "K. Yamauchi" 5 => "E. Hidaka" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/AAC.05165-11" "Revista" => array:5 [ "tituloSerie" => "Antimicrob Agents Chemother" "fecha" => "2012" "volumen" => "56" "paginaInicial" => "588" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22083470" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antimicrobial susceptibility and epidemiology of a worldwide collection of <span class="elsevierStyleItalic">Chryseobacterium</span> spp.: report from the SENTRY Antimicrobial Surveillance Program (1997–2001)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.T. Kirby" 1 => "H.S. Sader" 2 => "T.R. Walsh" 3 => "R.N. Jones" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2004" "volumen" => "42" "paginaInicial" => "445" "paginaFinal" => "448" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14715802" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reappraisal of the antimicrobial susceptibilities of <span class="elsevierStyleItalic">Chryseobacterium</span> and <span class="elsevierStyleItalic">Flavobacterium</span> species and methods for reliable susceptibility testing" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.L. Fraser" 1 => "J.H. Jorgensen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Antimicrob Agents Chemother" "fecha" => "1997" "volumen" => "41" "paginaInicial" => "2738" "paginaFinal" => "2741" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9420049" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implications of endotracheal tube biofilm in ventilator-associated pneumonia response: a state of concept" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Gil-Perotin" 1 => "P. Ramirez" 2 => "V. Marti" 3 => "J.M. Sahuquillo" 4 => "E. Gonzalez" 5 => "I. Calleja" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/cc11357" "Revista" => array:5 [ "tituloSerie" => "Crit Care" "fecha" => "2012" "volumen" => "16" "paginaInicial" => "R93" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22621676" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Selective decontamination of the digestive tract (SDD) does not prevent the formation of microbial biofilms on endotracheal tubes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.G. Adair" 1 => "S.P. Gorman" 2 => "F.B. O’Neill" 3 => "B. McClurg" 4 => "E.C. Goldsmith" 5 => "C.H. Webb" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "1993" "volumen" => "31" "paginaInicial" => "689" "paginaFinal" => "697" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8335497" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014600000011/v1_201609250103/S2387020616303849/v1_201609250103/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014600000011/v1_201609250103/S2387020616303849/v1_201609250103/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616303849?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 2 | 0 | 2 |
