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Inicio Enfermedades Infecciosas y Microbiología Clínica Vigilancia de resistencias a los antimicrobianos: estudio VIRA
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Vol. 20. Núm. 10.
Páginas 503-510 (diciembre 2002)
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Vol. 20. Núm. 10.
Páginas 503-510 (diciembre 2002)
Acceso a texto completo
Vigilancia de resistencias a los antimicrobianos: estudio VIRA
Surveillance for antimicrobial resistance: VIRA Study
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5818
Juan J.Picazo1
Autor para correspondencia
jpicazo@microb.net

Correspondencia: Dr. J. J. Picazo. Servicio de Microbiología Clínica. Hospital Clínico San Carlos. Pl. Cristo Rey s/n. 28040 Madrid. España
, Carmen Betriu, Iciar Rodríguez-Avial, Enrique Azahares, Blas Ali Sánchez
Servicio de Microbiología Clínica. Hospital Clínico San Carlos. Madrid. España
Grupo Viraa
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Estadísticas
Introducción

El objetivo de este estudio multicéntrico ha sido conocer la situación actual en España de los patrones de resistencia a los antimicrobianos de los agentes infecciosos más frecuentes, y cuya resistencia a los antibióticos se ha incrementado en los últimos años.

Material y métodos

Se han estudiado 1.475 cepas procedentes de 38 hospitales y correspondientes a aislamientos efectuados en octubre de 2001 distribuidos de la siguiente forma: Staphylococcus aureus resistente a meticilina (SARM) (294), estafilococos coagulasa negativos (ECN) clínicamente significativos (149), Enterococcus faecium (96) y Enterococcus faecalis (1) resistentes a ampicilina, Streptococcus pneumoniae resistente a penicilina (204), Haemophilus influenzae resistente a ampicilina (100), Escherichia coli resistente a ciprofloxacino (361), Pseudomonas aeruginosa (160), y Acinetobacter baumannii (110). Mediante un método de microdilución en caldo se estudió la sensibilidad a diferentes antibióticos. También se llevó a cabo una encuesta epidemiológica en los hospitales participantes sobre la incidencia de estos microorganismos multirresistentes.

Resultados

La incidencia global de aislamientos de E. coli resistentes a ciprofloxacino y de SARM fue del 24% en ambos casos. Los neumococos presentaron resistencia a múltiples antibióticos. Telitromicina mostró excelente actividad frente a todos los neumococos, incluyendo los resistentes a macrólidos. Todos los estafilococos fueron sensibles a linezolida y quinupristina-dalfopristina. Solamente el 50% de las cepas de A. baumannii fueron sensibles a imipenem.

Conclusión

Los resultados presentados ponen de manifiesto la multirresistencia creciente entre microorganismos como SARM, ECN, enterococos resistentes a ampicilina y neumococos resistentes a penicilina, lo cual representa un problema terapéutico importante y, por otra parte, subrayan la necesidad de efectuar estudios de vigilancia.

Palabras clave:
Antimicrobianos
Resistencias
Vigilancia
Introduction

Resistance to antimicrobial drugs has increased in recent years. The aim of this multicenter study was to determine the current situation in Spain regarding the resistance patterns of the most common infectious agents to antimicrobial drugs.

Material and methods

A total 1,475 strains isolated in 38 hospitals in October 2001 were studied. These included 294 methicillin-resistant Staphylococcus aureus (MRSA), 149 clinically significant coagulase-negative staphylococci (CNS), 96 Enterococcus faecium, 1 ampicillin-resistant Enterococcus faecalis, 204 penicillin-resistant Streptococcus pneumoniae, 100 ampicillin-resistant Haemophilus influenzae, 361 ciprofloxacin-resistant Escherichia coli, 160 Pseudomonas aeruginosa, and 110 Acinetobacter baumannii. Sensitivity to various antibiotics was studied by a broth microdilution method. Additionally, an epidemiologic survey was conducted in the participating hospitals to determine the incidence of these multi-drug resistant microorganisms.

Results

Overall incidence of ciprofloxacin-resistant E. coli and MRSA strains was 24% in both cases. The pneumococci were resistant to several antibiotics. Telithromycin showed excellent activity against all the pneumococci, including those resistant to macrolides. Most MRSA isolates were resistant to quinolones and macrolides. All the staphylococci were susceptible to linezolid and quinupristin-dalfopristin. Only 50% of A. baumannii strains were susceptible to imipenem.

Conclusion

The results of this study evidence increasing multi-drug resistance among various microorganisms, such as MRSA, CNS, ampicillin-resistant enterococci, and penicillin-resistant pneumococci, and underline the need for surveillance programs to gain information on this significant therapeutic problem.

Key words:
Antimicrobials
Resistance
Surveillance
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Grupo VIRA: Hospital General Universitario de Alicante (Alicante), Hospital Infanta Cristina (Badajoz), Ciutat Sanitária de la Vall d’Hebron (Barcelona), Hospital Clínic i Provincial de Barcelona (Barcelona), Hospital de Basurto (Bilbao), Complejo Hospitalario de Cáceres (Cáceres), Hospital Universitario Puerta del Mar (Cádiz), Hospital Carmen y Severo Ochoa (Cangas del Narcea), Complejo Hospitalario Reina Sofía (Córdoba), Hospital Comarcal Don Benito-Villanueva de la Serena (Don Benito), Hospital General Universitario de Elche (Elche), Hospital Universitario de Getafe (Getafe), Complejo Hospitalario Virgen de las Nieves (Granada), Hospital General y Universitario de Guadalajara (Guadalajara), Hospital Severo Ochoa (Leganés), Hospital 12 de Octubre (Madrid), Hospital Santa Cristina (Madrid), Hospital Universitario La Paz (Madrid), Hospital Clínico San Carlos (Madrid), Hospital General Universitario Gregorio Marañón (Madrid), Complejo Hospitalario Móstoles-Alcorcón (Móstoles), Hospital Universitario Virgen de la Arrixaca (Murcia), Hospital General Universitario J. M. Morales Meseguer (Murcia), Hospital Son Dureta (Palma De Mallorca), Hospital Insular de Gran Canaria (Las Palmas De Gran Canaria), Hospital General de las Palmas de Gran Canaria (Dr. Negrin) (Las Palmas de Gran Canaria), Hospital de Navarra (Pamplona/Iruña), Hospital Clínico (Salamanca), Complejo Hospitalario Universitario de Santiago (Santiago de Compostela), Hospital General (Segovia), Hospital Virgen del Rocío (Sevilla), Complejo Hospitalario Virgen Macarena (Sevilla), Complejo Hospitalario Nuestra Señora de Valme (Sevilla), Instituto Valenciano de Oncología (Valencia), Hospital Clínico Universitario (Valencia), Hospital Universitario La Fe (Valencia), Hospital Universitario de Valladolid (Valladolid), Hospital Clínico Universitario Lozano Blesa (Zaragoza)

Copyright © 2002. Elsevier España, S.L.. Todos los derechos reservados
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