Información del artículo
Resumen
La mediastinitis es una complicación grave entre los pacientes sometidos a cirugía cardiaca. Los agentes etiológicos más frecuentes son los cocos Gram positivos y los Gram negativos son una causa poco común en la mayoría de las series publicadas. Presentamos nuestra experiencia con cuatro pacientes con mediastinitis debida a bacilos Gram negativos multirresistentes, los cuales fueron tratados con tigeciclina.
Palabras clave:
tigeciclina
mediastinitis
Acinetobacter spp.
Klebsiella pneumoniae
Palabras clave:
tigecicline
mediastinitis
Acinetobacter spp
Klebsiella pneumoniae
Abstract
Mediastinitis is a life-threatening complication among patients undergoing cardiac surgery. Gram-positives cocci are the most frequent pathogens associated with post-surgical mediastinitis, being the Gram-negative etiology uncommon in most of the published series. We present our experience with four patients with mediastinitis due to multidrug-resistant Gram-negative bacilli, who have been treated with tigecycline.
El Texto completo está disponible en PDF
Bibliografía
[1.]
A. El Gamel, N.A. Yonan, R. Hassan, M.T. Jones, C.S. Campbell, A.K. Deiraniya, R.A. Lawson.
Treatment of mediastinitis: early modified robicsek closure and pectoralis major advancement flaps.
Ann Thorac Surg, 65 (1998), pp. 41-47
[2.]
R.M. Oakley, J.E. Wright.
Postoperative mediastinitis: classification and management.
Ann Thorac Surg, 61 (1996), pp. 1030-1036
[3.]
B. Gardlunda, C.Y. Bitkoverb, J. Vaageb.
Postoperative mediastinitis in cardiac surgery - microbiology and pathogenesis.
Eur J Cardiothorac Surg, 22 (2002), pp. 825-830
[4.]
A. Tegnell, C. Aren, L. Ohman.
Coagulase-negative staphylococci and sternal infections after cardiac operation.
Ann Thorac Surg, 69 (2000), pp. 1104-1109
[5.]
G.A. Noskin.
Tigecycline: a new glycylcycline for treatment of serious infections.
Clin Infect Dis, 41 (2005), pp. S303-S314
[6.]
D. Curcio, F. Fernández, A. Cané, L. Barcelona, D. Stamboulian.
Indications of a new antibiotic in clinical practice: results of the tigecycline initial use registry.
Braz J Infect Dis, 12 (2008), pp. 198-201
[7.]
S. Lemeshow, D. Teres, J. Klar, J.S. Avrunin, S.H. Gehlbach, J. Rapoport.
Mortality probability models (MPM II) based on an international cohort of intensive care patients.
JAMA, 270 (1993), pp. 2478-2486
[8.]
G. Baran, A. Erbay, H. Bodur, P. Ongürü, E. Akinci, N. Balaban, M.A. Cevik.
Risk factors for nosocomial imipenem-resistantAcinetobacter baumannii infections.
Int J Infect Dis, 12 (2008), pp. 16-21
[9.]
P.A. Bradford.
Extended-spectrum beta-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat.
Clin Microbiol Rev., 14 (2001), pp. 933-951
[10.]
D.P. Raymond, S.J. Pelletier, T.D. Crabtree, H.L. Evans, T.L. Pruett, R.G. Sawyer.
Impact of antibiotic-resistant Gram-negative bacilli infections on outcome in hospitalized patients.
Crit Care Med, 31 (2003), pp. 1035-1041
[11.]
H.K. Sun, C.T. Ong, A. Umer, D. Harper, S. Troy, C.H. Nightingale, D.P. Nicolau.
Pharmacokinetic profile of tigecycline in serum and skin blister fluid of healthy subjects after multiple intravenous administrations.
Antimicrob Agents Chemother, 49 (2005), pp. 1629-1632
[12.]
N.L. Tombs.
Tissue distribution of GAR-936, a broad-spectrum antibiotic in male rats.
Abstracts of the Thirty-ninth Interscience Conference on Antimicrobial Agents and Chemotherapy, American Society for Microbiology, (1999),
[13.]
R.R. Reinert, D.E. Low, F. Rossi, X. Zhang, C. Wattal, M.J. Dowzicky.
Antimicrobial susceptibility among organisms from the Asia/Pacific Rim Europe and Latin and North America collected as part of TEST and the in vitro activity of tigecycline.
J Antimicrob Chemother, 60 (2007), pp. 1018-1029
[14.]
Ellis-Grosse. European Congress in Clinical Microbiology and Infectious Diseases 2206. Programs and Abstracts: P1783.
[15.]
E. Lachanas, P. Tomos, N. Sfyras, S. Miyakis, A. Kostakis.
Acinetobacter baumannii mediastinitis after cardiopulmonary bypass: case report and literature review.
Surg Infect (Larchmt), 9 (2008), pp. 201-204
[16.]
E. Rouveix, A.M. Bure, B. Regnier, M. Wolff, B. Pangon, M.J. Laisne, F. Vachon.
Experience with imipenem/cilastatin in the intensive care unit.
J Antimicrob Chemother, 18 (1986), pp. 153-160
[17.]
M. Quinteros, M. Radice, A. Famiglietti, et al.
Análisis de la sensibilidad a los antimicrobianos en los aislamientos de pacientes internados, años 2004-2005.
Boletín de la Asociación Argentina de Microbiología, 172 (2006), pp. 13-16
[18.]
G. Levy Hara, W. Vasen, D. Pryluka, et al.
Red de infectología GCABA: estudio de prescripción-indicación de antibióticos (ATB) de mayor espectro en unidades de terapia intensiva (UTI) [abstract 90].
Programas y Resúmenes del VI Congreso Argentino de Infectología (Mar del Plata), Sociedad Argentina de Infectología, (2006),
[19.]
J. Li, R.L. Nation, J.D. Turnidge, R.W. Milne, K. Coulthard, C.R. Rayner, et al.
Colistin: the re-emerging antibiotic for multidrugresistant Gram-negative bacterial infections.
Lancet Infect Dis, 6 (2006), pp. 589-601
[20.]
B. Spellberg, J.H. Powers, E.P. Brass, L.G. Miller, J.E. Edwards Jr..
Trends in antimicrobial drug development: implications for the future.
Clin Infect Dis, 38 (2004), pp. 1279-1286
Copyright © 2009. Asociación Colombiana de Infectología (ACIN)
