Factores de riesgo en infección y colonización por Escherichia coli y Klebsiella pneumoniae productoras de betalactamasas de espectro extendido
Risk factors in extenoeo-spectrum betalactamase producing Escherichia coli ano Klebsiella pneumoniae infection and colonization
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Las betalactamasas de espectro extendido (BLEE) son enzimas producidas por bacterias Gram negativas, que tienen la capacidad de destruir el anillo betalactámico de las cefalosporinas de tercera generación, permitiendo a la bacteria continuar con el entrecruzamiento del peptidoglicano y con la formación de pared celular sin alteraciones. Descritas en los años ochenta su diseminación y aumento en la incidencia en todos los continentes ha llevado al incremento de la morbilidad y mortalidad de los pacientes, prolongación de los días de estancia hospitalaria, mayor demanda de uso de carbapenémicos e incremento de los costos de la atención en salud. Predecir el patrón de resistencia del microorganismo que infecta a un paciente con base en el análisis de los factores de riesgo asociados permite la óptima elección de la antibioticoterapia empírica, racionalizando el uso de los antibióticos de amplio espectro disponibles y mejorando la sobrevida de los pacientes. Para esta revisión se realizó una búsqueda de los estudios de casos y controles en los cuales se investigaron los factores de riesgo asociados con infección o colonización por bacterias productoras de BLEE a saber: exposición previa a antibióticos, estancia en UCI, uso de catéter vesical, catéter central o ventilación mecánica.
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