Nosocomial infection by enterococcus: Hospital de San José, 2005-2007
Infección nosocomial por enterococcus: Hospital de San José, 2005-2007
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Abstract
Objectives: to describe the epidemiological, clinical, sociodemographic characteristics and final outcome of the adult patients treated at Hospital de San José with nosocomial infection due to Enterococcus sp, the most compromised anatomical sites, the antimicrobial sensitivity profile and the presence of vancomycin resistance. , as well as determine the overall mortality in this pathology. Methods: To analyze the positive isolates of Enterococcus sp in patients aged 18 years and older, obtained from the LabPro database of the microbiology service of the Hospital of San José between October 2005 and December 2007; then select the positive isolates of nosocomial origin, based on the criteria established by the CDC of Atlanta. Clinical, demographic, and microbiological data were collected, as well as the mortality of the selected population. Results: of 303 positive isolates for Enterococcus sp 58 were nosocomial and the most frequent germ was Enterococcus faecalis; 56.9% were women and the average age was 50 years. The most common specific comorbidities were hypertension, neoplastic diseases and diabetes. 74.1% of the patients were managed by surgical services and 91.4% of the total were subjected to some surgical procedure prior to isolation. The mortality was 12%. Conclusions: in our population nosocomial infection by Enterococcus sp corresponds to 19% of the total of positive for this germ. The most frequent species is Enterococcus faecalis, which can be related to the high sensitivity found to vancomycin. Penicillins and aminoglycosides are still antibiotics of choice because a high sensitivity was identified in the antibiograms. High resistance to carbapenems was found after quinupristin / dalfopristin, explained by the high intrinsic resistance of Enterococcus faecalis to this antibiotic group. The nosocomial infection by Enterococcus sp in the Hospital of San José is frequently related to surgical procedures, especially the abdominal ones, which suggests in this type of patients a greater predisposition to nosocomial infection. Overall mortality was 12% of the total sample and for those who required management in the ICU was 31.8%, being able to infer that greater complexity and comorbidity influence a high risk of fatal outcome. Abbreviations: ICU, intensive care unit.
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