Susceptibility and phenotypic antimicrobial patterns of Staphylococcus aureus in the skin of hospitalized burned patients
Keywords:
Staphylococcus aureus, burned patient, infections, drug resistance microbialAbstract
Introduction: Due to its presence in hospitals, Staphylococcus aureus is known as a producer of sepsis, and for its antimicrobial resistance; therefore, it is considered a super bacterium. Objective: To characterize the susceptibility and phenotypic antimicrobial patterns of Staphylococcus aureus in the skin of hospitalized burned patients. Method: A descriptive, retrospective and cross-sectional study on skin infections caused by Staphylococcus aureus in hospitalized burned patients was conducted at the Arnaldo Milián Hospital from 2012 to 2016. The sample consisted of 53 isolates that were susceptible to methicillin, ciprofloxacin, chloramphenicol, gentamicin and trimethoprim/sulfamethoxazole. To determine the frequency of susceptibility, the responses to methicillin were interrelated with the homologous ones of each antimicrobial. T determine the patterns, 16 random combinations were designed with the four antimicrobials, except for methicillin, and they were divided into two groups according to their susceptibility. The frequencies of appearances in both variables were determined. Results: There was a clear predominance of individual sensitivity to methicillin 77.3%, to ciprofloxacin 67.9%, to chloramphenicol 94.3%, to gentamicin 64.1% and to trimethoprim/sulfamethoxazole 71.7%. There was a predominance of sensitive results of antimicrobials interrelated in the same way with methicillin. The analysis of the patterns showed the circulation of the 10 phenotypes, 77.3% is related to the sensitive methicillin and, of them, 30.1% with sensitivity to the four antimicrobials. Conclusions: There was a prevalence of the sensitivity of antimicrobials, individually and interrelated in the same sense to methicillin. The variability of phenotypic patterns was confirmed, with a clear predominance of those related to sensitivity to methicillin.Downloads
References
1. Stephen M. Milner, Caffrey J. Medical Management if the Burn patient. En: Cameron JL, Cameron AM. Current Surgical Therapy. 20th ed. España: Elsevier; 2017. p. 1295-1298. Disponible en: https://www.clinicalkey.es/#!/content/book/3-s2.0-B9780323376914002305?scrollTo=%23hl0000114
2. Greenhalgh DG. Sepsis in the burn patient: a different problem than sepsis in the general population. Burns Trauma [Internet]. 2017 Aug [citado 7 Oct 2017];5:23. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547526/
3. Vidaurreta Lara N, Suárez Morales O, García Urquijo A, Peláez Quintana G. Caracterización clínico-epidemiológica y microbiológica del paciente quemado leve con infección local. Acta Méd Centro [Internet]. 2014 [citado 15 Mar 2016];8(4):1-8. Disponible en: http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/190/278
4. Rowan MP, Cancio LC, Elster EA, Burmeister DM, Lloyd FR, Shanmugasundaram N, et al. Burn wound healing and treatment: review and advancements. Crit Care [Internet]. 2015 Jun [citado 15 Mar 2016];19:243. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464872/
5. Jeschke M, William F, Gaulitz G, Herdon D. Quemaduras. En: Courtney M, Beauchamp D, Evers M, Mattox K. Sabiston. Tratado de cirugía. Fundamentos biológicos de la práctica quirúrgica moderna.19th ed. Barcelona: Elsevier; 2013. p. 521-547.
6. García Urquijo A. Aislamientos microbiológicos de secreciones en piel quemada de pacientes hospitalizados [tesis]. Santa Clara: Hospital Universitario Clínico Quirúrgico Arnaldo Milián Castro; 2012.
7. Soriano Viladomiu A. Infecciones estafilocócicas. En: Farreras-Rozman Medicina Interna. Enfermedades del aparato digestivo. Gastroenterología y hepatología. 17th ed. España: Elsevier; 2012. p. 2002-2007.
8. Que YA, Moreillan P. Staphylococcus aureus (incluido el síndrome del shock tóxico). En: Mandell GL, Bennett JE, Dolin R. Enfermedades Infecciosas. Principios y Práctica. 7ma ed. Barcelona: Elsevier; 2012. p. 2543-2582.
9. Chambers H. Infecciones por estafilococos. En: Gooldman L, Schafer A. Tratado e Medicina Interna Cecil y Gooldman. 24th ed. Barcelona. Elsevier; 2013. p. 1819-1823.
10. Jawetz E, Melnick EA, Alderberg JL. Estafilococos. Microbiología Médica. 25th ed. Ciudad de México: Elsevier; 2011. p. 185-193.
11. Sendejas-Manzo GS, Avalos-Flores H, Soto-Padilla MY. Microbiología general de Staphylococcus aureus: Generalidades, patogenicidad y métodos de identificación. Rev Biomed [Internet]. 2014 [citado 15 Mar 2016]; 25:129-143. Disponible en: http://www.medigraphic.com/pdfs/revbio/bio-2014/bio143d.pdf
12. Hospital Clínico Quirúrgico Universitario Arnaldo Milián Castro. Protocolos de actuación y procedimientos de Microbiología; 2016.
13. CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-First Informational Supplement. CLSI document M100-S21. Wayne, PA: Clinical and Laboratory Standards Institute; 2011.
14. CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Third Informational Supplement. CLSI document M100-S23. Wayne, PA: Clinical and Laboratory Standards Institute; 2013. Disponible en: http://www.facm.ucl.ac.be/intranet/CLSI/CLSI-M100S23-susceptibility-testing-2013-no-protection.pdf
15. CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fifth Informational Supplement. CLSI document M100-S25. Wayne, PA: Clinical and Laboratory Standards Institute; 2015.
16. Armas Fernández A, Suárez Trueba B, Crespo Toledo N, Suárez Casal A. Resistencia de Staphylococcus aureus a la meticilina en aislamientos nosocomiales en un hospital provincial. Gaceta Medica Espirituana [Internet]. 2015 Dic [citado 15 Mar 2016];17(3):1-11. Disponible en: http://scielo.sld.cu/pdf/gme/v17n3/GME11315.pdf
17. Lorenzo Manzanas R. Resistencia antimicrobiana en aislamientos de piel y partes blandas en ingresados en la unidad de caumatología [tesis]. Santa Clara: Hospital Universitario Clínico Quirúrgico Arnaldo Milián Castro; 2012.
18. Mensa Pueyo J, Gatell Artigas J, García-Sánchez J. Guía de Terapéutica Antimicrobiana. 23th ed. Barcelona: Editorial Antares; 2014. Disponible en: http://media.axon.es/pdf/100157.pdf
19. García EA, Caballero López A, Martín García L, Linares Borges A. Antimicrobianos. En: Caballero López A. Terapia Intensiva. 2da ed. La Habana: Ciencias Médicas; 2009. p. 1570-1636.
20. Ministerio de Salud Pública. Viceministerio de Higiene, Epidemiología y Microbiología. Programa de prevención y control de las infecciones asociadas con la asistencia sanitaria; 2011.
21. Suárez Morales O, Gómez García N, Morales Valdés R. Sepsis en el paciente quemado grave. Acta Méd Centro [Internet]. 2009 [citado 15 Mar 2016];3(2). Disponible en: http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/445/606
22. García-Urquijo A, Rodríguez-Rodríguez JA. Rodríguez-Pérez R, Lorenzo-Manzanas R, Hernández-González G. Staphylococcus aureus en quemaduras: estudio de incidencia, tendencia y pronóstico. Cir Plást Iberolatinoam [Internet]. 2015 Abr-Jun [citado 15 Mar 2016];41(2). Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0376-78922015000200002
23. Lazo Arispe GF, Mamani Flores E, Vargas Loroño E, Camacho Aguilar JR, Sahonero Ampuero O. Sensibilidad y resistencia en el antibiograma del Staphylococcus aureus en pacientes del Hospital Clínico Viedma. Rev Cient Cienc Méd [Internet]. 2013 [citado 15 Mar 2016];16(2):15-17. Disponible en: http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S1817-74332013000200005
Published
How to Cite
Issue
Section
License
Authors who have publications with this journal agree to the following terms:
- Authors will retain their copyright and assign to the journal the right of first publication of their work, which will simultaneously be subject to a Creative Commons License / Attribution-Noncommercial 4.0 International (CC BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
- Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g., depositing it in an institutional repository or publishing it in a monographic volume) as long as the initial publication in this journal is indicated.
- Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which can produce interesting exchanges and increase citations of the published work. (See The effect of open access).