Altos porcentajes de corresistencia antimicrobiana entre Enterobacteriaceae: análisis comparativo entre aislamientos clínicos resistentes y sensibles a las cefalosporinas de tercera generación
- Autores: Emilio Bouza Santiago, María José Goyanes, L. Alcalá, A. Morente, Roser Insa Soria, Emilia Cercenado Mansilla
- Localización: Revista Española de Quimioterapia, ISSN-e 0214-3429, Vol. 20, Nº. 2, 2007, págs. 216-221
- Idioma: español
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Resumen
We compared the antimicrobial co-resistance of 3,402 clinical isolates of Enterobacteriaceae resistant to third-generation cephalosporins (2,569 ESBL-producing and 833 AmpC overproducing) with that of 16,220 susceptible isolates, in order to determine the impact of resistance to third-generation cephalosporins on the likelihood of resistance to other antimicrobial classes. Enterobacteriaceae resistant to third-generation cephalosporins, independently of their mechanism of resistance, were significantly more resistant to other classes of antimicrobials than susceptible isolates (p <0.001). Percentages of co-resistance to ciprofloxacin, gentamicin, tobramycin and trimethoprim-sulfamethoxazole of resistant isolates were: 51%, 39%, 53% and 51%, respectively. However, among the susceptible isolates, percentages were 17%, 7%, 6% and 19%, respectively. Fosfomycin exhibited excellent in vitro activity against urinary isolates (92%), mainly against ESBL-producing organisms (90%), and is a good alternative treatment of infections caused by multidrug resistant Enterobacteriaceae. Amikacin and imipenem were the most active antimicrobials against all species tested.
