Prevalencia caracteristicas y desenlaces de pacientes con neumonia adquirida en comunidad por Staphylococo aureus meticilino resistente

100 Páginas.

Autores:: Hurtado Mera, Liliana Andrea

Tipo de recurso:

Fecha de publicación:: 2013

Institución:: Universidad de la Sabana

Repositorio:: Repositorio Universidad de la Sabana

Idioma:: spa

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dc.title.es_CO.fl_str_mv	Prevalencia caracteristicas y desenlaces de pacientes con neumonia adquirida en comunidad por Staphylococo aureus meticilino resistente
title	Prevalencia caracteristicas y desenlaces de pacientes con neumonia adquirida en comunidad por Staphylococo aureus meticilino resistente
spellingShingle	Prevalencia caracteristicas y desenlaces de pacientes con neumonia adquirida en comunidad por Staphylococo aureus meticilino resistente Pulmones-Enfermedades Neumonía viral Enfermedades pulmonares Bacterias patógenas
title_short	Prevalencia caracteristicas y desenlaces de pacientes con neumonia adquirida en comunidad por Staphylococo aureus meticilino resistente
title_full	Prevalencia caracteristicas y desenlaces de pacientes con neumonia adquirida en comunidad por Staphylococo aureus meticilino resistente
title_fullStr	Prevalencia caracteristicas y desenlaces de pacientes con neumonia adquirida en comunidad por Staphylococo aureus meticilino resistente
title_full_unstemmed	Prevalencia caracteristicas y desenlaces de pacientes con neumonia adquirida en comunidad por Staphylococo aureus meticilino resistente
title_sort	Prevalencia caracteristicas y desenlaces de pacientes con neumonia adquirida en comunidad por Staphylococo aureus meticilino resistente
dc.creator.fl_str_mv	Hurtado Mera, Liliana Andrea
dc.contributor.advisor.none.fl_str_mv	Varón, Fabio Andrés González, Mauricio
dc.contributor.author.none.fl_str_mv	Hurtado Mera, Liliana Andrea
dc.subject.es_CO.fl_str_mv	Pulmones-Enfermedades Neumonía viral Enfermedades pulmonares Bacterias patógenas
topic	Pulmones-Enfermedades Neumonía viral Enfermedades pulmonares Bacterias patógenas
description	100 Páginas.
publishDate	2013
dc.date.accessioned.none.fl_str_mv	2013-09-04T19:32:37Z
dc.date.available.none.fl_str_mv	2013-09-04T19:32:37Z
dc.date.created.none.fl_str_mv	2013
dc.date.issued.none.fl_str_mv	2013-09-04
dc.type.none.fl_str_mv	bachelorThesis
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dc.type.local.none.fl_str_mv	Tesis de especialización
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dc.identifier.citation.none.fl_str_mv	Smith IM, Vickers AB. Natural history of 338 treated and untreated patients with staphylococcal septicaemia. Lancet 1960;i:1318-1320. MA Gardam. Is methicillin-resistant Staphylococcus aureus an emerging community pathogen? A review of the literature. Can J Infect Dis 2000;11(4):202-211. Catherine Liu, Arnold Bayer, Sara E. Cosgrove, Robert S. Daum, Scott K. Fridkin, Rachel J. Gorwitz, Sheldon L. Kaplan, Adolf W. Karchmer,Donald P. Levine, Barbara E. Murray, Michael J. Rybak, David. A. Talan, and Henry F. Chambers. Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of MethicillinResistant Staphylococcus aureus Infections in Adults and Children: Executive Summary. Clinical Infectious Diseases 2011;52(3):285–292 Hiramatsu K, Kondo N, Ito T. Genetic basis for molecular epidemiology of MRSA. J Infect Chemother 1996;2:117-29. Diep BA, Otto M. The role of virulence determinants in community-associated MRSA pathogenesis. Trends Microbiol. 2008;16:361-9 Labandiera-Rey M, Couzon F, Boisset S, Brown EL, Bes M, Benito Y, et al. Staphylococcus aureus Panton-Valentine leukocidin causes necrotizing pneumonia. Science. 2007;315:1130-3. Wang R, Braughton KR, Kretschmer D, Bach TH, Queck SY, Li M, et al. Identification of novel cytolytic peptides as key virulence determinants for community-associated MRSA. Nat Med. 2007;13:1510-4 Gillet Y, Vanhems P, Lina G, Bes M, Vandenesch F, Floret D, et al. Factors predicting mortality in necrotizing community acquired pneumonia caused by Staphylococcus aureus containing Panton-Valentine leukocidin. Clin Infect Dis. 2007;45:315-21. Hageman JC, Uyeki TM, Francis JS, Jernigan DB, Wheeler JG, Bridges CB, et al. Severe community acquired pneumonia due to Staphylococcus aureus, 2003-2004, influenza season. Emerg Infect Dis. 2006;12:894-9. Alaniz C, Pogue J. Vancomycin Versus Linezolid in the Treatment of MethicillinResistant Staphylococcus aureus Nosocomial Pneumonia: Implications of the ZEPHyR Trial. Ann. Pharmacother October 2012 46:1432-1435 Álvarez CA, Barrientes OJ, Leal AL, Contreras GA, Barrero L, Rincón S, et al. Community associated methicillin resistant Staphylococcus aureus, Colombia. Emerg Infect Dis. 2006;12:2000-1. Ribeiro A, Dias C, Silva-Carvalho M, Berquo L, Ferreira F, Santos RN, et al. First report of infection with community acquired methycillin resistant Staphylococcus aureus in South America. J ClinMicrobiol. 2005;43:1985-8 Cortés JA, Gómez CA, Cuervo SI, Leal AL. Community-acquired methycillin-resistant Staphylococcus aureus in Bogotá, Colombia: public health implications. Rev Salud Pública. 2007;9:448-54. Arias C, Rincón S, Chowdhury S, Martínez E, Coronell W, Reyes J, et al. MRSA USA 300 clone and VREF -a U.S.- Colombian connection? N Engl J Med. 2008;359:2177-9. Yomayusa N, Leal L, Álvarez C, Escobar J, Suárez IC, Ibáñez M, et al. Caracterización epidemiológica y molecular de infecciones causadas por Staphylococcus aureus resistente a meticilina adquirido en comunidad (SARM-AC) en 7 hospitales de Colombia. Infectio. 2008;12:73. de Miranda OP, Silva-Carvalho MC, Ribeiro A, Portela F, Cordeiro RP, Caetano N, et al. Emergence in Brazil of methycillin-resistant Staphylococcus aureus isolates carrying SCCmecIV that are related genetically to the USA800 clone. ClinMicrobiol Infect. 2007;13:1165-72 Gardella N, von Specht M, Cuirolo A, Rosato A, Gutkind G, Mollerach M. Communityassociated methycillin-resistant Staphylococcus aureus, eastern Argentina. DiagnMicrobiol Infect Dis. 2008;62:343-7. Shorr AF, Tabak YP, Gupta V, et al. Morbidity and cost burden of methicillin- resistant Staphylococcus aureus in early onset ventilator-associated pneumo- nia. Crit Care 2006; 10:R97 Zetola N, Francis JS, Nuermberger EL, et al. Community-acquired meticillin- resistant Staphylococcus aureus: an emerging threat. Lancet Infect Dis 2005; 5:275 – 286.) Gonzalez C, Rubio M, Romero-Vivas J, et al. Bacteremic pneumonia due to Staphylococcus aureus: a comparison of disease caused by methicillin- resistant and methicillin-susceptible organisms. Clin Infect Dis 1999; 29: 1171 – 1177.) Shorr AF, Haque N, Taneja C, et al. The changing epidemiology of non- nosocomial Staphylococcus aureus pneumonia. Chest 2008; 134:s15002– s115002) Datta R, Huang SS. Risk of infection and death due to methicillin-resistant ฀ Staphylococcus aureus in long-term carriers. Clin Infect Dis 2008; 47:176–A retrospective cohort study to evaluate the risk of subsequent MRSA infection and death in 281 prevalent carriers of MRSA) Rubinstein E, Kollef MH, Nathwani D. Pneumonia caused by methicillin- resistant Staphylococcus aureus. Clin Infect Dis 2008; 46 (Suppl 5): S378 – S385.)
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identifier_str_mv	Smith IM, Vickers AB. Natural history of 338 treated and untreated patients with staphylococcal septicaemia. Lancet 1960;i:1318-1320. MA Gardam. Is methicillin-resistant Staphylococcus aureus an emerging community pathogen? A review of the literature. Can J Infect Dis 2000;11(4):202-211. Catherine Liu, Arnold Bayer, Sara E. Cosgrove, Robert S. Daum, Scott K. Fridkin, Rachel J. Gorwitz, Sheldon L. Kaplan, Adolf W. Karchmer,Donald P. Levine, Barbara E. Murray, Michael J. Rybak, David. A. Talan, and Henry F. Chambers. Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of MethicillinResistant Staphylococcus aureus Infections in Adults and Children: Executive Summary. Clinical Infectious Diseases 2011;52(3):285–292 Hiramatsu K, Kondo N, Ito T. Genetic basis for molecular epidemiology of MRSA. J Infect Chemother 1996;2:117-29. Diep BA, Otto M. The role of virulence determinants in community-associated MRSA pathogenesis. Trends Microbiol. 2008;16:361-9 Labandiera-Rey M, Couzon F, Boisset S, Brown EL, Bes M, Benito Y, et al. Staphylococcus aureus Panton-Valentine leukocidin causes necrotizing pneumonia. Science. 2007;315:1130-3. Wang R, Braughton KR, Kretschmer D, Bach TH, Queck SY, Li M, et al. Identification of novel cytolytic peptides as key virulence determinants for community-associated MRSA. Nat Med. 2007;13:1510-4 Gillet Y, Vanhems P, Lina G, Bes M, Vandenesch F, Floret D, et al. Factors predicting mortality in necrotizing community acquired pneumonia caused by Staphylococcus aureus containing Panton-Valentine leukocidin. Clin Infect Dis. 2007;45:315-21. Hageman JC, Uyeki TM, Francis JS, Jernigan DB, Wheeler JG, Bridges CB, et al. Severe community acquired pneumonia due to Staphylococcus aureus, 2003-2004, influenza season. Emerg Infect Dis. 2006;12:894-9. Alaniz C, Pogue J. Vancomycin Versus Linezolid in the Treatment of MethicillinResistant Staphylococcus aureus Nosocomial Pneumonia: Implications of the ZEPHyR Trial. Ann. Pharmacother October 2012 46:1432-1435 Álvarez CA, Barrientes OJ, Leal AL, Contreras GA, Barrero L, Rincón S, et al. Community associated methicillin resistant Staphylococcus aureus, Colombia. Emerg Infect Dis. 2006;12:2000-1. Ribeiro A, Dias C, Silva-Carvalho M, Berquo L, Ferreira F, Santos RN, et al. First report of infection with community acquired methycillin resistant Staphylococcus aureus in South America. J ClinMicrobiol. 2005;43:1985-8 Cortés JA, Gómez CA, Cuervo SI, Leal AL. Community-acquired methycillin-resistant Staphylococcus aureus in Bogotá, Colombia: public health implications. Rev Salud Pública. 2007;9:448-54. Arias C, Rincón S, Chowdhury S, Martínez E, Coronell W, Reyes J, et al. MRSA USA 300 clone and VREF -a U.S.- Colombian connection? N Engl J Med. 2008;359:2177-9. Yomayusa N, Leal L, Álvarez C, Escobar J, Suárez IC, Ibáñez M, et al. Caracterización epidemiológica y molecular de infecciones causadas por Staphylococcus aureus resistente a meticilina adquirido en comunidad (SARM-AC) en 7 hospitales de Colombia. Infectio. 2008;12:73. de Miranda OP, Silva-Carvalho MC, Ribeiro A, Portela F, Cordeiro RP, Caetano N, et al. Emergence in Brazil of methycillin-resistant Staphylococcus aureus isolates carrying SCCmecIV that are related genetically to the USA800 clone. ClinMicrobiol Infect. 2007;13:1165-72 Gardella N, von Specht M, Cuirolo A, Rosato A, Gutkind G, Mollerach M. Communityassociated methycillin-resistant Staphylococcus aureus, eastern Argentina. DiagnMicrobiol Infect Dis. 2008;62:343-7. Shorr AF, Tabak YP, Gupta V, et al. Morbidity and cost burden of methicillin- resistant Staphylococcus aureus in early onset ventilator-associated pneumo- nia. Crit Care 2006; 10:R97 Zetola N, Francis JS, Nuermberger EL, et al. Community-acquired meticillin- resistant Staphylococcus aureus: an emerging threat. Lancet Infect Dis 2005; 5:275 – 286.) Gonzalez C, Rubio M, Romero-Vivas J, et al. Bacteremic pneumonia due to Staphylococcus aureus: a comparison of disease caused by methicillin- resistant and methicillin-susceptible organisms. Clin Infect Dis 1999; 29: 1171 – 1177.) Shorr AF, Haque N, Taneja C, et al. The changing epidemiology of non- nosocomial Staphylococcus aureus pneumonia. Chest 2008; 134:s15002– s115002) Datta R, Huang SS. Risk of infection and death due to methicillin-resistant ฀ Staphylococcus aureus in long-term carriers. Clin Infect Dis 2008; 47:176–A retrospective cohort study to evaluate the risk of subsequent MRSA infection and death in 281 prevalent carriers of MRSA) Rubinstein E, Kollef MH, Nathwani D. Pneumonia caused by methicillin- resistant Staphylococcus aureus. Clin Infect Dis 2008; 46 (Suppl 5): S378 – S385.) 255613 TE06016
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dc.publisher.none.fl_str_mv	Universidad de la Sabana
dc.publisher.program.none.fl_str_mv	Especialización en Medicina Crítica y Cuidado Intensivo
dc.publisher.department.none.fl_str_mv	Facultad de Medicina
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spelling	Varón, Fabio AndrésGonzález, MauricioHurtado Mera, Liliana AndreaEspecialista en Medicina Crítica y Cuidado Intensivo2013-09-04T19:32:37Z2013-09-04T19:32:37Z20132013-09-04Smith IM, Vickers AB. Natural history of 338 treated and untreated patients with staphylococcal septicaemia. Lancet 1960;i:1318-1320.MA Gardam. Is methicillin-resistant Staphylococcus aureus an emerging community pathogen? A review of the literature. Can J Infect Dis 2000;11(4):202-211.Catherine Liu, Arnold Bayer, Sara E. Cosgrove, Robert S. Daum, Scott K. Fridkin, Rachel J. Gorwitz, Sheldon L. Kaplan, Adolf W. Karchmer,Donald P. Levine, Barbara E. Murray, Michael J. Rybak, David. A. Talan, and Henry F. Chambers. Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of MethicillinResistant Staphylococcus aureus Infections in Adults and Children: Executive Summary. Clinical Infectious Diseases 2011;52(3):285–292Hiramatsu K, Kondo N, Ito T. Genetic basis for molecular epidemiology of MRSA. J Infect Chemother 1996;2:117-29.Diep BA, Otto M. The role of virulence determinants in community-associated MRSA pathogenesis. Trends Microbiol. 2008;16:361-9Labandiera-Rey M, Couzon F, Boisset S, Brown EL, Bes M, Benito Y, et al. Staphylococcus aureus Panton-Valentine leukocidin causes necrotizing pneumonia. Science. 2007;315:1130-3.Wang R, Braughton KR, Kretschmer D, Bach TH, Queck SY, Li M, et al. Identification of novel cytolytic peptides as key virulence determinants for community-associated MRSA. Nat Med. 2007;13:1510-4Gillet Y, Vanhems P, Lina G, Bes M, Vandenesch F, Floret D, et al. Factors predicting mortality in necrotizing community acquired pneumonia caused by Staphylococcus aureus containing Panton-Valentine leukocidin. Clin Infect Dis. 2007;45:315-21.Hageman JC, Uyeki TM, Francis JS, Jernigan DB, Wheeler JG, Bridges CB, et al. Severe community acquired pneumonia due to Staphylococcus aureus, 2003-2004, influenza season. Emerg Infect Dis. 2006;12:894-9.Alaniz C, Pogue J. Vancomycin Versus Linezolid in the Treatment of MethicillinResistant Staphylococcus aureus Nosocomial Pneumonia: Implications of the ZEPHyR Trial. Ann. Pharmacother October 2012 46:1432-1435Álvarez CA, Barrientes OJ, Leal AL, Contreras GA, Barrero L, Rincón S, et al. Community associated methicillin resistant Staphylococcus aureus, Colombia. Emerg Infect Dis. 2006;12:2000-1.Ribeiro A, Dias C, Silva-Carvalho M, Berquo L, Ferreira F, Santos RN, et al. First report of infection with community acquired methycillin resistant Staphylococcus aureus in South America. J ClinMicrobiol. 2005;43:1985-8Cortés JA, Gómez CA, Cuervo SI, Leal AL. Community-acquired methycillin-resistant Staphylococcus aureus in Bogotá, Colombia: public health implications. Rev Salud Pública. 2007;9:448-54.Arias C, Rincón S, Chowdhury S, Martínez E, Coronell W, Reyes J, et al. MRSA USA 300 clone and VREF -a U.S.- Colombian connection? N Engl J Med. 2008;359:2177-9.Yomayusa N, Leal L, Álvarez C, Escobar J, Suárez IC, Ibáñez M, et al. Caracterización epidemiológica y molecular de infecciones causadas por Staphylococcus aureus resistente a meticilina adquirido en comunidad (SARM-AC) en 7 hospitales de Colombia. Infectio. 2008;12:73.de Miranda OP, Silva-Carvalho MC, Ribeiro A, Portela F, Cordeiro RP, Caetano N, et al. Emergence in Brazil of methycillin-resistant Staphylococcus aureus isolates carrying SCCmecIV that are related genetically to the USA800 clone. ClinMicrobiol Infect. 2007;13:1165-72Gardella N, von Specht M, Cuirolo A, Rosato A, Gutkind G, Mollerach M. Communityassociated methycillin-resistant Staphylococcus aureus, eastern Argentina. DiagnMicrobiol Infect Dis. 2008;62:343-7.Shorr AF, Tabak YP, Gupta V, et al. Morbidity and cost burden of methicillin- resistant Staphylococcus aureus in early onset ventilator-associated pneumo- nia. Crit Care 2006; 10:R97Zetola N, Francis JS, Nuermberger EL, et al. Community-acquired meticillin- resistant Staphylococcus aureus: an emerging threat. Lancet Infect Dis 2005; 5:275 – 286.)Gonzalez C, Rubio M, Romero-Vivas J, et al. Bacteremic pneumonia due to Staphylococcus aureus: a comparison of disease caused by methicillin- resistant and methicillin-susceptible organisms. Clin Infect Dis 1999; 29: 1171 – 1177.)Shorr AF, Haque N, Taneja C, et al. The changing epidemiology of non- nosocomial Staphylococcus aureus pneumonia. Chest 2008; 134:s15002– s115002)Datta R, Huang SS. Risk of infection and death due to methicillin-resistant ฀ Staphylococcus aureus in long-term carriers. Clin Infect Dis 2008; 47:176–A retrospective cohort study to evaluate the risk of subsequent MRSA infection and death in 281 prevalent carriers of MRSA)Rubinstein E, Kollef MH, Nathwani D. Pneumonia caused by methicillin- resistant Staphylococcus aureus. Clin Infect Dis 2008; 46 (Suppl 5): S378 – S385.)http://hdl.handle.net/10818/8282255613TE06016100 Páginas.La neumonía por Staphylococo aureus resistente a la meticilina (SARM), ha sido considerada como una causa poco frecuente de neumonía extrahospitalaria, representando el 1 al 5% de los casos de neumonía adquirida en comunidad (NAC. En Colombia, las publicaciones se limitan a reportes de casos, lo cual nos plantea la necesidad de establecer como es el comportamiento de esta patología en nuestro medio Objetivo: Describir la epidemiología local, las características clínicas y paraclínicas y los desenlaces de la neumonía adquirida en la comunidad por Staphylococo aureus meticilino resistente de los pacientes ingresados al servicio de urgencias de la Fundación Cardioinfantil en el periodo comprendido entre 2010 y 2012. Metodología: Estudio descriptivo, observacional, retrospectivo se registraron las caracteristicas clínicas, paraclínicas y desenlaces, así como el perfil microbiológico de este patógeno; adicionalmente se realizo un analisis exploratorio de las diferencias de las caracteristicas de la NAC por SARM y la NAC por otros gérmenes.Resultados: 157 historias de NAC con una prevalencia del 5% para NAC por SAMR, como antecedentes de importancia encontramos la presencia de EPOC por tabaquismo y falla cardiaca , asi como el consumo previo de esteroides mostrando este ultimo diferencias significativas con respecto a otras neumonias; hubo una media de retraso en el inicio de manejo antibiotico dirijido de 47 horas, con un requerimiento de atención en unidad de cuidado intensivo del 75% y hospitalización polongada con una mediana de 25 dias y mortalidad de 12.5%.spaUniversidad de la SabanaEspecialización en Medicina Crítica y Cuidado IntensivoFacultad de MedicinaUniversidad de La SabanaIntellectum Repositorio Universidad de La SabanaPulmones-EnfermedadesNeumonía viralEnfermedades pulmonaresBacterias patógenasPrevalencia caracteristicas y desenlaces de pacientes con neumonia adquirida en comunidad por Staphylococo aureus meticilino resistentebachelorThesisTesis de especializaciónpublishedVersionhttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_7a1fhttp://purl.org/coar/access_right/c_abf2LICENSElicense.txtlicense.txttext/plain; charset=utf-8498https://intellectum.unisabana.edu.co/bitstream/10818/8282/2/license.txtf52a2cfd4df262e08e9b300d62c85cabMD52Liliana Andrea Hurtado Mera (Carta).pdfLiliana Andrea Hurtado Mera (Carta).pdfapplication/pdf1068466https://intellectum.unisabana.edu.co/bitstream/10818/8282/5/Liliana%20Andrea%20Hurtado%20Mera%20%28Carta%29.pdf96df4bb8dc9c5623bde3cd80c463f547MD55ORIGINALLILIANA ANDREA HURTADO (T) FINAL.pdfLILIANA ANDREA HURTADO (T) FINAL.pdfVer documento en PDFapplication/pdf3134180https://intellectum.unisabana.edu.co/bitstream/10818/8282/3/LILIANA%20ANDREA%20HURTADO%20%28T%29%20FINAL.pdf61ec53e04e944ef735b4754196f2533fMD53TEXTLILIANA ANDREA HURTADO (T) FINAL.pdf.txtLILIANA ANDREA HURTADO (T) FINAL.pdf.txtExtracted Texttext/plain102https://intellectum.unisabana.edu.co/bitstream/10818/8282/4/LILIANA%20ANDREA%20HURTADO%20%28T%29%20FINAL.pdf.txt55d093365fc274b949e9068899fae6efMD5410818/8282oai:intellectum.unisabana.edu.co:10818/82822017-03-21 18:43:18.131Intellectum Universidad de la Sabanacontactointellectum@unisabana.edu.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

Prevalencia caracteristicas y desenlaces de pacientes con neumonia adquirida en comunidad por Staphylococo aureus meticilino resistente

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