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• W2079119341 abstract "Las bacterias gramnegativas multirresistentes son un grave problema de salud en todo el mundo. Ello se relaciona con la gravedad de las infecciones que pueden causar, las dificultades para establecer un tratamiento empírico (e incluso dirigido) correcto, la facilidad para la dispersión de la multirresistencia y la ausencia de nuevos antimicrobianos activos frente a estos patógenos. La antibioterapia debe, por tanto, basarse en el antibiograma, pudiendo requerir la combinación de antibióticos. La producción de beta-lactamasas de espectro extendido es el mayor problema actual de resistencia entre las enterobacterias, que causan infecciones nosocomiales, pero que también se están aislando en pacientes no ingresados. En nuestro entorno son menos relevantes, por el momento, las enterobacterias productoras de AmpC plasmídica o de la mayoría de las carbapenemasas. Todas estas variantes suelen presentar notables tasas de resistencia a aminoglucósidos y quinolonas, debido a que los plásmidos que codifican las beta-lactamasas también contienen genes de resistencia adicionales, o a que se seleccionan mutaciones cromosómicas adicionales. De entre los bacilos gramnegativos no fermentadores multirresistentes debe destacarse Pseudomonas aeruginosa, con elevada resistencia intrínseca y facilidad para adquirir resistencias adicionales, Acinetobacter baumannii, con crecientes tasas de resistencia a los antimicrobianos, y en menor medida Stenotrophomonas maltophilia. Multiresistant Gram-negative bacteria represent a major health problem worldwide. This is related to the severity of the infections they cause, the difficulties for empiric (even directed) treatment, the ease of multiresistance spread, and the absence of new antimicrobial agents active against this group of pathogens. Accordingly, antimicrobial therapy should be based on the results of susceptibility testing, and may require using antimicrobial combinations. The production of extended-spectrum beta-lactamases represents the most important current problem of resistance among enterobacteria; these organisms cause nosocomial infections, but can also be cultured from non-hospitalised patients. In our country, enterobacteria producing plasmid-mediated AmpC enzymes or most carbapenemases are still uncommon, at the moment. Enterobacteria expressing these types of beta-lactamases present high rates of resistance to aminoglycosides and quinolones, because plasmids coding for beta-lactamases also contain other genes involved in additional resistances and/or the selection of additional chromosomal mutations. Among multiresistant Gram-negative non-fermenting bacteria, the most clinically relevant organism is Pseudomonas aeruginosa, an organism with intrinsic resistance to multiple agents and with ability to capture acquired resistance mechanisms. Other organisms in the latter group include Acinetobacter baumannii, with increasing rates of resistance to antimicrobial agents, and to a lesser extent Stenotrophomonas maltophilia." @default.
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• W2079119341 date "2013-06-01" @default.
• W2079119341 modified "2023-10-15" @default.
• W2079119341 title "Infecciones causadas por bacterias gramnegativas multirresistentes: enterobacterias, Pseudomonas aeruginosa, Acinetobacter baumannii y otros bacilos gramnegativos no fermentadores" @default.
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• W2079119341 doi "https://doi.org/10.1016/j.eimc.2013.03.016" @default.
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