Determinar la Resistencia Antimicrobiana de las Enterobacterias y el uso de antibióticos en pacientes de UCI de la Clínica D.A.M.E. 2014

Abstract

It was determined the antimicrobian resistance in enterobacteria ( productors of beta lactamases of spread spectrum) in patients of UCI (intensive Care Unit) of the DAME clinic (acute diagnostic and specialist) located in Quito city, Pichincha province. Were analyzed 279 biological samples of the UCI patients, were the originator m icroorganisms were identified and isolated, using the Microgen system, were the antibiotic susceptibility was proved through paper discs impregnated of antibiotic, determining the sensibility by the halo diameter whose reading comes standardized . It was de termined that the main microorganisms caused of nosocomial infections in the patients of UCI of medical care center, are the enterobacterias E. coli in 47.4% Klebsiella pneumoniae in 29.5%, Proteus mirabilis in 7.7 %, Staphylococcus aureus in 6.4%, Enteroc occus 6.4 % and Pseudomona aeruginosa 2.6% . The 57% of enterobacterias strains are multiresistant, of which the Klebsiella pneumoniae present 74% of multiresistant, E. coli 54%, Pseudomona aeruginosa 50% and Proteus mirabilis 16%. The antibiotics to the great resistance present the enterobacterias studied are the cephalosporins of third and fourth generation and sulfatrimtroprim; the amikacynis the antibiotic whose has 89% of sensibility. The multiresistance is related with th e type of microorganism, type of antibiotic and the use of previous antibiotic therapy. It was conclude that the antimicrobian resistance of the enterobacterias is a meaningful problem, due to mainly the inappropriate use of antibiotic that promotes develo ping of the different resistance mechanisms. It is recommended to realize culture and antibiogram to all the patients with infections processes, before to start with antibiotic therapy.