Caracterización clínica y microbiológica de la bacteriemia por Staphylococcus aureus

Hincapié-Osorno, Carolina; Caraballo-Cordovez, César; García, María Fernanda Tibaduiza; Garcés-Rodríguez, Daniela De Jesús; Echeverri-Toro, Lina; Ascuntar-Tello, Johana; León-Álvarez, Alba Luz; Jaimes, Fabián

doi:10.36104/amc.2018.1074

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…Local studies have reported a mortality due to SA of 24-30% [ 3 ]. In a study conducted at the San Vicente Fundación Hospital of Medellin, SA bacteremias cases were collected retrospectively for 4 years (2012-2016) the results showed 43% of those infected were in RRT [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Vancomycin is the drug of choice for the treatment of MRSA bacteremia [ 2 ]. This antibiotic has a narrow therapeutic margin, and inadequate dosage poses a risk of toxicity [ 4 ] while underdosing predisposes to therapeutic failure and emergence of resistant microorganisms [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…In Colombia, 6% of patients with CKD require renal replacement therapy (RRT) [1]. In patients with CKD-HD, bacteremia due to SA presents high morbidity, mortality and increased risk of MRSA [2]. Local studies have reported a mortality due to SA of 24-30% [3].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Vancomycin trough levels monitoring on uncomplicated methilcillin-resistant Staphylococcus aureus bacteremia in chronic kidney disease on hemodialysis, retrospective cohort

Ramirez-Osorio,

Velez-Hernandez,

Fernandez-Castaño

et al. 2024

BMC Infect Dis

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Background CKD patients on hemodialysis (HD) with Staphylococcus aureus (SA) bacteremia present high morbidity, mortality and increased risk of MRSA. Vancomycin is the antibiotic of choice in these cases, it has a narrow therapeutic margin and inadequate dosage generates a risk of toxicity, therefore, the recommendation is to dosage it through serum levels. Methods This is a retrospective cohort study in 3 hospitals of third level of complexity in the city of Medellin in which there were differences in the measurement and implementation of vancomycin25 dosage based on trough levels (VL) in patients with chronic kidney disease on hemodialysis (CKD- HD) with uncomplicated bacteremia based infection by methilcillin-resistant Staphyloccocus aureus (MRSA). The primary outcome was the composite of hospital mortality, clinical response (fever, hemodynamic instability and altered consciousness), complications associated with bacteremia, or bacteriological response failure (positive cultures at first week follow-up) at 7 days. The composite variables were analyzed individually as secondary outcomes. Results The main unadjusted outcome (OR 1.3, CI 0.6 - 2.7) and adjusted for age, Charlson index, loading dose, initial dose, dosing frequency and MIC to vancomycin (OR 1.2, CI 0.5 - 2.7). Regarding adjusted secondary outcomes: clinical response (OR 1.4 CI 0.3 - 5.8), death (OR 1.3 CI 0.3 - 4.6) and complications (OR 0.9, CI 0.37 - 2.2). Conclusions We conclude that the measurement of trough levels in patients with HD-CKD does not modify the composite outcome. The main limitation is the sample size and type of study, randomized control trials may be required to confirm the results presented.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Vancomycin trough levels monitoring on uncomplicated methilcillin-resistant Staphylococcus aureus bacteremia in chronic kidney disease on hemodialysis, retrospective cohort

Ramirez-Osorio,

Velez-Hernandez,

Fernandez-Castaño

et al. 2024

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…(1). In patients with CKD-HD, bacteremia due to SA presents high morbidity, mortality and increased risk of MRSA (2). Local studies have reported a mortality due to SA of 24-30% (3).…”

Section: Introductionmentioning

confidence: 99%

“…Vancomycin is the drug of choice for the treatment of MRSA bacteremia (2). This antibiotic has a narrow therapeutic margin and inadequate dosage generates risk of toxicity (4) while underdosing predisposes to therapeutic failure and emergence of resistant microorganisms (5).…”

Section: Introductionmentioning

confidence: 99%

Impact of Vancomycin trough levels monitoring on uncomplicated methilcillin-resistant Staphylococcus aureus bacteremia in chronic kidney disease on hemodialysis, retrospective cohort

Osorio,

Velez-Hernandez,

Castaño

et al. 2023

Preprint

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Background CKD patients on hemodialysis (HD) with Staphylococcus aureus (SA) bacteremia present high morbidity, mortality and increased risk of MRSA. Vancomycin is the antibiotic of choice in these cases, it has a narrow therapeutic margin and inadequate narrow therapeutic margin and inadequate dosage generates a risk of toxicity, therefore, they recommend that its dosage be guided through measurement of serum levels. Methods This is a retrospective cohort study in 3 hospitals of third level of complexity in the city of Medellin in which there were differences in the measurement and implementation of vancomycin25 dosage based on trough levels (VL) in patients with chronic kidney disease on hemodialysis (CKD- HD) with uncomplicated bacteremia based infection by methilcillin-resistant Staphyloccocus aureus (MRSA). The primary outcome was the composite of hospital mortality, clinical response (fever, hemodynamic instability and altered consciousness), complications associated with bacteremia or bacteriological response failure (positive cultures at first week follow-up) at 7 days, and the composite variables were analyzed individually as secondary outcomes. Results The main unadjusted outcome (OR 1.3, CI 0.6–2.7) and adjusted for age, Charlson index, loading dose, initial dose, dosing frequency and MIC to vancomycin (OR 1.2, CI 0.5–2.7). Regarding adjusted secondary outcomes: clinical response (OR 1.4 CI 0.3–5.8), death (OR 1.3 CI 0.3–4.6) and complications (OR 0.9, CI 0.37–2.2). Conclusions We conclude that the measurement of trough levels in patients with HD-CKD does not modify the composite outcome. The main limitation is the sample size and type of study, so that preferably randomized studies are required to confirm the results presented.

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Validation of VIRSTA and Predicting Risk of Endocarditis Using a Clinical Tool (PREDICT) Scores to Determine the Priority of Echocardiography in Patients With Staphylococcus aureus Bacteremia

Peinado-Acevedo

Hurtado-Guerra

Hincapié

et al. 2021

Clinical Infectious Diseases

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Introduction Infective endocarditis (IE) secondary to Staphylococcus aureus bacteremia (SAB) has high morbidity and mortality. The systematic use of echocardiography in SAB is controversial. We aimed to validate VIRSTA and PREDICT scores for predicting the risk of IE in Colombian patients with SAB and, consequently, to determine the need for echocardiography. Methodology Cohort of patients hospitalized with SAB in two high complexity institutions in Medellin, Colombia, between 2012-2018. The diagnosis of IE was established based on the modified Duke criteria. The VIRSTA and PREDICT scores were calculated from the clinical records, and their operational performance was calculated. Results The final analysis included 922 patients, 62 (6.7%) of whom were diagnosed with IE. The frequency of IE in patients with a negative VIRSTA scale was 0.44% (2/454). The frequency of IE in patients with a negative PREDICT scale on day 5 was 4.8% (30/622). The sensitivity and negative predictive value (NPV) of the VIRSTA scale was 96.7% and 99.5%, respectively. For the PREDICT scale on day 5, the sensitivity and NPV were 51.6% and 95.1%, respectively. The discrimination, given by the area under the ROC curve (AUC), was 0.86 for VIRSTA and 0.64 for PREDICT. Conclusions In patients with negative VIRSTA, screening echocardiography may be unnecessary due to the low frequency of IE. In PREDICT-negative patients, despite the low frequency of IE, it is not safe to omit echocardiography.

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Caracterización clínica y microbiológica de la bacteriemia por Staphylococcus aureus

Cited by 4 publications

References 18 publications

Impact of Vancomycin trough levels monitoring on uncomplicated methilcillin-resistant Staphylococcus aureus bacteremia in chronic kidney disease on hemodialysis, retrospective cohort

Impact of Vancomycin trough levels monitoring on uncomplicated methilcillin-resistant Staphylococcus aureus bacteremia in chronic kidney disease on hemodialysis, retrospective cohort

Impact of Vancomycin trough levels monitoring on uncomplicated methilcillin-resistant Staphylococcus aureus bacteremia in chronic kidney disease on hemodialysis, retrospective cohort

Validation of VIRSTA and Predicting Risk of Endocarditis Using a Clinical Tool (PREDICT) Scores to Determine the Priority of Echocardiography in Patients With Staphylococcus aureus Bacteremia

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