Abstract: TH-PO915
Microbiologic Surveys and Resistance Profiles in Mexican PD Patients
Session Information
- Dialysis: Infection
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 610 Dialysis: Infection
Authors
- Vargas ezquivel, Martín D., Regional General Hospital 46, Mexican Institute of Social Security, Guadalajara, Mexico
- Soto-Vargas, Javier, Regional General Hospital 46, Mexican Institute of Social Security, Guadalajara, Mexico
- López, Heriberto Reyes, Regional General Hospital 46, Mexican Institute of Social Security, Guadalajara, Mexico
- Garc?a-Vera, Ana Lya, Regional General Hospital 46, Mexican Institute of Social Security, Guadalajara, Mexico
- Jiménez Mejía, Carlos Daniel, Regional General Hospital 46, Mexican Institute of Social Security, Guadalajara, Mexico
- Ramos, Alfonso, Baxter Mexico, San Jer?nimo Chicahualco, Mexico
- Garc?a C?rdenas, Mario A., Regional General Hospital 46, Mexican Institute of Social Security, Guadalajara, Mexico
Background
Guidelines that recommend specific antibiotics for empiric treatment of peritonitis are not specific to populations and time variable microbiology. Our objective was to present the microbiologic change and antibiotic resistance in a reference center in México.
Methods
We recorded the cultures from PD patients with peritonitis from 2008-2015, an analysis was performed of resistance profile to different antibiotics according to their Gram stain and species.
Results
A total of 1814 samples were obtained, the more prevalent bacteria were Staphylococcus coagulasa negative (ConN) (23.7%), S. aureus (16.5%), Escherichia coli (12.2%) and Enterococcus spp (9.2%). The distribution of agents according to Gram stain between the years studied were no different (p=0.214), being Gram positive responsible of 70 to 64% of the cases of peritonitis. It was observed an increase of cases due to S. aureus and Klebsiella spp, as well to E. coli without a specific patron. The majority of the cases were in the ambulatory setting (73.5%).
60.3% of the infections caused by Staphylococcus were methicillin resistant. Of importance, 76% of CoNS had methicillin resistance and only 28.1% of S. aureus. The prevalence of Vancomycin resistant Enterococcus was 18%, with no difference between acquisitions on community or nosocomial setting. In the Gram negative bacilli group, 72.5% of the E. coli and 35.1% of the Klebsiella spp were BLEE-producing, but the susceptibility to carbapenems reached 98%. In respect to fluoroquinolones, E. coli resistance reached 77.8% of the cases, and Klebsiella spp only 20.9%. Surprisingly there were no differences between the resistance and the ambulatory or hospital setting of the infection.
Conclusion
The agents responsible of peritonitis during this 8 year study were primarily Gram positive coccus, with a high prevalence of methicillin resistance in both ambulatory and nosocomial setting. The presence of BLEE-producing Gram negative bacilli was high as well as the resistance to quinolones and aminoglycosides with a little variation over time.