Estudio de la resistencia a antimicrobianos en cepas de Enterococcus spp, aisladas de aves y cerdos de producción

The appearance of resistance bacterial strains appears concurrent with the use of antimicrobial drugs. Within recent times the progressively increasing use of the drugs in humans, animals and the agriculture have transformed this phenomena into a growing problem, that every day involves new number of strains, new bacterial species and mechanisms. In this context, bacteria are particularly efficient in developing greater resistance, not only because of their ability to rapidly multiply but also their capacity to transfer genes in a horizontal form. In this respect the importance of Enterococcus is natural resistance to multiple antibiotics and this aptitude to acquire new resistance included to the vancomycin. The objective of this study was to phenotypically and genotypically characterize the antimicrobial resistance in indicator strains Enterococcus spp isolated from healthy animals of economic importance, such as poultry and pigs. Firstly the percentage of resistance to the different antimicrobial drugs was determined by the method of dilution in plate (MIC), then the genetic mechanisms associated with resistance to erythromycin was defined. The results of this study give up to date information on the situation regarding bacterial resistance in Enterococcus strains isolated in two animal species producing of food which are highly consumed in our country. This information should be taken account in the development of public health policy for the use of antimicrobials in food producing animal with the aim of protecting human health.    La resistencia en las cepas bacterianas aparece junto con el uso de los antimicrobianos. Hoy en día el uso masivo de estos fármacos en el hombre, los animales y la agricultura ha transformado este fenómeno en un problema creciente, que involucra cada día mayor número de cepas, nuevas especies bacterianas y nuevos mecanismos. En este sentido, las bacterias son particularmente eficientes en aumentar los efectos de la resistencia, no sólo por su habilidad de multiplicarse rápidamente sino también, por su capacidad de transferir genes en forma horizontal. En este sentido la importancia del género Enterococcus radica en su resistencia natural a múltiples antibióticos y a su capacidad de adquirir nueva resistencia incluida a la vancomicina. El objetivo de este estudio fue caracterizar fenotípica y genotípicamente la resistencia a diversos antimicrobianos en cepas indicadoras Enterococcus spp aisladas desde animales sanos de importancia económica, como son las aves y los cerdos. Se determinaron los porcentajes de resistencia frente a distintos antimicrobianos mediante el método de dilución en placa o concentración mínima inhibitoria (CIM) y posteriormente se definió el mecanismo genético asociado a la resistencia a eritromicina. Los resultados de este estudio entregan información de la situación de la resistencia en cepas de Enterococcus spp aisladas de dos especies animales productoras de alimento de alto consumo en nuestro país. Por lo que estos resultados podrían servir para que los médicos veterinarios realicen una mejor utilización de los antimicrobianos en las distintas producciones lo que podría tener un impacto en salud pública.  

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat