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handle: 10017/59502
Fundamento. Las enterobacterias productoras de carbapenemasas (EPC) constituyen un problema sanitario de enorme importancia, por su frecuencia y gravedad. Se desconoce en qué medida la pandemia de COVID-19 puede haber impactado en la frecuencia de aislados de EPC y en la presentación clínica y gravedad de los cuadros. Material y Métodos. Revisión de la literatura con selección de los artículos publicados y comunicaciones a congresos. Se recogen también datos no publicados del HURyC sobre la evolución de EPC en este periodo. La mayor parte de las publicaciones se refieren a la primera ola de la pandemia en Europa. Resultados. Con los datos disponibles, no parece haber aumentado la frecuencia de aislados de EPC durante la primera ola de COVID-19. El perfil del paciente con coinfección SARS-CoV-2/EPC sería un varón más joven (63 años) que los pacientes habitualmente hospitalizados con COVID-19, que en un porcentaje significativo (21%) carece de comorbilidades asociadas. En su mayoría se trata de pacientes hospitalizados en UCI, a donde llegarían tras una mediana de 3 días en planta, con un SOFA de 8 puntos y donde pasaría un total de 21 días de mediana. La bacteria implicada con mayor probabilidad sería Klebsiella pneumoniae productora de KPC, provocando infección respiratoria en la mayoría de los casos, seguida de ITU y bacteriemia. Habría recibido en todos los casos antibioterapia antes del aislamiento de la EPC y corticoides en la gran mayoría (83%). La mortalidad global sería del 43%. Conclusiones. Las EPC no han visto aumentada la frecuencia de aislamiento durante la primera ola de la pandemia de COVID-19. El perfil clínico es similar al de las infecciones causadas por EPC en pacientes sin COVID-19, aunque la mortalidad es elevada
Basis. Carbapenemase-producing Enterobacteriaceae (CPE) constitute a health problem of enormous importance, due to their frequency and severity. It is unknown to what extent the COVID-19 pandemic may have impacted the frequency of CLD isolates and the clinical presentation and severity of the symptoms. Material and methods. Review of the literature with a selection of published articles and communications to congresses. Unpublished data from the HURyC are also collected on the evolution of CPE in this period. Most of the publications refer to the first wave of the pandemic in Spain. Results. With the available data, the frequency of CPE isolates does not appear to have increased during the first wave of COVID-19. The profile of the patient with SARS-CoV-2 / CPE coinfection would be a younger male (63 years) than the patients usually hospitalized with COVID-19, who in a significant percentage (21%) lacks associated comorbidities. Most of these are patients hospitalized in the ICU, where they would arrive after an average of 3 days in the ward, with a SOFA of 8 points and where they would spend a total of 21 days on average. The most likely involved organism would be KPC-producing Klebsiella pneumoniae, causing respiratory infection in most cases, followed by UTI and bacteremia. In all cases, they would have received antibiotic therapy before isolation of CPE and corticosteroids in the vast majority (83%). The overall mortality was 43%. Conclusions. An increase in the isolates of CPE has not been seen during the first wave of the COVID-19 pandemic. The clinical profile is similar to that of CPE infections in patients without COVID-19, although mortality is high
Grado en Medicina
28 p.
Carbapenemase, Carbapenemase producing enterobacteriaceae, Carbapenemasa, SARS-CoV-2, Medicina, COVID-19, Medicine, Enterobacteria productora de carbapenemasa, Multidrug resistance, Multirresistencia farmacológica
Carbapenemase, Carbapenemase producing enterobacteriaceae, Carbapenemasa, SARS-CoV-2, Medicina, COVID-19, Medicine, Enterobacteria productora de carbapenemasa, Multidrug resistance, Multirresistencia farmacológica
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