{"id":112418,"date":"2018-03-11T10:39:20","date_gmt":"2018-03-11T10:39:20","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/caracterizacion-de-los-mecanismos-de-resistencia-de-aislamientos-cla%c2%adnicos-de-pseudomonas-aeruginosa-no-sensibles-a-carbapenems-y-factores-de-riesgo-asociados-a-su-adquisicion\/"},"modified":"2018-03-11T10:39:20","modified_gmt":"2018-03-11T10:39:20","slug":"caracterizacion-de-los-mecanismos-de-resistencia-de-aislamientos-cla%c2%adnicos-de-pseudomonas-aeruginosa-no-sensibles-a-carbapenems-y-factores-de-riesgo-asociados-a-su-adquisicion","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/microbiologia\/caracterizacion-de-los-mecanismos-de-resistencia-de-aislamientos-cla%c2%adnicos-de-pseudomonas-aeruginosa-no-sensibles-a-carbapenems-y-factores-de-riesgo-asociados-a-su-adquisicion\/","title":{"rendered":"Caracterizaci\u00f3n de los mecanismos de resistencia de aislamientos cl\u00ednicos de pseudomonas aeruginosa no sensibles a carbapenems y factores de riesgo asociados a su adquisici\u00f3n"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Melania Elena \u00ed\u00f1igo Pesta\u00f1a <\/strong><\/h2>\n<p>The epidemiology-related features of antibiotic resistant pseudomonas aeruginosa strains (pa) isolated in the university hospital of navarra from january 2002 to february 2009 were analyzed. An increase of pa isolates not susceptible to carbapenems (pa-nsc) was detected and the profile of antibiotic resistance of these organisms was markedly different from that of carbapenem susceptible pa (pasc). Both pa-nsc and the overall pa isolates increased their resistance to several antibiotic classes, whereas pa-sc maintained their level of susceptibility. Phenotypic methods most commonly used for detection of metallo-beta-lactamase producing strains (mbl) including e-test mbl, simple microdilution test, double disk synergy test and disks combined test were compared and found to  render 100% sensitivity. The combined disk test using imipenem and edta provided the greatest specificity. The susceptibility to doripenem in pa isolates not susceptible to imipenem and meropenem was analyzed. Depending on the cut-off points established by clsi, eucast and fda, it was found that 28.6% to 11.9% of the strains not susceptible to imipenem were susceptible to doripenem, while 26.2% to 10.7% of strains not susceptible to meropenem were susceptible to doripenem. The mechanisms of resistance to carbapenems in clinical isolates of pa-nsc were characterized. The altered expression of the porin oprd was the most common resistance mechanism (87.5%), followed by the overproduction of ampc (33.3%). Four mbl-producing strains of the vim-2 family were detected including the first mbl-producing strain sensitive to doripenem (mic 1 \u00ed\u00ac\/ml). The use of urinary catheter and the consumption  of broad-spectrum antibiotics (piperacillin-tazobactam, carbapenems, fluoroquinolones and aminoglycosides) were established as risk factors for the acquisition of pa-nsc. Exposure to hospital environment and the use of mechanical ventilation were identified as risk factors when the groups under comparison were pa-nsc isolates versus isolates different from pa. Finally, a prolonged hospital admission, the isolation of multiresistant pa, the administration of chemotherapy and the use of immunosuppressive drugs were predictors of mortality attributable to pa-nsc.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Caracterizaci\u00f3n de los mecanismos de resistencia de aislamientos cl\u00ednicos de pseudomonas aeruginosa no sensibles a carbapenems y factores de riesgo asociados a su adquisici\u00f3n<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Caracterizaci\u00f3n de los mecanismos de resistencia de aislamientos cl\u00ednicos de pseudomonas aeruginosa no sensibles a carbapenems y factores de riesgo asociados a su adquisici\u00f3n <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Melania Elena \u00ed\u00f1igo Pesta\u00f1a <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Navarra<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 24\/02\/2012<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Guillermo Mart\u00ednez De Tejada De Garaiz\u00e1bal<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: jose Leiva le\u00f3n <\/li>\n<li>Juan  pablo Horcajada gallego (vocal)<\/li>\n<li>Jaime Esteban moreno (vocal)<\/li>\n<li>Luis Martinez Martinez (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Melania Elena \u00ed\u00f1igo Pesta\u00f1a The epidemiology-related features of antibiotic resistant pseudomonas aeruginosa strains (pa) isolated in the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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