Publication: Impacto de un conjunto de medidas diagnósticas y terapéuticas sobre el pronóstico de la bacteriemia por Staphylococcus aureus sensible a meticilina asociada a catéter intravascular
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2018-11-23
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Universidad Complutense de Madrid
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Abstract
La bacteriemia por Staphylococcus aureus supone una causa importante de morbi-mortalidad. La bacteriemia asociada a catéter (BAC) clásicamente se ha categorizado como una infección de bajo riesgo, sin embargo, teniendo en cuenta la elevada incidencia de estos episodios, el coste tanto económico como en cuanto al deterioro en la calidad de vida, es importante.En los últimos años se han publicado múltiples trabajos que avalan la recomendación de aplicar medidas asistenciales concretas para evitar la aparición de infecciones asociadas a catéter. Sin embargo, una vez establecida la infección, la realización de ensayos clínicos aleatorizados resulta más compleja, y el manejo óptimo de estos pacientes aún no está completamente establecido. Recientemente se ha descrito una mejoría en la supervivencia al aplicar ciertas medidas asistenciales basadas en la evidencia en los casos de bacteriemia por S. aureus de cualquier foco. Sin embargo estos estudios incluyen focos heterogéneos de infección e incluyen tanto S. aureus sensible como resistente a meticilina, lo cual supone una variabilidad importante en cuanto al pronóstico...
Bloodstream infection (BSI) due to Staphylococcus aureus constitutes an important cause of morbidity and mortality. When the different forms of infection are considered separately, the impact of S. aureus catheter-related BSI (CR-BSI) has been considered historically to be lower, in terms of mortality, than that of other sources. However, the clinical and economic burden of S. aureus CR-BSI is not neglectable since most of the hospitalized patients have some type of intravascular device during their admission.Notable efforts have been undertaken over the last years on the prevention and control of S. aureus BSI. Once infection is established, and due to the paucity of randomized trials in the field, the concept of ensuring the adherence to a number of broadly accepted interventions is gaining growing interest in the clinical arena. A significant improvement in survival has been demonstrated when the management of S. aureus BSI is compliant with these evidence-based therapeutic measures. However, these studies comprised rather heterogeneous sources of BSI in terms of intrinsic severity and jointly analyzed methicillin-sensitive and methicillin-resistant strains, with the inherent variability in therapeutic approaches and expected prognosis...
Bloodstream infection (BSI) due to Staphylococcus aureus constitutes an important cause of morbidity and mortality. When the different forms of infection are considered separately, the impact of S. aureus catheter-related BSI (CR-BSI) has been considered historically to be lower, in terms of mortality, than that of other sources. However, the clinical and economic burden of S. aureus CR-BSI is not neglectable since most of the hospitalized patients have some type of intravascular device during their admission.Notable efforts have been undertaken over the last years on the prevention and control of S. aureus BSI. Once infection is established, and due to the paucity of randomized trials in the field, the concept of ensuring the adherence to a number of broadly accepted interventions is gaining growing interest in the clinical arena. A significant improvement in survival has been demonstrated when the management of S. aureus BSI is compliant with these evidence-based therapeutic measures. However, these studies comprised rather heterogeneous sources of BSI in terms of intrinsic severity and jointly analyzed methicillin-sensitive and methicillin-resistant strains, with the inherent variability in therapeutic approaches and expected prognosis...
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Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 19-06-2017