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Colegio de Medicina Interna de México.

2014, Número 2

Med Int Mex 2014; 30 (2)


Factores de riesgo y epidemiología de la candidemia en el Hospital Juárez de México

de la Torre-Saldaña VA, Martínez-Velázquez M, Reséndiz-Sánchez J

Idioma: Español
Referencias bibliográficas: 55
Paginas: 121-132
Archivo PDF: 677.99 Kb.


RESUMEN

Antecedentes: la incidencia de las infecciones fúngicas severas ha aumentado, por ello es importante identificar los factores predisponentes y definir con criterios clínicos el inicio temprano de un tratamiento antimicótico.
Objetivo: determinar los factores de riesgo de candidemia en pacientes adultos, la susceptibilidad a fármacos y la especie de Candida sp en pacientes atendidos en el Hospital Juárez de México.
Material y método: estudio retrospectivo y descriptivo efectuado de agosto de 2012 a julio de 2013 con pacientes con candidemia. Los datos se obtuvieron del expediente clínico y del laboratorio de microbiología; siete cepas se enviaron al Laboratorio de Micología del Hospital Infantil de México Federico Gómez para determinar la susceptibilidad a antimicóticos e identificar la especie de Candida sp.
Resultados: se reportaron 18 casos de candidemia, en 7 se determinó la especie de Candida sp, la principal fue Candida albicans; la Unidad de Cuidados Intensivos fue el servicio con más casos. El 94.4% de los pacientes tuvo tres puntos o más del puntaje de Candida; los principales factores de riesgo de candidemia fueron: nutrición parenteral total, sepsis grave, catéteres venosos centrales y exposición a múltiples antibióticos de amplio espectro. Tres cepas tuvieron resistencia a azoles.
Conclusiones: los enfermos críticos tienen mayor predisposición a candidemia; tener sepsis severa, recibir antibióticos de amplio espectro, nutrición parenteral total y usar dispositivos invasivos son los principales factores de riesgo. En las cepas de Candida de nuestra población se observó resistencia a azoles, por lo que es importante determinar rutinariamente la susceptibilidad a los fármacos para proporcionar profilaxis y tratamiento efectivos.


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