Incidencia de microorganismos en hemocultivos procesados en un hospital del estado Zulia y su resistencia a los agentes antimicrobianos

Bloodstream infections cause significant morbidity and mortality worldwide. To determine in- cidence of the main microorganisms isolated from blood cultures and their antimicrobial resistance in a university hospital, 31,486 blood culture reports processed from January, 2008, to December, 2012, were reviewed. The percentage of positive blood cultures was 9.49%; the highest number was obtained in intensive care units (36.22%). 3,054 microorganisms were isolated: 67.62% Gram posi- tive, 25.51% Gram negative, 6.84% yeast and 0.03% strict anaerobes. The predominant organisms were coagulase-negative Staphylococcus, S. aureus, Candida spp., Klebsiella pneumoniae, Entero- coccus spp., Acinetobacter baumannii, Escherichia coli and Pseudomonas aeruginosa. Both, S. au- reus and the coagulase-negative species showed high resistance to oxacillin (72.0% and 88.9%, re- spectively) and sensitivity to vancomycin. A 26.4% of enterococci (E. faecium almost exclusively) were resistant to vancomycin. Acinetobacter baumannii and K. pneumoniae showed a high rate of resistance to the tested antibiotics. Overall, most of the microorganisms showed a progressive in- crease in antimicrobial resistance during the five years studied. It is necessary to review and adjust hospital policies for antibiotic use and strengthen control measures for the infected patient. Resumen: Las infecciones del torrente sanguíneo causan una importante morbi-mortalidad en todo el mundo. Para conocer la incidencia de los principales microorganismos aislados de hemocultivos y su resistencia antimicrobiana en un hospital universitario, se revisaron los informes de 31.486 he- mocultivos procesados desde enero de 2008 a diciembre de 2012. El porcentaje de hemocultivos positivos fue de 9,49%, el mayor número se obtuvo en las unidades de cuidados intensivos (36,22%). Se aislaron 3.054 microorganismos, 67,62% Gram positivos, 25,51% Gram negativos, 6,84% levaduras y 0,03% anaerobios estrictos. Los microorganismos predominantes fueron Staphylococcus coagulasa negativa, Staphylococcus aureus, Candida spp., Klebsiella pneumo- niae, Enterococcus spp., Acinetobacter baumannii, Escherichia coli y Pseudomonas aeruginosa. Tanto S. aureus como las especies coagulasa negativa mostraron alta resistencia a oxacilina (72,0% y 88,9%, respectivamente) y sensibilidad a vancomicina. Un 26,4% de los enterococos (casi exclusivamente E. faecium) fueron resistentes a vancomicina. Acinetobacter baumannii y K. pneumoniae mostraron un al