Browsing by Author "Cerón, Inés"

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    Análisis de los fenotipos y genotipos de resistencia a eritromicina y clindamicina en cepas de Streptococcus pyogenes aisladas en Chile en un período de 10 años
    (2011) Rodríguez, Carlos; Rojas, Pablo; Wozniak, Aniela; Kalergis, Alexis M.; Cerón, Inés; Riedel, Ingrid; Román, Juan C.; Villarroel, Luis A.; Berríos, Ximena; Bavestrello, Luis; García, Patricia
    Background: Macrolide and lincosamide resistance in Streptococcus pyogenes is due to the acquisition of mef, ermB and ermA genes, which confer different resistance phenotypes, namely M, MLSBconstitutive and MLSBinducible respectively. The last report of resistance in Chile was done in the period 1990-1998, in which resistance to macrolides was 5.4%, with M phenotype as the predominant one. Aim: To characterize the evolution of erythromycin and clindamycin resistance and their associated genes in S. pyogenes strains isolated from patients with invasive and noninvasive infections in the period 1996 to 2005. Material and Methods: Resistance to erythromycin and clindamycin was determined in 1,282 clinical isolates using the disk diffusion test. Resistant isolates were analyzed by polymerase chain reaction (PCR) for the presence of the above mentioned resistance genes. Results: Global resistance to erythromycin and clindamycin was 3.5 and 0.7% respectively. Eighty percent of the resistant strains possessed the M. phenotype. Conclusions: Resistance levels of S. pyogenes have decreased in Chile in the last years. Most resistant strains have M phenotype in contrast to many countries in which the MLSB constitutive phenotype is the predominant one.
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    Corticosteroids use and risk of respiratory coinfections in mechanically ventilated patients with COVID-19
    (2021) Ceballos, María Elena; Núñez Palma, Carolina Verónica; Uribe, Javier; Vera Alarcón, María Magdalena; Castro López, Ricardo; García C., Patricia; Arriata, Gabriel; Gándara, Vicente; Vargas, Camila; Domínguez De Landa, María Angélica; Cerón, Inés; Born, Pablo; Espíndola, Eduardo
    Background: To describe respiratory coinfections, predictive factors and outcomes in patients requiring mechanical ventilation (MV) with COVID-19. Methods: Cohort study, carried out in a Chilean single tertiary Hospital. All patients with COVID-19 admitted to ICU that required MV were included between 1 June and 31 July 2020 Results: 175 patients were admitted to ICU and required MV. Of these, 71 patients developed at least one respiratory coinfection (40.6 %). Early coinfections and late coinfections were diagnosed in 1.7% and 31.4% of all patients admitted to ICU respectively. Within late coinfections, 88% were bacterial, 10% were fungal, and 2% were viral coinfections. One third of isolated bacteria were multidrug-resistant. Multivariate analysis showed that the risk for coinfection was 7.7 times higher for patients with history of corticosteroids (adOR = 7.65, CI 95%: 1.04-56.2, p=0,046) and 2.7 times higher for patients that received dexamethasone during hospitalization (adOR=2.69; CI 95%: 1.14-6.35, p=0,024) than patients that were not exposed. For each additional day in MV, the risk of coinfection increases 1.1 times (adOR=1.06; CI 95%: 1.01-1.11, p=0,025)
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    Perfil etiológico de las meningitis adquiridas en la comunidad en pacientes adultos en el Complejo Asistencial Sótero del Río, Santiago 2011-2017
    (2022) Pinochet Valenzuela, Francisca; Uribe Monasterio, Javier; Reyes Barros, Tomás Alejandro; Echavarri Vesperinas, Sylvia; Cerón, Inés; Corsi Sotelo, Óscar
    Introducción: En Chile existe poca información sobre los microorganismos causantes de meningitis adquirida en la comunidad (MAC), la que es relevante a la hora de escoger el esquema antimicrobiano empírico. Objetivo: Describir la microbiología de MAC en pacientes mayores de 15 años atendidos en un hospital público de Santiago (Chile). Metodología: Revisión de cultivos de líquido cefalorraquídeo positivos durante 2011-2017. Se recolectó la información clínica de los pacientes incluidos. Se excluyeron cultivos considerados como contaminación y las meningitis post-quirúrgicas. Resultados: Se identificaron 20 episodios de meningitis bacteriana aguda (MBA) y seis episodios de meningitis criptocócica (MC) entre 2.720 cultivos. Los microorganismos causantes de MBA fueron: Streptococcus pneumoniae (50%), Listeria monocytogenes (25%) y otros cinco agentes (25%). Todos los pacientes con infección por L. monocytogenes presentaban alguna comorbilidad significativa. Cuatro de cinco casos de MC presentaban infección por VIH. Conclusión: Streptococcus pneumoniae fue el microorganismo más frecuente de las MAC en esta serie, seguido por L. monocytogenes. Las recomendaciones actuales de esquemas empíricos de MAC consideran adecuadamente la cobertura de S. pneumoniae en todos los pacientes y de L. monocytogenes solo ante factores de riesgo. Además, es relevante considerar MC en casos en pacientes inmunocomprometidos.
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    Secondary respiratory early and late infections in mechanically ventilated patients with COVID-19
    (2022) Ceballos, María Elena; Nuñez, Ingrid; Uribe, Javier; Vera Alarcón, María Magdalena; Castro López, Ricardo; García C., Patricia; Arriata, Gabriel; Gándara, Vicente; Vargas Muñoz, Camila; Domínguez De Landa, María Angélica; Cerón, Inés; Born, Pablo; Espíndola, Eduardo
    Background: Patients with COVID-19 receiving mechanical ventilation may become aggravated with a secondary respiratory infection. The aim of this study was to describe secondary respiratory infections, their predictive factors, and outcomes in patients with COVID-19 requiring mechanical ventilation. Methods: A cohort study was carried out in a single tertiary hospital in Santiago, Chile, from 1st June to 31st July 2020. All patients with COVID-19 admitted to the intensive care unit that required mechanical ventilation were included. Results: A total of 175 patients were enrolled, of which 71 (40.6%) developed at least one secondary respiratory infection during follow-up. Early and late secondary infections were diagnosed in 1.7% and 31.4% respectively. Within late secondary infections, 88% were bacterial, 10% were fungal, and 2% were of viral origin. One-third of isolated bacteria were multidrug-resistant. Bivariate analysis showed that the history of corticosteroids used before admission and the use of dexamethasone during hospitalization were associated with a higher risk of secondary infections (p = 0.041 and p = 0.019 respectively). Multivariate analysis showed that for each additional day of mechanical ventilation, the risk of secondary infection increases 1.1 times (adOR = 1.07; 95% CI 1.02–1.13, p = 0.008) Conclusions: Patients with COVID-19 admitted to the intensive care unit and requiring mechanical ventilation had a high rate of secondary infections during their hospital stay. The number of days on MV was a risk factor for acquiring secondary respiratory infections.