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Caracterización clínica y molecular de un brote por enterococcus faecium resistente a la vancomicina en el Hospital Universitario Mayor-Méderi, Bogotá 2016

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dc.contributorLópez, Carolina
dc.contributorPatarroyo, Manuel A.
dc.contributorPardo Oviedo, Juan Mauricio
dc.contributorLeal, Aura Lucía
dc.contributorAguilera, Paula
dc.contributorChica, Claudia
dc.contributor.advisorPrieto Garzón, Lina Maria
dc.contributor.advisorRodriguez-Leguizamon, Giovanni
dc.creatorCorredor Obregón, Nancy Carolina
dc.creator.degreeMagíster en epidemiologíaspa
dc.creator.degreetypePart timespa
dc.date.accessioned2019-06-18T21:22:30Z
dc.date.available2019-06-18T21:22:30Z
dc.date.created2019-06-12
dc.date.issued2019
dc.descriptionIntroducción. Este estudio describe el patrón de diseminación de los Enterococcus faecium resistente a la vancomicina entre abril a mayo de 2016, en el hospital de mayor capacidad de camas instaladas de Colombia, integrando estrategias clínicas y moleculares. Métodos. Se adaptó un algoritmo de Tiempo - Lugar - Clonalidad para estimar las rutas de transmisión, a través del análisis multi-locus de número variable de repeticiones en tándem (MLVA) para la identificación clonal y la ruta de transferencia interna de los pacientes durante su hospitalización. Resultados. Debido a dificultades en la reproducibilidad para VNTR-2, el análisis de agrupamiento de 5 VNTRs fue el método de elección para determinar clonalidad. Se identificaron cuatro perfiles clonales entre los 33 aislamientos recuperados, de los cuales, 13 fueron obtenidos de pacientes del brote. Los perfiles con mayor frecuencia identificados durante el brote fueron el A y el B: 9 y 2 pacientes, respectivamente (69,2% y 15,4%). En la mayoría de los casos, los pacientes compartieron piso (contacto indirecto), pero no habitación o cama de hospitalización (contacto directo), lo que sugiere una transmisión cruzada a través de personal de salud. Discusión. Tras el análisis de los resultados se pudo concluir que el brote tuvo un comportamiento dinámico, de fuente múltiple y origen policlonal, con una vía de transmisión indirecta a través del personal de salud. Dentro de los principales beneficios obtenidos a nivel local, fueron la optimización de los recursos en control de infecciones y la implementación de estrategias más eficaces en la prevención de futuros brotes, individualizadas a la institución.spa
dc.description.abstractIntroduction. This study describes the dissemination pattern of the vancomycin-resistant Enterococcus faecium between April to May 2016, in the highest installed capacity hospital in Colombia, integrating clinical and molecular strategies. Methods A Time-Place-Clonality algorithm was adapted to estimate the transmission routes, through the multi-locus variable number tandem repeats analysis (MLVA) for the clonal identification and the internal transfer route of the patients during their hospital stay. Results. Due to difficulties in reproducibility for VNTR-2, the cluster analysis of 5 VNTRs was the method of choice to determine clonality. Four clonal profiles were identified among the 33 isolates recovered, 13 of which were obtained from outbreak patients. The profiles most frequently identified during the outbreak were A and B: 9 and 2 patients, respectively (69. 2% and 15. 4%). In most of cases, patients shared a floor (indirect contact), but not a room or hospitalization bed (direct contact), which suggests a cross transmission by health-care providers. Discussion. After the analysis of the results, we concluded that the outbreak had a dynamic, multiple source and polyclonal behavior, with an indirect transmission route through the health personnel. Among the main benefits obtained locally, were the optimization of resources in infection control and the implementation of more effective strategies in the prevention of future outbreaks, individualized to the institution. eng
dc.description.sponsorshipHospital Universitario Mayor - Méderispa
dc.description.sponsorshipFundación Instituto de Inmunología de Colombiaspa
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_19879
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/19879
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentMaestría en Actividad Física y Saludspa
dc.publisher.otherUniversidad CESspa
dc.publisher.programMaestría en Epidemiologíaspa
dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombiaspa
dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombiaspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectEnterococcus faecium resistente a la vancomicinaspa
dc.subjectVigilancia de brotespa
dc.subjectResistencia antimicrobianaspa
dc.subjectAlgoritmo tiempo-espacio-clonalidadspa
dc.subject.ddcIncidencia & prevención de la enfermedadspa
dc.subject.decsVacunas bacterianasspa
dc.subject.decsEnterococcusspa
dc.subject.keywordVancomycin-resistant Enterococcus faeciumspa
dc.subject.keywordOutbreak surveillancespa
dc.subject.keywordAntimicrobial resistancespa
dc.subject.keywordTime–place–clonality algorithmspa
dc.subject.lembEpidemiologíaspa
dc.titleCaracterización clínica y molecular de un brote por enterococcus faecium resistente a la vancomicina en el Hospital Universitario Mayor-Méderi, Bogotá 2016spa
dc.typemasterThesiseng
dc.type.documentTesisspa
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTesis de maestríaspa
local.department.reportEscuela de Medicina y Ciencias de la Saludspa
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