Características clínicas, microbiológicas y desenlaces de pacientes pediátricos tratados con ceftarolina en Manizales

Figuras, tablas

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Fecha de publicación:
2024
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Universidad de Caldas
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Repositorio Institucional U. Caldas
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spa
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oai:repositorio.ucaldas.edu.co:ucaldas/20192
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https://repositorio.ucaldas.edu.co/handle/ucaldas/20192
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610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría
3. Ciencias Médicas y de la Salud
Ceftaroline
Pediatrics
Bacterial resistance
Staphylococcus aureus
Pediatría
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id REPOUCALDA_b62a1894be499def8651bc4b8075cd7c
oai_identifier_str oai:repositorio.ucaldas.edu.co:ucaldas/20192
network_acronym_str REPOUCALDA
network_name_str Repositorio Institucional U. Caldas
repository_id_str
dc.title.none.fl_str_mv Características clínicas, microbiológicas y desenlaces de pacientes pediátricos tratados con ceftarolina en Manizales
title Características clínicas, microbiológicas y desenlaces de pacientes pediátricos tratados con ceftarolina en Manizales
spellingShingle Características clínicas, microbiológicas y desenlaces de pacientes pediátricos tratados con ceftarolina en Manizales
610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría
3. Ciencias Médicas y de la Salud
Ceftaroline
Pediatrics
Bacterial resistance
Staphylococcus aureus
Pediatría
title_short Características clínicas, microbiológicas y desenlaces de pacientes pediátricos tratados con ceftarolina en Manizales
title_full Características clínicas, microbiológicas y desenlaces de pacientes pediátricos tratados con ceftarolina en Manizales
title_fullStr Características clínicas, microbiológicas y desenlaces de pacientes pediátricos tratados con ceftarolina en Manizales
title_full_unstemmed Características clínicas, microbiológicas y desenlaces de pacientes pediátricos tratados con ceftarolina en Manizales
title_sort Características clínicas, microbiológicas y desenlaces de pacientes pediátricos tratados con ceftarolina en Manizales
dc.contributor.none.fl_str_mv González Leal, Natalia
Arango, Fernando
Universidad de Caldas
Sánchez Rodríguez, Diego Alfonso
Hernandez Botero, Johan Sebastian
dc.subject.none.fl_str_mv 610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría
3. Ciencias Médicas y de la Salud
Ceftaroline
Pediatrics
Bacterial resistance
Staphylococcus aureus
Pediatría
topic 610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría
3. Ciencias Médicas y de la Salud
Ceftaroline
Pediatrics
Bacterial resistance
Staphylococcus aureus
Pediatría
description Figuras, tablas
publishDate 2024
dc.date.none.fl_str_mv 2024-09-17T04:13:23Z
2024-09-17T04:13:23Z
2024-09-17
dc.type.none.fl_str_mv Trabajo de grado - Especialización
http://purl.org/coar/resource_type/c_18ws
Text
info:eu-repo/semantics/report
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_93fc
dc.identifier.none.fl_str_mv https://repositorio.ucaldas.edu.co/handle/ucaldas/20192
Universidad de Caldas
Repositorio Institucional Universidad de Caldas
repositorio.ucaldas.edu.co
url https://repositorio.ucaldas.edu.co/handle/ucaldas/20192
identifier_str_mv Universidad de Caldas
Repositorio Institucional Universidad de Caldas
repositorio.ucaldas.edu.co
dc.language.none.fl_str_mv spa
language spa
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dc.publisher.none.fl_str_mv Universidad de Caldas
Facultad de Ciencias para la Salud
Colombia, Caldas, Manizales
Especialización en Pediatría
publisher.none.fl_str_mv Universidad de Caldas
Facultad de Ciencias para la Salud
Colombia, Caldas, Manizales
Especialización en Pediatría
institution Universidad de Caldas
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Características clínicas, microbiológicas y desenlaces de pacientes pediátricos tratados con ceftarolina en Manizales610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría3. Ciencias Médicas y de la SaludCeftarolinePediatricsBacterial resistanceStaphylococcus aureusPediatríaFiguras, tablasLa ceftarolina es una cefalosporina con actividad para Staphylococcus aureus meticilinoresistente y Streptococcus pneumoniae resistente a penicilina. Sin embargo, los datos sobre su uso en pediatría en infecciones invasivas son limitados. Objetivo: Describir las características clínicas, microbiológicas y desenlaces de los pacientes pediátricos que recibieron ceftarolina. Metodología: Es un estudio observacional, descriptivo y retrospectivo. Incluyó pacientes de 0 meses a 18 años que recibieron ceftarolina entre 2018 y 2023. Se excluyeron los pacientes trasladados a otra institución fuera del estudio o con historia clínica incompleta. Se recolectaron variables sociodemográficas, clínicas y microbiológicas, y se reportaron los resultados clínicos y los eventos adversos. Resultados: Se incluyeron 32 pacientes, desde neonatos hasta adolescentes. El principal diagnóstico asociado al uso de ceftarolina fue la neumonía adquirida en la comunidad (62,5%), seguido por infecciones osteoarticulares (21,9%), infección de tejidos blandos (12,5%) y bacteriemia sin foco primario (3,1%). El 46,9% de los pacientes estaban previamente sanos, entre los que presentaban comorbilidades el 18,8% tenía previamente enfermedad pulmonar, el 12,5% cardiopatía congénita, el 12,5% antecedente de prematuridad y el 7,1% inmunosupresión. El 56% estuvo en unidad de cuidados intensivos y el 50% requirió ventilación mecánica invasiva. Adicionalmente una proporción significativa de pacientes presentó choque (62,5%), falla renal (46,8%) y bacteriemia (46,9%). Se obtuvo aislamiento microbiológico en el 75% de los casos. El Staphylococcus aureus fue el patógeno más común (95,6%), y S. aureus meticilino- resistente se presentó en el 56,5% de todos los aislamientos. Todos los pacientes recibieron terapia antibiótica antes del inicio de ceftarolina. El 53,1% de los pacientes recibió ceftarolina en monoterapia y el 46,9% en terapia combinada. El 84,3% de los pacientes tuvo curación clínica sin necesidad de antibióticos adicionales. La mortalidad fue del 12,5%. No se reportó ningún evento adverso. Conclusiones: La ceftarolina es una opción de tratamiento en los pacientes pediátricos con infecciones complicadas, incluyendo bacteriemia por Staphylococcus aureus, y cepas resistentes a la meticilina. En nuestro estudio se demostró curación clínica tanto en monoterapia como en terapia combinada.Background: Ceftaroline is a broad-spectrum cephalosporin indicated for use in skin infections and community-acquired bacterial pneumonia and predominantly used for the fight against drug-resistant bacteria. However, data on its use in pediatrics are limited and no previous studies from Latin America have been reported. Our objective was to describe the clinical and laboratory outcomes of Colombian pediatric patients who received ceftaroline to treat invasive infections. Methods: A descriptive, retrospective study was performed on patients aged 1 month to 18 years who received ceftaroline, (600 mg IV q8hr x 5-7 days with dose adjustments based on ranges of weight and age), for bacteremia at two tertiary care pediatric hospitals of Manizales, between 2018 and 2023. Sociodemographic, clinical, and microbiological variables were collected, and clinical outcomes and adverse reactions were reported. Results: Thirty-two patients from neonates to adolescents were included [median (Q1-Q3): 3.3 years (0.8 - 9.9 years)]. The main diagnosis associated with ceftaroline use was community-acquired pneumonia (62.5%), followed by osteoarticular infections (21.9%), soft tissue infections (12.5%), and late sepsis (3.1%). Among the patient population, 46.9% were previously healthy, while the others had diverse medical histories, including lung disease (18.8%), congenital heart disease (12.5%), prematurity (12.5%), and immunosuppression (7.1%). Over half of the patients (56%) required intensive care unit admission, and nearly half (50%) required invasive mechanical ventilation. Additionally, a significant proportion of patients experienced shock (62.5%), renal failure (46.8%), and bacteremia (46.9%). Microbiological isolation was obtained in 75% of cases. Staphylococcus aureus was the most common pathogen (91.7%), with 59.1% being methicillin-resistant S. aureus (MRSA). Clinical cure without additional antibiotics was achieved in 84.3% of patients. The mortality rate was 12.5%. No adverse events were reported. Conclusions: In our study, clinical cure was demonstrated in both monotherapy and combined ceftaroline therapy without adverse effects. Ceftaroline offers a promising therapeutic option for pediatric patients battling difficult-to-treat invasive MRSA infections.LISTA DE TABLAS /LISTA DE FIGURAS /LISTA DE ANEXOS /GLOSARIO / RESUMEN /INTRODUCCIÓN /ANTECEDENTES /PLANTEAMIENTO DEL PROBLEMA /JUSTIFICACIÓN /MARCO TEORICO /OBJETIVOS /ASPECTOS ÉTICOS / RESULTADOS / DISCUSION / CONCLUSIONES / BIBLIOGRAFÍAEspecializaciónSe realizó un estudio observacional y descriptivo con un diseño retrospectivo para el periodo comprendido entre el 2018 y el 2023.Especialista en PediatríaUniversidad de CaldasFacultad de Ciencias para la SaludColombia, Caldas, ManizalesEspecialización en PediatríaGonzález Leal, NataliaArango, FernandoUniversidad de CaldasSánchez Rodríguez, Diego AlfonsoHernandez Botero, Johan SebastianCardona Soto, Marisol2024-09-17T04:13:23Z2024-09-17T04:13:23Z2024-09-17Trabajo de grado - Especializaciónhttp://purl.org/coar/resource_type/c_18wsTextinfo:eu-repo/semantics/reporthttp://purl.org/coar/resource_type/c_93fc74 páginasapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttps://repositorio.ucaldas.edu.co/handle/ucaldas/20192Universidad de CaldasRepositorio Institucional Universidad de Caldasrepositorio.ucaldas.edu.cospaHamdy RF, Hsu AJ, Stockmann C, Olson JA, Bryan M, Hersh AL, et al. 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