Comparación del perfil de resistencia bacteriana en la infección de vías urinarias sintomática versus asintomática en gestantes atendidas en la Ese Isabu Hospital Local del Norte de Bucaramanga

La infección de vías urinarias (IVU) en gestantes tienen una tasa de incidencia elevada, el diagnóstico y tratamiento adecuado de este tipo de infecciones, recobran gran importancia dentro del tamizaje prenatal, ya que de no ser tratadas pueden llevar a desenlaces fatales tanto maternos como fetales...

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Autores:
Ariza Gamboa, Sergio Andres
Tipo de recurso:
Fecha de publicación:
2025
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/29798
Acceso en línea:
http://hdl.handle.net/20.500.12749/29798
Palabra clave:
Pregnant
Antimicrobial susceptibility pattern
Urinary tract infection
Extended spectrum beta lactamases
Antibiotic resistance
Risk factors
Bacterial profile
Gynecology
Urinary organs
Gram-negative bacteria
Infections caused by gram-negative bacteria
Pregnant women
Anti-infective agents
Antibiotics
Ginecología
Aparato urinario
Bacterias gram negativas
Infecciones por bacterias gram negativas
Mujeres embarazadas
Agentes anti-infecciosos
Antibióticos
Embarazo
Patrón de susceptibilidad antimicrobiana
Perfil bacteriano
Betalactamasas de espectro extendido
Resistencia a antibióticos
Infección del tracto urinario
Factores de riesgo
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id UNAB2_749c4169f6c21fb5707b43907eb85b84
oai_identifier_str oai:repository.unab.edu.co:20.500.12749/29798
network_acronym_str UNAB2
network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Comparación del perfil de resistencia bacteriana en la infección de vías urinarias sintomática versus asintomática en gestantes atendidas en la Ese Isabu Hospital Local del Norte de Bucaramanga
dc.title.translated.spa.fl_str_mv Comparison of the Bacterial Resistance Profile in Symptomatic versus Asymptomatic Urinary Tract Infection in Pregnant Women Attended at the Local Hospital ESE ISABU Norte in Bucaramanga
title Comparación del perfil de resistencia bacteriana en la infección de vías urinarias sintomática versus asintomática en gestantes atendidas en la Ese Isabu Hospital Local del Norte de Bucaramanga
spellingShingle Comparación del perfil de resistencia bacteriana en la infección de vías urinarias sintomática versus asintomática en gestantes atendidas en la Ese Isabu Hospital Local del Norte de Bucaramanga
Pregnant
Antimicrobial susceptibility pattern
Urinary tract infection
Extended spectrum beta lactamases
Antibiotic resistance
Risk factors
Bacterial profile
Gynecology
Urinary organs
Gram-negative bacteria
Infections caused by gram-negative bacteria
Pregnant women
Anti-infective agents
Antibiotics
Ginecología
Aparato urinario
Bacterias gram negativas
Infecciones por bacterias gram negativas
Mujeres embarazadas
Agentes anti-infecciosos
Antibióticos
Embarazo
Patrón de susceptibilidad antimicrobiana
Perfil bacteriano
Betalactamasas de espectro extendido
Resistencia a antibióticos
Infección del tracto urinario
Factores de riesgo
title_short Comparación del perfil de resistencia bacteriana en la infección de vías urinarias sintomática versus asintomática en gestantes atendidas en la Ese Isabu Hospital Local del Norte de Bucaramanga
title_full Comparación del perfil de resistencia bacteriana en la infección de vías urinarias sintomática versus asintomática en gestantes atendidas en la Ese Isabu Hospital Local del Norte de Bucaramanga
title_fullStr Comparación del perfil de resistencia bacteriana en la infección de vías urinarias sintomática versus asintomática en gestantes atendidas en la Ese Isabu Hospital Local del Norte de Bucaramanga
title_full_unstemmed Comparación del perfil de resistencia bacteriana en la infección de vías urinarias sintomática versus asintomática en gestantes atendidas en la Ese Isabu Hospital Local del Norte de Bucaramanga
title_sort Comparación del perfil de resistencia bacteriana en la infección de vías urinarias sintomática versus asintomática en gestantes atendidas en la Ese Isabu Hospital Local del Norte de Bucaramanga
dc.creator.fl_str_mv Ariza Gamboa, Sergio Andres
dc.contributor.advisor.none.fl_str_mv Padilla Mier, Alonso
Ochoa Vera, Miguel Enrique
dc.contributor.author.none.fl_str_mv Ariza Gamboa, Sergio Andres
dc.contributor.cvlac.spa.fl_str_mv Padilla Mier, Alonso [0000093535]
Ochoa Vera, Miguel Enrique [898465]
dc.contributor.orcid.spa.fl_str_mv Ochoa Vera, Miguel Enrique [0000-0002-4552-3388]
Ariza Gamboa, Sergio Andrés [0000-0001-6121-6065]
dc.contributor.researchgate.spa.fl_str_mv Ochoa Vera, Miguel Enrique [Miguel_Ochoa7]
dc.contributor.researchgroup.spa.fl_str_mv Semilleros de Investigación UNAB
dc.contributor.apolounab.spa.fl_str_mv Padilla Mier, Alonso [alonso-padilla-mier]
Ochoa Vera, Miguel Enrique [miguel-enrique-ochoa-vera]
dc.contributor.linkedin.spa.fl_str_mv Ochoa Vera, Miguel Enrique [miguel-enrique-ochoa-vera-ab1468100/]
dc.subject.keywords.spa.fl_str_mv Pregnant
Antimicrobial susceptibility pattern
Urinary tract infection
Extended spectrum beta lactamases
Antibiotic resistance
Risk factors
Bacterial profile
Gynecology
Urinary organs
Gram-negative bacteria
Infections caused by gram-negative bacteria
Pregnant women
Anti-infective agents
Antibiotics
topic Pregnant
Antimicrobial susceptibility pattern
Urinary tract infection
Extended spectrum beta lactamases
Antibiotic resistance
Risk factors
Bacterial profile
Gynecology
Urinary organs
Gram-negative bacteria
Infections caused by gram-negative bacteria
Pregnant women
Anti-infective agents
Antibiotics
Ginecología
Aparato urinario
Bacterias gram negativas
Infecciones por bacterias gram negativas
Mujeres embarazadas
Agentes anti-infecciosos
Antibióticos
Embarazo
Patrón de susceptibilidad antimicrobiana
Perfil bacteriano
Betalactamasas de espectro extendido
Resistencia a antibióticos
Infección del tracto urinario
Factores de riesgo
dc.subject.lemb.spa.fl_str_mv Ginecología
Aparato urinario
Bacterias gram negativas
Infecciones por bacterias gram negativas
Mujeres embarazadas
Agentes anti-infecciosos
Antibióticos
dc.subject.proposal.spa.fl_str_mv Embarazo
Patrón de susceptibilidad antimicrobiana
Perfil bacteriano
Betalactamasas de espectro extendido
Resistencia a antibióticos
Infección del tracto urinario
Factores de riesgo
description La infección de vías urinarias (IVU) en gestantes tienen una tasa de incidencia elevada, el diagnóstico y tratamiento adecuado de este tipo de infecciones, recobran gran importancia dentro del tamizaje prenatal, ya que de no ser tratadas pueden llevar a desenlaces fatales tanto maternos como fetales. Las bacterias gramnegativas, en particular Escherichia coli y Klebsiella sp, son la principal fuente de infección del tracto urinario durante la gestación. En las últimas décadas se ha observado un incremento importante en la resistencia bacteriana. Los microorganismos causantes de IVU resistentes a cefalosporinas de tercera generación, productores de betalactamasas hasta hace poco tiempo eran considerados un problema intrahospitalario; sin embargo, este tipo de cepas se han documentado en mujeres gestantes con infecciones adquiridas en la comunidad, lo que es alarmante teniendo en cuenta las pocas opciones terapéuticas disponibles, fuera de los carbapenémicos, y los riesgos de complicaciones severas. Por esto, un diagnóstico oportuno debe estar acompañado de la elección adecuada de un esquema antibiótico empírico, seleccionado de acuerdo con los factores de riesgo predisponentes y al perfil de resistencia bacteriana local. La resistencia bacteriana para IVU baja sintomática y asintomática se han descrito por separado y se asume que son similares en una misma población; sin embargo, no se cuenta con estudios que evalúen si los gérmenes con sus respectivos patrones de resistencia son equiparables. Ante la escasez de publicaciones que respondan a este interrogante se propone el presente estudio. Durante el periodo comprendido entre el 2022 a 2023 se desarrolló un estudio analítico de corte transversal en la ESE ISABU - Hospital Local del Norte de la ciudad de Bucaramanga, hospital de segundo nivel que atiende población con alto riesgo social de la ciudad, la corte fueron pacientes gestantes atendidas en el servicio de urgencias, consulta externa y hospitalización que cuenten con urocultivo positivo y antibiograma, se analizarán los reportes de los urocultivos evaluando el patrón de resistencia bacteriana y la presencia de gérmenes productores de betalactamasas con el fin de determinar si son los mismos en la IVU sintomática y asintomática.
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-06-16T15:54:23Z
dc.date.available.none.fl_str_mv 2025-06-16T15:54:23Z
dc.date.issued.none.fl_str_mv 2025-05-27
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.local.spa.fl_str_mv Tesis
dc.type.hasversion.none.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.redcol.none.fl_str_mv http://purl.org/redcol/resource_type/TM
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12749/29798
dc.identifier.instname.spa.fl_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional UNAB
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unab.edu.co
url http://hdl.handle.net/20.500.12749/29798
identifier_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
reponame:Repositorio Institucional UNAB
repourl:https://repository.unab.edu.co
dc.language.iso.spa.fl_str_mv spa
language spa
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spelling Padilla Mier, Alonso93e25a22-7ee8-43b2-bf57-af679fc9aa4aOchoa Vera, Miguel Enriqueb2f66b1f-7691-4abf-a110-466c07955478Ariza Gamboa, Sergio Andres1e209cd1-49c1-482f-bace-3ab7be67387aPadilla Mier, Alonso [0000093535]Ochoa Vera, Miguel Enrique [898465]Ochoa Vera, Miguel Enrique [0000-0002-4552-3388]Ariza Gamboa, Sergio Andrés [0000-0001-6121-6065]Ochoa Vera, Miguel Enrique [Miguel_Ochoa7]Semilleros de Investigación UNABPadilla Mier, Alonso [alonso-padilla-mier]Ochoa Vera, Miguel Enrique [miguel-enrique-ochoa-vera]Ochoa Vera, Miguel Enrique [miguel-enrique-ochoa-vera-ab1468100/]Bucaramanga (Santander, Colombia)2022-2023UNAB Campus Bucaramanga2025-06-16T15:54:23Z2025-06-16T15:54:23Z2025-05-27http://hdl.handle.net/20.500.12749/29798instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coLa infección de vías urinarias (IVU) en gestantes tienen una tasa de incidencia elevada, el diagnóstico y tratamiento adecuado de este tipo de infecciones, recobran gran importancia dentro del tamizaje prenatal, ya que de no ser tratadas pueden llevar a desenlaces fatales tanto maternos como fetales. Las bacterias gramnegativas, en particular Escherichia coli y Klebsiella sp, son la principal fuente de infección del tracto urinario durante la gestación. En las últimas décadas se ha observado un incremento importante en la resistencia bacteriana. Los microorganismos causantes de IVU resistentes a cefalosporinas de tercera generación, productores de betalactamasas hasta hace poco tiempo eran considerados un problema intrahospitalario; sin embargo, este tipo de cepas se han documentado en mujeres gestantes con infecciones adquiridas en la comunidad, lo que es alarmante teniendo en cuenta las pocas opciones terapéuticas disponibles, fuera de los carbapenémicos, y los riesgos de complicaciones severas. Por esto, un diagnóstico oportuno debe estar acompañado de la elección adecuada de un esquema antibiótico empírico, seleccionado de acuerdo con los factores de riesgo predisponentes y al perfil de resistencia bacteriana local. La resistencia bacteriana para IVU baja sintomática y asintomática se han descrito por separado y se asume que son similares en una misma población; sin embargo, no se cuenta con estudios que evalúen si los gérmenes con sus respectivos patrones de resistencia son equiparables. Ante la escasez de publicaciones que respondan a este interrogante se propone el presente estudio. Durante el periodo comprendido entre el 2022 a 2023 se desarrolló un estudio analítico de corte transversal en la ESE ISABU - Hospital Local del Norte de la ciudad de Bucaramanga, hospital de segundo nivel que atiende población con alto riesgo social de la ciudad, la corte fueron pacientes gestantes atendidas en el servicio de urgencias, consulta externa y hospitalización que cuenten con urocultivo positivo y antibiograma, se analizarán los reportes de los urocultivos evaluando el patrón de resistencia bacteriana y la presencia de gérmenes productores de betalactamasas con el fin de determinar si son los mismos en la IVU sintomática y asintomática.1.TÍTULO 4 2. RESUMEN DEL PROYECTO 4 3. PLANTEAMIENTO DEL PROBLEMA 5 4. MARCO TEÓRICO 10 4.1. DEFINICIONES 10 4.1.1 BACTERIURIA ASINTOMATICA (BA) 10 4.1.2 INFECCIÓN DE LAS VÍAS URINARIAS (IVU) 10 4.1.3 IVU BAJA 10 4.1.4 IVU ALTA 10 4.1.5 IVU NO COMPLICADA 10 4.1.6 IVU COMPLICADA 11 4.1.7 IVU RECURRENTE 11 4.1.8 UROSEPSIS 11 4.2 EPIDEMIOLOGÍA 11 4.3 CAMBIOS FISIOLÓGICOS RENALES DURANTE EL EMBARAZO 13 4.4 MÉTODOS DIAGNÓSTICOS 14 4.5 TAMIZAJE DE INFECCIÓN DE VÍAS URINARIAS EN GESTANTES 16 4.6 AGENTES ETIOLÓGICOS 18 4.7 MECANISMOS DE RESISTENCIA BACTERIANA 19 4.8 ELECCIÓN DEL TRATAMIENTO ANTIMICROBIANO 22 4.8.1 MANEJO EMPÍRICO 22 4.8.2 MANEJO DIRIGIDO 24 5. ESTADO DEL ARTE 28 6. OBJETIVOS 31 6.1 OBJETIVO GENERAL 31 6.2 OBJETIVOS ESPECÍFICOS 31 7. METODOLOGÍA 32 7.1 TIPO DE ESTUDIO 32 7.2 POBLACIÓN 32 7.3 MUESTREO 32 7.3.1 CÁLCULO DEL TAMAÑO MUESTRAL 32 7.4 CRITERIOS DE SELECCIÓN 32 7.4.1 CRITERIOS DE INCLUSIÓN 32 7.4.2 CRITERIOS DE EXCLUSIÓN 33 7.5 VARIABLES DEL ESTUDIO 33 7.5.1 VARIABLES DEPENDIENTES 33 7.5.2 VARIABLES INDEPENDIENTES 33 7.6 PROCEDIMIENTO DEL ESTUDIO 33 7.6.1 ESTRATEGIA DE EJECUCIÓN 34 7.7 PLAN DE ANÁLISIS 35 7.7.1 UNIVARIADO 35 7.7.2 BIVARIADO 36 7.7.3 MULTIVARIADO 36 7.8 CONSIDERACIONES ÉTICAS 36 8. RESULTADOS 37 8.1 ANÁLISIS UNIVARIADO 38 8.1.1 CARACTERÍSTICAS CLÍNICAS 39 8.1.2 PREVALENCIA DE LA RESISTENCIA BACTERIANA. 41 8.1.3 DETECTAR LA PREVALENCIA DE BACTERIAS PRODUCTORAS DE BETALACTAMASAS EN IVU 42 8.1.4 IDENTIFICAR LOS AGENTES ETIOLÓGICOS DE LAS IVU EN MUJERES GESTANTES 44 8.1.5 DETERMINAR LOS PATRONES DE RESISTENCIA SEGÚN EL AGENTE ETIOLÓGICO DE LAS IVU. 45 8.1.6 DETERMINAR LA FRECUENCIA DE IVU SINTOMÁTICA Y ASINTOMÁTICA. 46 8.1.7 ANALIZAR LA RESISTENCIA ANTIMICROBIANA EN LA IVU SINTOMÁTICA Y LA BA. 47 8.2 ANÁLISIS BIVARIADO 52 8.3 ANÁLISIS MULTIVARIADO PROPUESTO 55 9. DISCUSIÓN 56 10. FORTALEZAS Y DEBILIDADES 64 11. CONCLUSIONES 65 12. REFERENCIAS 67 13. ANEXOS 77EspecializaciónUrinary tract infections (UTIs) in pregnant women have a high incidence rate. Accurate diagnosis and appropriate treatment of these infections are of great importance in prenatal screening, as failure to treat them can lead to serious maternal and fetal outcomes. Gram-negative bacteria, particularly Escherichia coli and Klebsiella species, are the main sources of urinary tract infections during pregnancy. In recent decades, there has been a significant increase in bacterial resistance. UTI-causing microorganisms resistant to third-generation cephalosporins and producers of beta-lactamases were until recently considered a problem restricted to hospital settings. However, such strains have now been documented in pregnant women with community-acquired infections, which is alarming considering the limited therapeutic options outside of carbapenems and the risk of severe complications. Therefore, timely diagnosis must be accompanied by the proper selection of an empirical antibiotic regimen, based on predisposing risk factors and the local bacterial resistance profile. Resistance patterns in lower UTIs, both symptomatic and asymptomatic, have typically been described separately, and it is generally assumed that they are similar within the same population. However, there is a lack of studies evaluating whether the pathogens and their respective resistance profiles are comparable. Given the scarcity of publications addressing this question, the present study was designed. Between 2022 and 2023, a cross-sectional analytical study was conducted at ESE ISABU - Hospital Local del Norte in Bucaramanga, a second-level healthcare center that serves a socially vulnerable population. The study cohort included pregnant patients attended in the emergency department, outpatient clinics, and inpatient services who had a positive urine culture and corresponding antibiogram. Urine culture reports were analyzed to assess bacterial resistance patterns and the presence of beta-lactamase-producing organisms, with the aim of determining whether the same pathogens and resistance profiles are present in symptomatic and asymptomatic UTIs.Modalidad Presencialapplication/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Comparación del perfil de resistencia bacteriana en la infección de vías urinarias sintomática versus asintomática en gestantes atendidas en la Ese Isabu Hospital Local del Norte de BucaramangaComparison of the Bacterial Resistance Profile in Symptomatic versus Asymptomatic Urinary Tract Infection in Pregnant Women Attended at the Local Hospital ESE ISABU Norte in BucaramangaEspecialista en Ginecología y ObstetriciaUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Ginecología y ObstetriciaEGO-1385info:eu-repo/semantics/masterThesisTesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/redcol/resource_type/TMPregnantAntimicrobial susceptibility patternUrinary tract infectionExtended spectrum beta lactamasesAntibiotic resistanceRisk factorsBacterial profileGynecologyUrinary organsGram-negative bacteriaInfections caused by gram-negative bacteriaPregnant womenAnti-infective agentsAntibioticsGinecologíaAparato urinarioBacterias gram negativasInfecciones por bacterias gram negativasMujeres embarazadasAgentes anti-infecciososAntibióticosEmbarazoPatrón de susceptibilidad antimicrobianaPerfil bacterianoBetalactamasas de espectro extendidoResistencia a antibióticosInfección del tracto urinarioFactores de riesgoDavey PG, Marwick C. 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