Infecciones por bacilos gramnegativos productores de carbapenemasas

Abstract

Carbapenemase-producing enterobacteriaceae (CPE) are the Gram-negative bacilli that this type of carbapenemic hydrolysis enzymes most often carry. In particular, Klebsiella pneumoniae is the most common. The carbapenemases KPC, VIM, NDM, IMP, and OXA-48 are the most common. They are usually acquired in a nosocomial setting and are associated with healthcare (time of hospitalization; ICU stay; prior antibiotic therapy; comorbidity; use of vascular catheters, bladder catheters, mechanical ventilation, etc.). They produce symptoms similar those caused by enterobacteriaceae, with urinary tract infections (UTIs) those that have the best prognosis and bacteremias and pneumonias those with greater associated mortality. Antibiotic treatments available include colistin, aminoglycosides, fosfomycin, aztreonam, and tigecycline. Carbapenems can also be used so long as the minimum inhibitory concentration (MIC) allows for them; their combined use is preferred. New available drugs include ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, plazomicin, cefiderocol, and eravacycline.