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Bacteriemia por Acinetobacter baumannii
Resumen
Acinetobacter baumannii es un patógeno nosocomial emergente de difícil control y tratamiento. Los pacientes adultos más graves o con infección previa tienen mayor riesgo de ser colonizados o infectados. La epidemiología de las infecciones por A. baumannii es compleja y coexisten las infecciones epidémicas y las endémicas. A. baumannii es la especie que se aísla con mayor frecuencia en las infecciones nosocomiales. Por el lugar donde se adquieren, las unidades de cuidados intensivos presentan el mayor número de bacteriemias nosocomiales por este agente, en las cuales los principales sitios de origen son el tracto respiratorio, las heridas quirúrgicas, el sitio de inserción de los catéteres, el tracto urinario y otros. La sepsis es la manifestación clínica más frecuente. Se observa curso fulminante cuando los pacientes presentan choque séptico. La resistencia progresiva de A. baumannii a múltiples antimicrobianos limita las opciones terapéuticas. Los pacientes con bacteriemias nosocomiales por A. baumannii resistentes a múltiples fármacos tienen mayor estancia, costos y tasas altas de mortalidad atribuida. Las estrategias de control se dirigen a erradicar el brote y a disminuir la incidencia y prevalencia de las infecciones.
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