Pneumologie 2016; 70 - P255
DOI: 10.1055/s-0036-1572225

Respiratory infections and sprectrum betalactamase producing bacteria: A prevalence study

EJ Soto Hurtado 1, MJ Gutiérrez Fernández 2, JC Rodriguez 2, AA Arregosa 3, F Cabello Rueda 3, JM González Miret 4, M Zaragoza Rascón 1, A Ruíz Cantero 5
  • 1Neumology Department, Internal Medicine Service, Hospital La Serranía
  • 2Microbiology Department, Laboratory Service, Hospital La Serrania
  • 3Internal Medicine Service, Hospital La Serrania
  • 4Pharmacy Service, Hospital La Serranía.
  • 5Laboratory Service, Hospital La Serranía

Objectives: Respiratory infections caused by multidrug resistant (MDR) pathogens and Extended Spectrum beta-Lactamase (ESBL) producing pathogens are a major concern to treat by health professionals. The objectives of this study were determine the aetiology of respiratory infections along with MDR bacterial strains producing ESBL, and describe some clinical features of these patients.

Material and methods: We studied a total of 52 bacterial isolates from patients diagnosed of respiratory infections in 2014 in outpatients (Primary Care) and inpatients. The samples were: sputum (63.3%), bronchial aspirates (36.6%), and biological fluids (pleural and bronchoalveolar lavage). The bacterial resistance was determined by study of the Minimum Inhibitory Concentration (MIC) (Walk-away) following the recommendations of the Clinical and Laboratory Standars Institute (CLSI 2013) and confirmed with a combination disk method.

Results: Out of total bacterial isolates Klebsiella pneumoniae was found to more predominant (32%), followed by Pseudomona aeruginosa (12%). Serratia marcenscens, Enterobacter spp and Escherichia coli were others bacterial genera. A high percentage (31%) of bacterial isolates were ESBL producers in which Pseudomona aeruginosa was found to be more predominant (44.2%) followed by Klebsiella pneumoniae (31.6%). We did not aislate Acinetobacter calcoaecetus baumannii (Acb) complex.

In relation to respiratory diseases, COPD was present in 19 (36%), of which 60% were severe; asthma in 12 patients (23%); and 3 (5.7%) had interstitial lung disease. 19 patients (36%) had bronchiectasis (42% of them with chronic infectious colonization). 40% of patients had had previous hospital admission (2013 and 2014) due to respiratory diseases, being pneumonia (42%); respiratory infection (33%), COPD exacerbations (14%) as the most frequent causes.

Conclusions: A high prevalence of multidrug resistant bacterial strains that produce ESBL in the respiratory isolates studied was found. The presence of COPD, bronchiectasis and recent hospitalizations could be related to the emergence of these strains. All these factors mentioned contribute to the acquisition of bacterial mutations and the appearance of ESBL. Therefore it is necessary to establish control measures to prevent the spread of these strains.