Neumonía adquirida en la comunidad polimicrobiana y multirresistente. Reporte de un caso

World Health Organization. The top 10 causes of death. Geneva: WHO; 2013 [consultado 1 Jun 2014]. Disponible en: http:/www.who.int/mediacentre/factsheets/fs310/en/index.html. Ewig, 2011, Towards a sensible comprehension of severe community-acquired pneumonia, Intensive Care Med., 37, 214, 10.1007/s00134-010-2077-0 Comité Nacional Conjunto de NAC (Asociación Colombiana de Neumología y Cirugía de Tórax, Asociación Colombiana de Infectología, Asociación Colombiana de Medicina Interna). Recomendaciones para el diagnóstico, tratamiento y prevención de la neumonía adquirida en la comunidad en adultos. Rev Colomb Neumol. 2003;15 Suppl 3:S1-42. Montúfar, 2006, Características de la Neumonía Adquirida en Comunidad (NAC) por S. pneumoniae, con y sin bacteremia en el Valle de Aburrá, 2005-2006, ACMI, Cartagena Hohenadel, 2001, Role of bronchoalveolar lavage in immunocompromized patients with pneumonia treated with a broad spectrum antibiotic and antifungal regimen, Thorax, 56, 115, 10.1136/thorax.56.2.115 Vélez, 2006, Caracterización clínica y etiológica de NAC, Valle de Aburrá. Infectio., 10, 103 Giraldo, 1993, Neumonías en la Clínica Shaio de Bogotá, Rev Colomb Neumol., 171 Montúfar, 2006, Características y comportamiento de la Neumonía Adquirida en la Comunidad (NAC) en adultos mayores (>65 años) hospitalizados en el Valle de Aburrá, Antioquia, Colombia. Infectio., 10, 113 Caballero, 2010, Agentes etiológicos de Neumonía Adquirida en Comunidad (NAC) en pacientes adultos inmunocompetentes que consultan al servicio de urgencias de la Clínica Reina Sofía, Bogotá, 2006-2007, Rev Médica Sanitas., 13, 8 Robledo, 2003, Neumonías adquiridas en la comunidad en adultos: un estudio etiológico prospectivo conénfasis en el diagnóstico, Rev Colomb Neumol., 15, 7 De Roux, 2006, Mixed community-acquired pneumonia in hospitalised patients, Eur Respir J., 27, 795, 10.1183/09031936.06.00058605 Lieberman, 1996, Multiple pathogens in adult patients admitted with community-acquired pneumonia: a one year prospective study of 346 consecutive patients, Thorax., 51, 179, 10.1136/thx.51.2.179 Arancibia, 2002, Community-acquired pneumonia due to Gram-negative bacteria and Pseudomonas aeruginosa: incidence, risk, and prognosis, Arch Intern Med, 162, 1849, 10.1001/archinte.162.16.1849 Falguera, 2009, Risk factors and outcome of community-acquired pneumonia due to Gram-negative bacilli, Respirology., 14, 105, 10.1111/j.1440-1843.2008.01371.x Cillóniz, 2011, Community-acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis, Crit Care., 15, R209, 10.1186/cc10444 Shindo, 2009, Health-care-associated pneumonia among hospitalized patients in a Japanese community hospital, Chest, 135, 633, 10.1378/chest.08-1357 Von Baum, 2010, CAP NETZ study group. Community-acquired pneumonia through Enterobacteriaceae and Pseudomonas aeruginosa: diagnosis, incidence and predictors, Eur Respir J., 35, 598, 10.1183/09031936.00091809 Schreiber, 2010, Resistant pathogens in nonnosocomial pneumonia and respiratory failure: is it time to refine the definition of health-care-associated pneumonia?, Chest, 137, 1283, 10.1378/chest.09-2434 Tablan, 2004, Guidelines for preventing health-care—associated pneumonia;, 2003 recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee, MMWR Recomm Rep., 53, 1 Kett, 2011, Implementation of guidelines for management of possible multidrug-resistant pneumonia in intensive care: An observational, multicentre cohort study, Lancet Infect Dis., 11, 181, 10.1016/S1473-3099(10)70314-5 Chalmers, 2011, Epidemiology, antibiotic therapy, and clinical outcomes in health care-associated pneumonia: A UK cohort study, Clin Infect Dis., 53, 107, 10.1093/cid/cir274 Kollef, 1999, Inadequate antimicrobial treatment of infections: A risk factor for hospital mortality among critically ill patients, Chest., 115, 462, 10.1378/chest.115.2.462 Wei, 2013, Microbiology and prognostic factors of hospital- and community-acquired aspiration pneumonia in respiratory intensive care unit, Am J Infect Control., 41, 880, 10.1016/j.ajic.2013.01.007 Venditti, 2009, Study Group of the Italian Society of Internal Medicine. Outcomes of patients hospitalized with community-acquired, health care-associated, and hospital-acquired pneumonia, Ann Intern Med, 150, 19, 10.7326/0003-4819-150-1-200901060-00005 Aliberti, 2012, Stratifying Risk Factors for Multidrug-Resistant Pathogens in Hospitalized Patients Coming From the Community With Pneumonia, ClIN Infect Dis., 54, 470, 10.1093/cid/cir840 Shorr, 2013, A risk score for identifying methicillin-resistant Staphylococcus aureus in patients presenting to the hospital with pneumonia, BMC Infect Dis., 13, 268, 10.1186/1471-2334-13-268 Shindo, 2013, Risk factors for drug-resistant pathogens in community acquired and health care-associated pneumonia, Am J Respir Crit Care Med., 188, 985, 10.1164/rccm.201301-0079OC De Jaeger, 1999, Protected specimen brush and bronchoalveolar lavage to diagnose bacterial nosocomial pneumonia in ventilated adults: a meta-analysis, Crit Care Med, 27, 2548, 10.1097/00003246-199911000-00037 Hohenthal, 2004, Diagnostic Value of Bronchoalveolar Lavage in Community-acquired Pneumonia in a Routine Setting: A Study on Patients Treated in a Finnish University Hospital, Scand J Infect Dis., 36, 198, 10.1080/00365540410019183 Pereira Gomes, 2000, Impact of BAL in the management of pneumonia with treatment failure: positivity of BAL culture under antibiotic therapy, Chest., 118, 1739, 10.1378/chest.118.6.1739 Welte, 2012, Risk factors and severity scores in hospitalized patients with community-acquired pneumonia: predilection of severity and mortality, Eur J Clin Microbiol Infect Dis, 31, 33, 10.1007/s10096-011-1272-4 Ishiguro, 2013, Etiology and Factors Contributing to the Severity and Mortality of Community-acquired Pneumonia, Intern Med, 52, 317, 10.2169/internalmedicine.52.8830 Martin-Loeches, 2010, Combination antibiotic therapy with macrolides improves survival in intubated patients with community-acquired pneumonia, Intensive Care Med, 36, 612, 10.1007/s00134-009-1730-y Bernard, 1994, The American European Consensus Conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination, Am J Respir Crit Care Med., 149, 818, 10.1164/ajrccm.149.3.7509706 Dennesen, 2001, Resolution of infectious parameters after antimicrobial therapy in patients with ventilator-associated pneumonia, Am J Respir Crit Care Med., 163, 1371, 10.1164/ajrccm.163.6.2007020 Luna, 2003, Resolution of ventilator associated pneumonia: prospective evaluation of the clinical pulmonary infection score as an early clinical predictor of outcome, Crit Care Med., 31, 676, 10.1097/01.CCM.0000055380.86458.1E Wu, 2007, Early evolution of arterial oxygenation in severe community-acquired pneumonia: A prospective observational study, J Crit Care, 22, 129, 10.1016/j.jcrc.2006.06.009 Coates, 2011, Novel classes of antibiotics or more of the same, Br J Pharmacol., 163, 184, 10.1111/j.1476-5381.2011.01250.x Fariñas, 2013, Infecciones causadas por bacterias gramnegativas multirresistentes: enterobacterias, Pseudomonas aeruginosa, Acinetobacter baumannii y otros bacilos gramnegativos no fermentadores, Enferm Infecc Microbiol Clin., 31, 402, 10.1016/j.eimc.2013.03.016 Navarro, 2010, Interpretive reading of enterobacteria antibiograms, Enferm Infecc Microbiol Clin., 28, 638, 10.1016/j.eimc.2010.05.002 Peralta, 2012, Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study, BMC Infect Dis., 12, 245, 10.1186/1471-2334-12-245 Peterson, 2008, Antibiotic policy and prescribing strategies for therapy of extended-spectrum β-lactamase-producing Enterobacteriaceae: the role of piperacillin-tazobactam, Clin Microbiol Infect., 14, 181, 10.1111/j.1469-0691.2007.01864.x Gavin, 2006, Clinical correlation of the CLSI susceptibility breakpoint for piperacillin-tazobactam against extended-spectrum-β-lactamase-producing Escherichia coli and Klebsiella species, Antimicrob Agents Chemother., 50, 2244, 10.1128/AAC.00381-05 Thomson, 2001, Cefepime, piperacillin-tazobactam, and the inoculum effect in tests with extended-spectrum β-lactamase-producing Enterobacteriaceae, Antimicrob Agents Chemother., 45, 3548, 10.1128/AAC.45.12.3548-3554.2001 Rodríguez-Baño, 2008, Clinical significance of extended spectrum betalactamases, Expert Rev Anti Infect Ther., 6, 671, 10.1586/14787210.6.5.671 Falagas, 2006, The use of intravenous and aerosolized polymyxins for the treatment of infections in critically ill patients: A review of the recent literature, Clin Med Res., 4, 138, 10.3121/cmr.4.2.138 Vila, 2012, Therapeutic options for Acinetobacter baumannii infections: An update, Expert Opin Pharmacother., 13, 2319, 10.1517/14656566.2012.729820