<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022016000200062</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Análisis de las bacteremias por Klebsiella pneumoniae en pacientes del Hospital México]]></article-title>
<article-title xml:lang="en"><![CDATA[Analysis of Klebsiella pneumoniae bacteremia in Patients from Mexico hospital]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez-Alfaro]]></surname>
<given-names><![CDATA[Christian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villalobos-Vindas]]></surname>
<given-names><![CDATA[Juan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Escalante Pradilla Unidad Cuidados Intensivos ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Caja Costarricense de Seguro Social Servicio de Infectología Hospital México]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<volume>58</volume>
<numero>2</numero>
<fpage>62</fpage>
<lpage>68</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022016000200062&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022016000200062&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022016000200062&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Justificación: En los últimos años a nivel mundial ha habido un incremento de bacteremias por Klebsiella pneumoniae productora de BLEA, que han contribuido como un factor importante de resistencia a los antibióticos &#946;-lactámicos, y de morbilidad y mortalidad intrahospitalaria. Es relevante para la práctica diaria conocer la incidencia, los factores de riesgo, las complicaciones y la letalidad de estas infecciones en el Hospital México. Se planteó documentar los sitios más frecuentes de infección por Klebsiella pneumoniae, la producción de BLEA, y su asociación a bacteremia y letalidad.  Métodos: Se realizó un estudio observacional retrospectivo. Se estudió a los pacientes ingresados al Hospital México, entre enero de 2008 y diciembre de 2011, que hicieron bacteremia por Klebsiella pneumoniae. Se estudió una población de 118 pacientes que hicieron bacteremia por Klebsiella pneumoniae no productora de BLEA y Klebsiella pneumoniae productora de BLEA. Se recopiló los datos demográficos, clínicos y microbiológicos relevantes.  Resultados: En el Hospital México es frecuente encontrar casos de bacteremia primaria por Klebsiella pneumoniae no productora de BLEA y Klebsiella pneumoniae productora de BLEA. Se encontró que es más frecuente la infección del tracto urinario por Klebsiella pneumoniae productora de BLEA, asociada a bacteremia. Como factores de riesgo: la anemia, la sonda foley, la infección previa y concomitante, y el uso previo de cefalosporinas, incrementan la posibilidad de aumentar el riesgo de desarrollar bacteremia por Klebsiella pneumoniae productora de BLEA (IC95%: 1,1- 12,3%). Asimismo, en los pacientes con bacteremia por Klebsiella pneumoniae, la neutropenia, la insuficiencia renal, la sonda foley y un tratamiento inadecuado, aumentan la letalidad (IC95%:1,1- 39,8%). Sin embargo en los pacientes con bacteremia por Klebsiella pneumoniae, la expresión de BLEA no aumentó la letalidad. La tasa de letalidad a los 30 días fue de un 19% para ambos grupos.  Conclusión: Las bacteremias por Klebsiella pneumoniae son un problema serio en nuestro hospital, con factores de riesgo específicos, tratada adecuadamente la mayoría de las veces, pero con una tasa de letalidad alta.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Background:  In the last years there has been a worldwide increase of ESBL-producing Klebsiella pneumoniae bacteraemias, which have been an important factor of resistance to &#946;-lactam antibiotics, and of nosocomial morbidity and mortality. It is relevant to day-to-day practice to know the incidence, risk factors, complications and lethality of these infections in the Mexico hospital. We proposed to register the most frequent sites of infection by Klebsiella pneumoniae, the production of ESBLs and its association to bacteremia and lethality.  Methods:  A retrospective review was performed in patients from the Mexico hospital that developed a Klebsiella pneumoniae bacteremia from January 2008 to December 2011. We studied a total of 118 patients that developed non-ESBL-producing Klebsiella pneumonia and ESBL-producing Klebsiella pneumoniae. Demographic, clinical and microbiological data was recorded for all patients.  Results:  Non-ESBL-producing Klebsiella pneumoniae and ESBL-producing Klebsiella pneumoniae cases are found frequently in the Mexico hospital. We found that urinary tract infection by ESBLproducing Klebsiella pneumoniae bacteremia is the most frequent. Risk factors like anemia, foley catheter, previous and concomitant infection, and previous use of cephalosphorines increase the risk of ESBL-producing Klebsiella pneumoniae bacteremia (CI95%: 1.1-12.3%). Also neutropenia, renal failure, foley catheter and an inadequate treatment in patients with ESBL-producing Klebsiella pneumoniae increase lethality (CI95%:1.1-39.8%). Nevertheless in patients with ESBL-producing Klebsiella pneumoniae bacteremia, the presence of ESBL doesn`t increase lethality. The 30-day lethality rate was 19% for both groups.  Conclusion:  Klebsiella pneumoniae bacteremias are a serious problem in our hospital, with specific risk factors, treated adequately most of the time, but with a high lethality rate.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Klebsiella pneumoniae]]></kwd>
<kwd lng="es"><![CDATA[BLEA (&#946;-lactamasa de espectro ampliado)]]></kwd>
<kwd lng="es"><![CDATA[bacteremia]]></kwd>
<kwd lng="es"><![CDATA[neutropenia.]]></kwd>
<kwd lng="en"><![CDATA[Klebsiella pneumoniae]]></kwd>
<kwd lng="en"><![CDATA[ESBL (extended spectrum &#946;-lactamase)]]></kwd>
<kwd lng="en"><![CDATA[bacteremia]]></kwd>
<kwd lng="en"><![CDATA[neutropenia.]]></kwd>
</kwd-group>
</article-meta>
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</back>
</article>
