<?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>1409-0015</journal-id>
<journal-title><![CDATA[Medicina Legal de Costa Rica]]></journal-title>
<abbrev-journal-title><![CDATA[Med. leg. Costa Rica]]></abbrev-journal-title>
<issn>1409-0015</issn>
<publisher>
<publisher-name><![CDATA[Asociación Costarricense de Medicina Forense]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1409-00152019000100021</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Caracterización de la bacteremia por Staphylococcus aureus en pacientes hospitalizados del Hospital San Juan de Dios entre enero 2015 a diciembre 2017]]></article-title>
<article-title xml:lang="en"><![CDATA[Characterization of bacteremia by Staphylococcus aureus in hospitalized patients of the San Juan de Dios Hospital between January 2015 to December 2017]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Méndez Ramírez]]></surname>
<given-names><![CDATA[Erick]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital San Juan de Dios  ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<volume>36</volume>
<numero>1</numero>
<fpage>21</fpage>
<lpage>31</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1409-00152019000100021&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1409-00152019000100021&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1409-00152019000100021&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción:  Staphylococcus aureus es un importante patógeno humano que causa una amplia gama de infecciones clínicas; es una de las principales causas de bacteremia, endocarditis infecciosa, así como de infecciones osteoarticulares, cutáneas, tejidos blandos e infecciones pleuro-pulmonares. La bacteriemia es quizás la manifestación mejor descrita de la infección por S. aureus. Varios estudios han documentado la prevalencia, el pronóstico y el resultado de la bacteriemia por S. aureus (SAB) en las regiones industrializadas del mundo. Sin embargo, muchas preguntas básicas sobre la epidemiología del SAB, en particular en las regiones no industrializadas del mundo, permanecen sin respuesta.  Materiales y métodos:  Se trata de un estudio observacional, descriptivo, de tipo retrospectivo realizado en el Hospital San Juan de Dios entre los años de 2015 al 2017. El objetivo del estudio es describir las características clínicas y de laboratorio en pacientes a los que se le documento una bacteremia por S. aureus en el periodo en cuestión.  Resultados y Conclusiones: La mayoría de los pacientes son masculinos, con mayor incidencia en pacientes mayores de 60 años. La estancia hospitalaria promedio fue de 43 días. La bacteremia por S. aureus adquirida en el hospital fue la más frecuente. El 43,9% de los pacientes se presentan con sepsis severa o shock séptico al momento del diagnóstico. La infección de piel y tejidos blandos es la infección asociada más común. Se documento que los factores de riesgo más importantes para desarrollar una bacteremia por S. aureus es la cirugía y hospitalización previa. Las comorbilidades más frecuente asociadas son la diabetes mellitus, hipertensión arterial, enfermedad renal crónica. La invasión más frecuente fue el catéter venoso central. Solo el 78% de los pacientes con bacteremia por S. aureus recibió un tratamiento antibiótico adecuado Solo el 52.5% de todos los casos tuvo un manejo óptimo de la bacteremia.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Staphylococcus aureus is an important human pathogen that causes a wide range of clinical infections; It is one of the main causes of bacteremia, endocarditis, infectious, as well as musculoskeletal, skin infections and soft, pleuro-pulmonary tissues. Bacteremia is perhaps best described by S. aureus infection manifestation. Several studies have documented the prevalence, prognosis and outcome of bacteremia by S. aureus (SAB) in the industrialized regions of the world. However, many basic questions about the epidemiology of the SAB, particularly in non-industrialized regions of the world, remain unanswered.  Materials and methods:  It&#8217;s an observational, descriptive, study retrospective type made in the Hospital San Juan de Dios between the years from 2015 to 2017. The study objective is to describe, laboratory and clinical characteristics in patients who were documented a bacteremia by S. aureus in the period in question.  Results and conclusions: The majority of patients are male, with higher incidence in patients older than 60 years. The average hospital stay was 43 days. Bacteraemia by S. aureus acquired in the hospital was the most frequent. 43.9% of patients present with severe sepsis or septic shock at the time of diagnosis. Skin and soft tissue infection is the most common associated infection. Document risk factors more important in developing a S. aureus bacteremia is prior hospitalization and surgery. Comorbidities most frequent associates are diabetes mellitus, hypertension, renal disease chronic. The invasion most frequent was the central venous catheter.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Bacteremia]]></kwd>
<kwd lng="es"><![CDATA[Staphylococcus aureus]]></kwd>
<kwd lng="es"><![CDATA[mortalidad]]></kwd>
<kwd lng="es"><![CDATA[antibioticoterapia]]></kwd>
<kwd lng="es"><![CDATA[resistencia antimicrobiana]]></kwd>
<kwd lng="en"><![CDATA[Bacteremia]]></kwd>
<kwd lng="en"><![CDATA[Staphylococcus aureus]]></kwd>
<kwd lng="en"><![CDATA[antibiotic therapy]]></kwd>
<kwd lng="en"><![CDATA[mortality]]></kwd>
<kwd lng="en"><![CDATA[antimicrobial resistance]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tong]]></surname>
<given-names><![CDATA[SYC]]></given-names>
</name>
<name>
<surname><![CDATA[Davis]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Eichenberger]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Holland]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
<name>
<surname><![CDATA[Fowler]]></surname>
<given-names><![CDATA[VG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Staphylococcus aureus infections Epidemiology, pathophysiology, clinical manifestations, and management.]]></article-title>
<source><![CDATA[Clinical Microbiology Reviews]]></source>
<year>2015</year>
<volume>28</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>603-61</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[van Hal]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Jensen]]></surname>
<given-names><![CDATA[SO]]></given-names>
</name>
<name>
<surname><![CDATA[Vaska]]></surname>
<given-names><![CDATA[VL]]></given-names>
</name>
<name>
<surname><![CDATA[Espedido]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Paterson]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Gosbell]]></surname>
<given-names><![CDATA[IB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Predictors of mortality in staphylococcus aureus bacteremia]]></article-title>
<source><![CDATA[Clinical Microbiology Reviews]]></source>
<year>2012</year>
<volume>25</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>362-86</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cosgrove]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Fowler]]></surname>
<given-names><![CDATA[VG]]></given-names>
</name>
</person-group>
<source><![CDATA[Optimizing Therapy for Methicillin-Resistant Staphylococcus aureus Bacteremia]]></source>
<year>2007</year>
<volume>1</volume>
<numero>212</numero>
<issue>212</issue>
<page-range>624-31</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yasmin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[El Hage]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Obeid]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[El Haddad]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Zaarour]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Khalil]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology of bloodstream infections caused by methicillinresistant Staphylococcus aureus at a tertiary care hospital in New York]]></article-title>
<source><![CDATA[American Journal of Infection Control]]></source>
<year>2016</year>
<volume>44</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>41-6</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yilmaz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Elaldi]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Balkan]]></surname>
<given-names><![CDATA[II]]></given-names>
</name>
<name>
<surname><![CDATA[Arslan]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Batirel]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Bakici]]></surname>
<given-names><![CDATA[MZ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mortality predictors of Staphylococcus aureus bacteremia: a prospective multicenter study]]></article-title>
<source><![CDATA[Annals of Clinical Microbiology and Antimicrobials]]></source>
<year>2016</year>
</nlm-citation>
</ref>
<ref id="B6">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Goto]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Schweizer]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Vaughan-Sarrazin]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Perencevich]]></surname>
<given-names><![CDATA[EN]]></given-names>
</name>
<name>
<surname><![CDATA[Livorsi]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Diekema]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association of Evidence-Based Care Processes With Mortality in Staphylococcus aureus Bacteremia at Veterans Health Administration Hospitals, 2003-2014]]></article-title>
<source><![CDATA[JAMA Internal Medicine. 1 de octubre de]]></source>
<year>2017</year>
<volume>177</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1489</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carnicer-Pont]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Bailey]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Mason]]></surname>
<given-names><![CDATA[BW]]></given-names>
</name>
<name>
<surname><![CDATA[Walker]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Evans]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Salmon]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors for hospital-acquired methicillinresistant Staphylococcus aureus bacteraemia a case-control study]]></article-title>
<source><![CDATA[Epidemiology and Infection. diciembre de]]></source>
<year>2006</year>
<volume>134</volume>
<numero>06</numero>
<issue>06</issue>
<page-range>1167</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Elshaboury]]></surname>
<given-names><![CDATA[RH]]></given-names>
</name>
<name>
<surname><![CDATA[Munson]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Dilworth]]></surname>
<given-names><![CDATA[TJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A Retrospective Analysis of Treatment and Clinical Outcomes among Patients with Methicillin-Susceptible Staphylococcus aureus Bloodstream Isolates Possessing Detectable mecA by a Commercial PCR Assay Compared to Patients with Methicillin-Resistant Staphylococcus aureus Bloodstream Isolates]]></article-title>
<source><![CDATA[Antimicrobial Agents and Chemotherapy.]]></source>
<year>2017</year>
<volume>62</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>e01396-17</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>8</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bayer]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Cosgrove]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Daum]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Fridkin]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Gorwitz]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
</person-group>
<source><![CDATA[Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin- Resistant Staphylococcus Aureus Infections in Adults and Children]]></source>
<year>2011</year>
<volume>52</volume>
</nlm-citation>
</ref>
<ref id="B10">
<label>9</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vargas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[caracterización clínica, epidemiológica y microbiológica de las bacteremias por staphylococcus aureus que desarrollan los pacientes hospitalizados en el hospital Dr. Rafael Angel Calderón guardia de abril del 2014 a setiembre del 2014]]></source>
<year>2014</year>
</nlm-citation>
</ref>
<ref id="B11">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Coneghy]]></surname>
<given-names><![CDATA[K. W.]]></given-names>
</name>
<name>
<surname><![CDATA[Bleasdale]]></surname>
<given-names><![CDATA[S. C.]]></given-names>
</name>
<name>
<surname><![CDATA[Rodvold]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The empirical combination of vancomycin and a ß-lactam for Staphylococcal bacteremia]]></article-title>
<source><![CDATA[Clin. Infect Dis]]></source>
<year>2013</year>
<volume>57</volume>
<page-range>1760-5</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Togneri]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Podestá]]></surname>
<given-names><![CDATA[LB]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Santiso]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Estudio de las infecciones por Staphylococcus aureus en un hospital general de agudos (2002-2013)]]></article-title>
<source><![CDATA[Revista Argentina de Microbiología. enero de]]></source>
<year>2017</year>
<volume>49</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>24-31</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nirwan]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Srivastava]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Abbas]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence and antibiogram of hospital acquiredmethicillin resistant Staphylococcus aureus and community acquired-methicillin resistant Staphylococcus aureus at a tertiary care hospital National Institute of Medical Sciences]]></article-title>
<source><![CDATA[Community Acquired Infection]]></source>
<year>2015</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>13</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>13</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fowler]]></surname>
<given-names><![CDATA[VG]]></given-names>
</name>
<name>
<surname><![CDATA[Olsen]]></surname>
<given-names><![CDATA[MK]]></given-names>
</name>
<name>
<surname><![CDATA[Corey]]></surname>
<given-names><![CDATA[GR]]></given-names>
</name>
<name>
<surname><![CDATA[Woods]]></surname>
<given-names><![CDATA[CW]]></given-names>
</name>
<name>
<surname><![CDATA[Cabell]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Reller]]></surname>
<given-names><![CDATA[LB]]></given-names>
</name>
</person-group>
<source><![CDATA[Clinical]]></source>
<year></year>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
