<?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>1409-1429</journal-id>
<journal-title><![CDATA[Revista Costarricense de Salud Pública]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. costarric. salud pública]]></abbrev-journal-title>
<issn>1409-1429</issn>
<publisher>
<publisher-name><![CDATA[Asociación Costarricense de Salud Pública]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1409-14292017000100069</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Primer aislamiento de una cepa de Klebsiella pneumoniae productora de carbapenemasa tipo KPC-1 en el Hospital de San Carlos durante el 2011]]></article-title>
<article-title xml:lang="en"><![CDATA[First isolation of a type KPC-1 carbapenemase-producing Klebsiella pneumoniae strain in the San Carlos Hospital during 2011]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ordóñez Varela]]></surname>
<given-names><![CDATA[Wendy]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Blanco Quirós]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Caja Costarricense de Seguro Social Hospital Los Chiles ]]></institution>
<addr-line><![CDATA[ San José]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Caja Costarricense de Seguro Social Hospital de San Carlos ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<volume>26</volume>
<numero>1</numero>
<fpage>69</fpage>
<lpage>73</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1409-14292017000100069&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1409-14292017000100069&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1409-14292017000100069&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo Demostrar el aislamiento de una Klebsiella pneumoniae productora de carbapenemasa tipo 1 a partir de una paciente femenina de 1 año con historial de problemas hepáticos e infecciones renales a repetición.  Métodos Se realizó la identificación bacteriana y la prueba de resistencia a antibióticos por medio del sistema Vitek 2. La determinación fenotípica de carbapenemasas se realizó por medio de la prueba de ácido borónico y Hodge modificado. La confirmación molecular se hizo utilizando PCR-RT para el gen blaKPC.  Resultados Por la prueba de sensibilidad a antibióticos, se sospecha de una betalactamasa de espectro ampliado con sensibilidad reducida a carbapenémicos (imipenem 4 &#956;g/mL, meropenem 1 &#956;g/mL). Las pruebas de ácido borónico y Hodge modificado sugieren la presencia de carbapenemasas. La confirmación molecular es positiva para carbapenemasas tipo 1.  Discusión La emergencia y diseminación de cepas con carbapenemasas constituye un riesgo para pacientes hospitalizados y la comunidad. Estas cepas usualmente son resistentes a múltiples antibióticos y los mecanismos de resistencia diseminan con facilidad. Los hospitales constituyen escenarios que favorecen la diseminación de estas bacterias. Las opciones terapéuticas en estos casos son reducidas, por lo que se insta a un uso consciente de los antibióticos, la higiene intrahospitalaria y vigilancia epidemiológica interdisciplinaria.  Conclusiones Se confirma la presencia de Klebsiella pneumoniae KPC-1 como aislamiento de una infección del tracto urinario en una niña con problemas hepáticos. Los lineamientos del Centro Nacional de Referencia en Bacteriología para sospechar de carbapenemasas, las pruebas fenotípicas y la confirmación molecular permitieron corroborar la carbapenemasa.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective To demonstrate the finding of a Klebsiella pneumoniae carbapenemase-1 positive, isolated from a 1-year-old female patient with liver illness and kidney recurrent infections.  Methods Bacterial identification and antimicrobial susceptibility testing was performed with Vitek 2 systems. Phenotypic determination of carbapenemases was performed using boronic acid test and Hodge modified test. Molecular confirmation was done using PCR-RT for gene blaKPC.  Results Antimicrobial susceptibility testing suggested an extended spectrum betalactamase with reduced sensitivity to carbapenems (imipenem 4 &#956;g/mL, meropenem 1 &#956;g/mL). Boronic acid test and Hodge modified test were consistent with carbapenemase production. Molecular confirmation was positive for carbapenemase-1.  Discusion The emergence and spread of carbapenemase-positive strains constitutes a risk for patients and community. These strains are usually resistant to multiple antimicrobials and the resistance mechanisms easily spread. Hospitals are scenarios that favor the spread of these bacteria. Therapeutic options in these cases are reduced, so it is necessary a conscious use of antibiotics, hospital hygiene and interdisciplinary epidemiological surveillance.  Conclusions It is confirmed the presence of Klebsiella pneumoniae KPC-1, isolated from a girl with urinary tract infection and liver illness. The guidelines of Centro Nacional de Reference en Bacteriology, phenotypic tests and molecular confirmation made possible the confirmation of this finding.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Klebsiella pneumoniae]]></kwd>
<kwd lng="es"><![CDATA[carbapenemasas]]></kwd>
<kwd lng="es"><![CDATA[KPC]]></kwd>
<kwd lng="es"><![CDATA[resistencia a antibióticos]]></kwd>
<kwd lng="en"><![CDATA[Klebsiella pneumoniae]]></kwd>
<kwd lng="en"><![CDATA[carbapenemases]]></kwd>
<kwd lng="en"><![CDATA[KPC]]></kwd>
<kwd lng="en"><![CDATA[drug resistance]]></kwd>
</kwd-group>
</article-meta>
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