{"id":65520,"date":"2022-12-22T19:21:51","date_gmt":"2022-12-22T17:21:51","guid":{"rendered":"https:\/\/blog.cofb.cat\/?p=65520"},"modified":"2023-10-09T10:51:59","modified_gmt":"2023-10-09T10:51:59","slug":"els-farmaceutics-hospitalaris-sactualitzen-en-labordatge-de-les-infeccions-multiresistents","status":"publish","type":"post","link":"https:\/\/www.cofb.org\/es\/2022\/12\/22\/els-farmaceutics-hospitalaris-sactualitzen-en-labordatge-de-les-infeccions-multiresistents\/","title":{"rendered":"Los farmac\u00e9uticos hospitalarios se actualizan en el abordaje de las infecciones multirresistentes"},"content":{"rendered":"

El pasado 13 de diciembre, el Col\u00b7legi Oficial de Farmac\u00e8utics de Barcelona (COFB)<\/strong> y la Sociedad Catalana de Farmacia Cl\u00ednica (SCFC)<\/a><\/strong> organizaron la actividad "Revisi\u00f3n del abordaje de las infecciones multirresistentes"<\/strong>, con el patrocinio de Shionogi<\/a><\/strong>. La formaci\u00f3n, que se realiz\u00f3 en formato presencial y en formato webinar, fue presentada y moderada por Daniel Echevarria<\/strong>, farmac\u00e9utico adjunto del Servicio de Farmacia del Hospital del Mar y primer farmac\u00e9utico hospitalario del Estado acreditado por el Board Certified Pharmacist en Enfermedades Infecciosas. La sesi\u00f3n cont\u00f3 con la microbi\u00f3loga del Servicio de Microbiolog\u00eda del Hospital Cl\u00ednic de Barcelona, Cristina Pitart<\/strong>; el Consultor Senior de Enfermedades Infecciosas del Hospital Universitari Vall d'Hebron, Benito Almirante<\/strong>; y con el farmac\u00e9utico del Servicio de Farmacia del Hospital Universitario Vall d'Hebron, David Campany<\/strong>.<\/p>\n\n\n\n

\"\"<\/a>
Un momento de la formaci\u00f3n: "Revisi\u00f3n del abordaje de las infecciones multirresistentes". <\/figcaption><\/figure>\n\n\n\n

Los objetivos principales<\/strong> de la formaci\u00f3n, dirigida a los farmac\u00e9uticos hospitalarios<\/strong>, eran dar a conocer<\/strong> cu\u00e1l problem\u00e1tica de tratamiento generan las bacterias gramnegativas multirresistentes<\/strong>; revisar<\/strong> los nuevos antibi\u00f3ticos aprobados contra bacterias gramnegativas<\/strong>, la gesti\u00f3n del tratamiento<\/strong> en circunstancias especiales y resolver problemas farmacoterap\u00e9uticos<\/strong> relacionados con tratamientos antiinfecciosos; y saber c\u00f3mo afrontar las dificultades de tratamiento<\/strong>.<\/p>\n\n\n\n

El farmac\u00e9utico, Daniel Echeverr\u00eda<\/strong>, inici\u00f3 la sesi\u00f3n asegurando que actualmente "estamos ante una nueva pandemia por todo el tema de las multiresistencias"<\/strong>; y a\u00f1adi\u00f3 que recientemente \u201cha salido publicado un art\u00edculo<\/a> que estima que las muertes atribuibles a estas bacterias multirresistentes, de las cuales hay cuatro por gramnegativos, ha supuesto la muerte de 1,27 millones de personas en 2019\u201d<\/strong>.<\/p>\n\n\n\n

La pandemia silenciosa de las resistencias antimicrobianas<\/strong><\/h2>\n\n\n\n

La microbi\u00f3loga del Servicio de Microbiolog\u00eda del Hospital Cl\u00ednic de Barcelona, Cristina Pitart<\/strong>, abord\u00f3 cu\u00e1l es la problem\u00e1tica de las bacterias gramnegativas multirresistentes<\/strong>. Pitart empez\u00f3 su ponencia haciendo referencia a el informe de 2016<\/strong> Tackling Drug-resistante infecciones globally. Review on Antimicrobial Resistance<\/a>,<\/em> del economista Jim O'Neill<\/strong>, en el que \u201cestim\u00f3 qu\u00e9 pasar\u00eda si no hubiera nuevos antibi\u00f3ticos a partir de 2017<\/strong>\u201d. Seg\u00fan Pitart, una de las conclusiones del estudio fue que \u201cen 2050, 10 millones de personas morir\u00edan a causa de la resistencia a los antibi\u00f3ticos\u201d.<\/strong> La microbi\u00f3loga quiso diferenciar este informe del art\u00edculo que hab\u00eda referenciado Echevarr\u00eda, puesto que el art\u00edculo se basa en cifras reales del a\u00f1o 2019: \u201c1,27 millones de muertes por delante del sida, del c\u00e1ncer de mama y de la malaria; \u00e9stos son n\u00fameros muy alarmantes\u201d<\/strong>, sentenci\u00f3.<\/p>\n\n\n\n

\"La<\/a>
La microbi\u00f3loga, Cristina Pitart, durante su intervenci\u00f3n.<\/figcaption><\/figure>\n\n\n\n

Estas cifras la microbi\u00f3loga las mostr\u00f3 en un mapa de Europa, en el que se pod\u00eda observar c\u00f3mo ha aumentado la resistencia a los carbapenemos desde 2005 a 2020<\/strong>. Seg\u00fan Pitart, este aumento \u201cse debe al mal uso de los antibi\u00f3ticos en humanos\u201d<\/strong> y a\u00f1adi\u00f3 que \u201ceste no es el \u00fanico hecho responsable, sino tambi\u00e9n el mal uso que se ha hecho en animales\u201d<\/strong>. <\/p>\n\n\n\n

Los microorganismos que preocupan<\/strong> son los llamados ESCAPE<\/strong>, que es el acr\u00f3nimo de: Enterococcus resistente a vancomicina, MRSA, K. pneumoniae, Acinetobacter baumannii, P. aeruginosa MR o XDR y el Enterobacterales.<\/p>\n\n\n\n

Abordaje terap\u00e9utico desde el punto de vista cl\u00ednico<\/strong><\/h2>\n\n\n\n

En cuanto a el abordaje terap\u00e9utico de las infecciones por bacterias gramnegativas multirresistentes<\/strong>, desde la visi\u00f3n cl\u00ednica, el Consultor Senior de Enfermedades Infecciosas del Hospital Universitari Vall d'Hebron, Benito Almirante<\/strong>, coment\u00f3 que "es una problem\u00e1tica universal" <\/strong>y adem\u00e1s "con una gran repercusi\u00f3n cl\u00ednica"<\/strong>. Almirante explic\u00f3 que \u201cesta problem\u00e1tica<\/strong> con estas bacterias (Enterobacterales, P. aeruginosa MR o XDR y el Acinetobacter baumannii) es especialmente relevante en pacientes cr\u00edticos<\/strong> y en quienes tienen alguna infecci\u00f3n producida por alguna de estas bacterias\u201d.<\/p>\n\n\n\n

El doctor destac\u00f3 que estas infecciones por BGN son importantes y detall\u00f3 c\u00f3mo afecta en el pron\u00f3stico a las UCIs: \u201cla mortalidad de los pacientes con infecci\u00f3n se duplica de los no infectados;<\/strong> la mortalidad en pacientes con bacteriemia por BGN,<\/strong> resistentes a carbapenemas, es muy superior a la de los pacientes sin bacteriemia<\/strong>; la bacteriemia por BGN MR alarga hasta 3 veces la estancia media en la UCI<\/strong>; y la infecci\u00f3n causada por un BGN MR es un factor independiente de mortalidad intra-UCI\u201d.<\/p>\n\n\n\n

\"\"<\/a>
El dr. Benito Almirante durante su explicaci\u00f3n sobre el abordaje terap\u00e9utico de las infecciones por bacterias gramnegativas multirresistentes.<\/figcaption><\/figure>\n\n\n\n

Despu\u00e9s de explicar las opciones terap\u00e9uticas<\/strong> para tratar las infecciones por BGN productores de carbapenemas, el papel de los nuevos antimicrobianos<\/strong> y las diferentes estrategias de tratamiento<\/strong>; Almirante cerr\u00f3 su presentaci\u00f3n aportando algunas conclusiones como \u201cel tratamiento de las infecciones producidas por BGN multirresistentes debe ser individualizado, <\/strong>seg\u00fan la comorbilidad del paciente, el tipo de infecci\u00f3n, la gravedad cl\u00ednica y el tipo de bacteria resistente, entre otros.<\/p>\n\n\n\n

Nuevas opciones farmacol\u00f3gicas<\/strong><\/h2>\n\n\n\n

En la \u00faltima parte de la sesi\u00f3n, el farmac\u00e9utico del Servicio de Farmacia del Hospital Universitario Vall d'Hebron, David Campany<\/strong>, detall\u00f3 las nuevas opciones farmacol\u00f3gicas para el tratamiento de las infecciones producidas por bacterias gramnegativas productoras de carbapenemasas<\/strong>, que se han incorporado. El farmac\u00e9utico coment\u00f3 que \u201cactualmente se dispone de tres antibi\u00f3ticos beta-lact\u00e1micos<\/strong>: la ceftazidima\/avibactam (\u00b1 aztreonam)<\/strong>, el meropenemos\/vaborbactam<\/strong> y el cefiderocolo<\/strong>\u201d. En cuanto a estos tratamientos, Campany cree que \u201cel meropenem vaborbactam<\/strong> es una opci\u00f3n especialmente interesante en infecciones producidas por cepas de entorobacterias productoras de carbapenemasas tipo KPC\u201d; y que el \u201cCefiderocolo<\/strong> ofrece buena actividad frente a los BGN productores de carbapenemasas, especialmente en cepas productoras de MBL\u201d.<\/p>\n\n\n\n

\"El<\/a>
El farmac\u00e9utico, David Campany, durante su exposici\u00f3n.<\/figcaption><\/figure>\n\n\n\n

Aparte ofreci\u00f3 su punto de vista sobre el uso de antibi\u00f3ticos activos frente a los BGN productores de carbapenemasas en unidades de hospitalizaci\u00f3n domiciliaria<\/strong>, el farmac\u00e9utico cree que "se debe dar prioridad en la utilizaci\u00f3n de bombas elastom\u00e9ricas y conservaci\u00f3n en nevera".<\/strong> Por \u00faltimo, a\u00f1adi\u00f3 que \u201chay varias l\u00edneas de desarrollo de nuevos antibi\u00f3ticos con actividad frente a BGN productores de MCP<\/strong>: monobactams; combinaciones \u03b2-lact\u00e1micos\/inhibidores carbapenmaes (\u00b1MCP)\u201d.<\/p>\n\n\n\n

\n
<\/div>\n\n\n\n
<\/div>\n\n\n\n
\n

Con el patrocinio de:<\/strong><\/p>\n\n\n\n

\"\"<\/a><\/figure>\n<\/div>\n<\/div>\n\n\n\n

<\/p>","protected":false},"excerpt":{"rendered":"

El pasado 13 de diciembre, el Colegio Oficial de Farmac\u00e9uticos de Barcelona (COFB) y la Sociedad Catalana de Farmacia Cl\u00ednica (SCFC) organizaron la actividad "Revisi\u00f3n del abordaje de las infecciones multirresistentes", con el patrocinio de Shionogi . La formaci\u00f3n, que se realiz\u00f3 en formato presencial y en formato webinar, va [\u2026]<\/p>","protected":false},"author":1,"featured_media":67798,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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