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Información de la revista
Vol. 23. Núm. S3.
Neumonía nosocomial
Páginas 30-36 (Diciembre 2005)
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Vol. 23. Núm. S3.
Neumonía nosocomial
Páginas 30-36 (Diciembre 2005)
Neumonía nosocomial
Acceso a texto completo
Neumonía por Pseudomonas aeruginosa
Pneumonia due to Pseudomonas aeruginosa
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91247
Jordi Vallésa,
Autor para correspondencia
jvalles@cspt.es

Correspondencia: Dr. J. Vallés. Centre de Crítics. Hospital de Sabadell. Institut Universitari Parc Taulí. Parc Taulí, s/n. 08208 Sabadell. Barcelona. España.
, Dolors Mariscalb
a Centre de Crítics. Hospital de Sabadell. Institut Universitari Parc Taulí. Sabadell. Barcelona. España
b Laboratorio de Microbiología. UDIAT. Sabadell. Barcelona. España
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Resumen
Bibliografía
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Pseudomonas aeruginosa es uno de los principales bacilos gramnegativos que causa con mayor frecuencia neumonía nosocomial. Es además el patógeno más común causante de neumonía asociada a ventilación mecánica y el que se asocia a una mayor mortalidad entre las infecciones adquiridas en el hospital. P. aeruginosa produce un elevado número de toxinas y tiene en su superficie diversos componentes que lo hacen especialmente virulento comparado con otros microorganismos. Entre éstos se incluyen los pili, flagelos lipopolisacárido y otros productos excretados como exotoxina A, S y U, elastasa, proteasa alcalina, citotoxinas y fosfolipasas. La vía más común de infección en los pacientes ventilados mecánicamente es a través de la aspiración de secreciones procedentes del tracto respiratorio superior y previamente colonizadas debido a la manipulación de la vía respiratoria artificial o a través de las manos contaminadas del personal sanitario. El tratamiento antibiótico frente a P. aeruginosa debe de establecerse de forma precoz ante la sospecha o confirmación de la neumonía. Debe de iniciarse tratamiento empírico frente a P. aeruginosa, especialmente en los pacientes que han recibido previamente tratamiento antibiótico o que desarrollan una neumonía tardía.

Palabras clave:
Neumonía
Infección nosocomial
Pseudomonas aeruginosa

Pseudomonas aeruginosa is one of the leading causes of Gram-negative nosocomial pneumonia. It is the most common cause of ventilator-associated pneumonia and carries the highest mortality among hospital-acquired infections. P. aeruginosa produces a large number of toxins and surface components that make it especially virulent compared with other microorganisms. These include pili, flagella, membrane bound lipopolysaccharide, and secreted products such as exotoxins A, S and U, elastase, alkaline protease, cytotoxins and phospholipases. The most common mechanism of infection in mechanically ventilated patients is through aspiration of upper respiratory tract secretions previously colonized in the process of routine nursing care or via contaminated hands of hospital personnel. Intravenous therapy with an antipseudomonal regimen should be started immediately when P. aeruginosa pneumonia is suspected or confirmed. Empiric therapy with drugs active against P. aeruginosa should be started, especially in patients who have received previous antibiotics or present late-onset pneumonia.

Key words:
Pneumonia
Nosocomial infection
Pseudomonas aeruginosa
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Copyright © 2005. Elsevier España S.L.. Todos los derechos reservados
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