Bacterial profile of septic shock in an intensive care unit of the Peruvian social security altitude

Abstract

Knowing the bacterial profile of septic shock allowed an adequate choice of empirical antibiotics. Objectives: a) To describe the bacterial profile of septic shock in an intensive care unit at altitude. b) Know the location of positive cultures. c) Identify the sensitivity and the mechanism of bacterial resistance. d) Find differences in the bacterial profiles of altitude. Retrospective cross-sectional study. Done in an intensive care unit at 3,250 "masl". Positive cultures and antibiograms from high-altitude residents with septic shock taken before antibiotics for 7 years were included. 1,212 samples. Escherichia coli (18.48%). Gram-negative bacteria showed sensitivity to colistin (94-99%), the primary resistance mechanism was extended-spectrum beta-lactamase (43-91%). Staphylococcus aureus (22.19%). Gram-positive bacteria showed sensitivity to tigecillin, linezolid (100%), and vancomycin (36-100%); the primary resistance mechanism was resistant ampicillin/sulbactam producer of beta-lactamase (50-97%) and resistant methicillin (87-100%). In Conclusions.- a) Escherichia coli is the most frequent gram-negative and Staphylococcus aureus the gram-positive. b) The most frequent culture came from the lower respiratory tract. c) Of the gram-negative ones, Pseudomonas aeruginosa showed a high sensitivity for colistin, the rest also for tigecillin. The most frequent resistance mechanism was extended-spectrum beta-lactamase. Gram-positive bacteria have a high sensitivity for tigecillin, linezolid, and vancomycin. Its most common resistance mechanism was resistant ampicillin/sulbactam. d) We did not find differences in the reported bacterial profiles at altitude. We recommend confirming the “in vitro” sensitivity results for Tigecycline.