Vol. 34 Núm. 1 (2017)
Artículos de Investigación

Factores asociados a nefrotoxicidad por polimixina B en un hospital universitario de Neiva, Colombia. 2011-2015

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  • Johanna Osorio,
  • Jackeline Barreto,
  • Claudia F. Samboni,
  • Lina A. Cándelo,
  • Luis C. Álvarez,
  • Susana Benavidez,
  • Roso P. Téllez,
  • Dagoberto Santofimio,
  • Jorge A. Ramos,
  • Carlos A. Gomez

Publicado 2017-03-31

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Cómo citar

1.
Osorio J, Barreto J, Samboni CF, Cándelo LA, Álvarez LC, Benavidez S, Téllez RP, Santofimio D, Ramos JA, Gomez CA. Factores asociados a nefrotoxicidad por polimixina B en un hospital universitario de Neiva, Colombia. 2011-2015. Rev. Chilena. Infectol. [Internet]. 31 de marzo de 2017 [citado 26 de noviembre de 2025];34(1). Disponible en: https://revinf.cl/index.php/revinf/article/view/1

Derechos de autor 2017 Revista Chilena de Infectología

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Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.

Resumen

Background: The rise of infections caused by multidrug-resistant Gram negative bacilli (MDR-GNB), added to paucity of newer therapy, have led to increase polymyxin B use, despite adverse renal toxicity profile.Aim: To determine the incidence and risk factors associated to acute kidney injury (AKI) and polymyxin B use, in patients with infections caused by MDR-GNB.

Methods: A retrospective cohort, with a nested case-control study of adults who received polymyxin B for more than 48 hours at a tertiary university hospital in Colombia (2011-2015) was performed. AKI was definedby AKIN criteria. Results: Of 139 patients included in our study, 102 were male with median age of 49 years (IQR:28-64). Sixty-one patients (44%) developed AKI. Independent risk factors for development of AKI included: total polymyxin B daily dose (OR = 2.19, 95% CI, 1.04-4.64); length of stay at ICU (OR = 1.03, 95% CI, 1.00-1.06); nosocomial infection (OR = 6.43, 95% CI, 2.12, -19.47); and vasopressor use (OR = 5.38, 95% CI, 2.40-12.07). Mortality was higher among AKI-patients (58.6%) compared with non-AKI patients (25.6%) (p = 0.001).

Conclusion: In this study, the rate of AKI associated to polymyxin B use was greater than reported in studies from last decade, and associated with increased mortality. AKI associated to polymyxin B use is likely multifactorial and aggravated by the critically ill state of patients sufferingnosocomial infections caused by mdr-gnb.

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