Antimicrobial resistance of Gram negative bacilli isolated from terciary-care hospitals in Colombia
Keywords:
Gram-negative bacteria, drug resistance, bacterial, epidemiologic surveillance, Colombia
Abstract
Introduction. Antimicrobial resistance has been identified as one of the major public health problems worldwide. To facilitate its control, bacterial resistance levels must be monitored permanently by effective surveillance systems.Objective. To describe the antimicrobial resistance patterns of Gram negative bacilli in Colombian hospitals over a 3-year period.
Materials and methods. This descriptive study used the bacterial susceptibility profiles provided by 14 tertiary-care hospitals belonging to the Colombian Nosocomial Resistance Study Group. The hospitals were located in 7 major cities in Colombia, and provided records over the period January 2006 to December 2008. Using WHONET 5.4, the antimicrobial resistance patterns were described for the Enterobacteriaceae (Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae) and non-fermenters (Pseudomonas aeruginosa and Acinetobacter baumannii). Comparisons were made in the bacterial responses to selected antibiotics in samples from general wards and from adult intensive care units.
Results. The antimicrobial resistance frequencies of several Enterobacteriaceae species showed a decreasing trend. In contrast, P. aeruginosa was demonstrated to be a multidrug-resistance organism with increasing resistance frequencies.
Conclusions. These data emphasize the importance of surveillance programs in detecting presence of multidrug-resistant organisms. This information will aid the implementation of protocols aimed to strengthen the infection control strategies and antibiotic stewardship in each hospital.
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References
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24. Chow J, Fine M, Shlaes D, Quinn JP, Hooper DC, Johnson MP, et al. Enterobacter bacteremia: Clinical features and emergence of antibiotic resistance during therapy. Ann Intern Med. 1991;115:585-90.
25. Jacoby GA. AmpC beta-lactamases. Clin Microbiol Rev. 2009;22:161-82.
26. Villegas MV, Lolans K, Correa A, Kattan JN, López JA, Quinn JP. First Identification of Pseudomonas aeruginosa isolates producing a KPC-type carbapenem-hydrolyzing β-lactamase. Antimicrob Agents Chemother. 2007;5:1553-5.
27. Paterson DL, Ko WC, Von GA, Mohapatra S, Casellas JM, Goossens H, et al. Antibiotic therapy for Klebsiella pneumoniae bacteremia: implications of production of extended-spectrum β-lactamases. Clin Infect Dis. 2004;39:31-7.
28. Paterson DL, Depestel DD. Doripenem. Clin Infect Dis. 2009;49:291-8.
29. Oudhuis GJ, Verbon A, Hoogkamp-Korstanje JA, Stobberingh EE. Antimicrobial resistance in Escherichia coli and Pseudomonas aeruginosa from intensive care units in The Netherlands, 1998-2005. Int J Antimicrob Agents. 2008;31:58-63.
30. Gales AC, Jones RN, Turnidge J, Rennie R, Ramphal R. Characterization of Pseudomonas aeruginosa isolates: occurrence rates, antimicrobial susceptibility patterns, and molecular typing in the global SENTRY Antimicrobial Surveillance Program, 1997-1999. Clin Infect Dis. 2001;32(Suppl.2):S146-55.
31. Paterson DL. The role of antimicrobial management programs in optimizing antibiotic prescribing within hospitals. Clin Infect Dis. 2006;42(Suppl.2):S90-5.
32. Ibrahim EH, Ward S, Sherman G, Schaiff R, Fraser VJ, Kollef MH. Experience with a clinical guideline for the treatment of ventilator-associated pneumonia. Crit Care Med. 2001;29:1109-15.
33. File TM. The science of selecting antimicrobials for community-acquired pneumonia (CAP). J Manag Care Pharm. 2009;15(Suppl.V):S5-11.
2. Critchley IA, Karlowsky JA. Optimal use of antibiotic resistance surveillance systems. Clin Microbiol Infect. 2004;10:502-11.
3. Tokars JI, Richards C, Andrus M, Klevens M, Curtis A, Horan T, et al. The changing face of surveillance for health care-associated infections. Clin Infect Dis. 2004;39:1347-52.
4. Jones RN, Mendes C, Turner PJ, Masterton R. An overview of the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program: 1997-2004. Diagn Microbiol Infect Dis. 2005;53:247-56.
5. Falagas ME, Karageorgopoulos DE. Pandrug resistance (PDR), extensive drug resistance (XDR), and multidrug resistance (MDR) among Gram-negative bacilli: need for international harmonization in terminology. Clin Infect Dis. 2008;46:1121-2.
6. Masterton R. The importance and future of antimicrobial surveillance studies. Clin Infect Dis. 2008;47(Suppl.1):S21-31.
7. Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest. 1999;115:462-74.
8. Leal AL, Eslava-Schmalbach J, Álvarez C, Buitrago G, Méndez M. Endemic tendencies and bacterial resistance markers in third-level hospitals in Bogotá, Colombia. Rev Salud Pública (Bogotá). 2006;8(Suppl.1):59-70.
9. Villegas MV, Correa A, Pérez F, Miranda MC, Zuluaga T, Quinn JP, et al. Prevalence and characterization of extended-spectrum β-lactamases in Klebsiella pneumoniae and Escherichia coli isolates from Colombian hospitals. Diagn Microbiol Infect Dis. 2004;49:217-22.
10. Villegas MV, Lolans K, Correa A, Suárez CJ, López JA, Vallejo M, et al. First detection of the plasmid-mediated class A carbapenemase KPC-2 in clinical isolates of Klebsiella pneumoniae from South America. Antimicrob Agents Chemother. 2006;50:2880-2.
11. Villegas MV, Kattan JN, Correa A, Lolans K, Guzmán AM, Woodford N, et al. Dissemination of Acinetobacter baumannii clones with OXA-23 Carbapenemase in Colombian hospitals. Antimicrob Agents Chemother. 2007;5:2001-4.
12. Miranda MC, Pérez F, Zuluaga T, Olivera MR, Correa A, Reyes SL, et al. Resistencia a antimicrobianos en bacilos Gram negativos aislados en unidades de cuidado intensivo en hospitales de Colombia, WHONET 2003, 2004 y 2005. Biomédica. 2006;26:424-33.
13. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36:309-32.
14. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; 19th Informational Supplement. CLSI document M100-S19. Wayne, PA: Clinical and Laboratory Standards Institute; 2009.
15. Stelling JM, O'Brien TF. Surveillance of antimicrobial resistance: the WHONET program. Clin Infect Dis. 1997;24(Suppl.1):S157-68.
16. Jones RN. Global epidemiology of antimicrobial resistance among community-acquired and nosocomial pathogens: a five-year summary from the SENTRY Antimicrobial Surveillance Program (1997-2001). Semin Respir Crit Care Med. 2003;24:121-34.
17. Quinn JP. Pseudomonas aeruginosa infections in the intensive care unit. Semin Respir Crit Care Med. 2003;24:61-8.
18. Giske CG, Monnet DL, Cars O, Carmeli Y. Clinical and economic impact of common multidrug-resistant Gram-negative bacilli. Antimicrob Agents Chemother. 2008;52: 813-21.
19. Livermore DM, Woodford N. The β-lactamase threat in Enterobacteriaceae, Pseudomonas and Acinetobacter. Trends Microbiol. 2006;14:413-20.
20. Schwaber MJ, Navon-Venezia S, Schwartz D, Carmeli Y. High levels of antimicrobial coresistance among extended-spectrum-β-lactamase-producing Enterobacteriaceae. Antimicrob Agents Chemother. 2005;49:2137-9.
21. Rahal JJ, Urban C, Horn D, Freeman K, Segal-Maurer S, Maurer J, et al. Class restriction of cephalosporin use to control total cephalosporin resistance in nosocomial Klebsiella. JAMA. 1998;280:1233-7.
22. Rice LB, Eckstein EC, DeVente J, Shlaes DM. Ceftazidime-resistant Klebsiella pneumoniae isolates recovered at the Cleveland Department of Veterans Affairs Medical Center. Clin Infect Dis. 1996;23:118-24.
23. Lucet JC, Decre D, Fichelle A, Joly-Guillou ML, Pernet M, Deblangy C, et al. Control of a prolonged outbreak of extended-spectrum β-lactamase-producing Enterobacteriaceae in a university hospital. Clin Infect Dis. 1999;29:1411-8.
24. Chow J, Fine M, Shlaes D, Quinn JP, Hooper DC, Johnson MP, et al. Enterobacter bacteremia: Clinical features and emergence of antibiotic resistance during therapy. Ann Intern Med. 1991;115:585-90.
25. Jacoby GA. AmpC beta-lactamases. Clin Microbiol Rev. 2009;22:161-82.
26. Villegas MV, Lolans K, Correa A, Kattan JN, López JA, Quinn JP. First Identification of Pseudomonas aeruginosa isolates producing a KPC-type carbapenem-hydrolyzing β-lactamase. Antimicrob Agents Chemother. 2007;5:1553-5.
27. Paterson DL, Ko WC, Von GA, Mohapatra S, Casellas JM, Goossens H, et al. Antibiotic therapy for Klebsiella pneumoniae bacteremia: implications of production of extended-spectrum β-lactamases. Clin Infect Dis. 2004;39:31-7.
28. Paterson DL, Depestel DD. Doripenem. Clin Infect Dis. 2009;49:291-8.
29. Oudhuis GJ, Verbon A, Hoogkamp-Korstanje JA, Stobberingh EE. Antimicrobial resistance in Escherichia coli and Pseudomonas aeruginosa from intensive care units in The Netherlands, 1998-2005. Int J Antimicrob Agents. 2008;31:58-63.
30. Gales AC, Jones RN, Turnidge J, Rennie R, Ramphal R. Characterization of Pseudomonas aeruginosa isolates: occurrence rates, antimicrobial susceptibility patterns, and molecular typing in the global SENTRY Antimicrobial Surveillance Program, 1997-1999. Clin Infect Dis. 2001;32(Suppl.2):S146-55.
31. Paterson DL. The role of antimicrobial management programs in optimizing antibiotic prescribing within hospitals. Clin Infect Dis. 2006;42(Suppl.2):S90-5.
32. Ibrahim EH, Ward S, Sherman G, Schaiff R, Fraser VJ, Kollef MH. Experience with a clinical guideline for the treatment of ventilator-associated pneumonia. Crit Care Med. 2001;29:1109-15.
33. File TM. The science of selecting antimicrobials for community-acquired pneumonia (CAP). J Manag Care Pharm. 2009;15(Suppl.V):S5-11.
How to Cite
1.
Briceño DF, Correa A, Valencia C, Torres JA, Pacheco R, Montealegre MC, et al. Antimicrobial resistance of Gram negative bacilli isolated from terciary-care hospitals in Colombia. Biomed. [Internet]. 2010 Sep. 30 [cited 2026 Jan. 13];30(3):371-81. Available from: https://revistabiomedicaorg.biteca.online/index.php/biomedica/article/view/271
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Published
2010-09-30
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