Antimicrobial resistance in Gram negative bacteria isolated from intensive care units of Colombian hospitals, WHONET 2003, 2004 and 2005
Keywords:
Epidemiologic surveillance, drug resistance, bacterial, Gram-negative bacteria, antibiotic, software
Abstract
Introduction. Surveillance systems play a key role in the detection and control of bacterial resistance. It is necessary to constantly collect information from all institutions because the mechanisms of bacterial resistance can operate in different ways between countries, cities and even in hospitals in the same area. Therefore local information is important in order to learnabout bacterial behaviour and design appropriate interventions for each institution. Between January 2003 and December 2004, the Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM) developed a surveillance project in 10 tertiary hospitals in 6 cities of Colombia.
Objectives. Describe the trends of antibiotic resistance among the isolates of Escherichia coli, Klebsiella pneumoniae, Pseudomona aeruginosa, Acinetobacter baumannii and Enterobacter cloacae, five of the most prevalent nosocomial Gram negative pathogens.
Materials and Methods: The susceptibility tests were performed by automated methods in 9 hospitals and by Kirby Bauer in 1 hospital. Antibiotics with known activity against Gram negatives,
according to the Clinical Laboratory Standards Institute guidelines, were selected. The laboratories performed internal and external quality controls. During the study period, the information was downloaded monthly from the databases of each microbiology laboratory and sent to CIDEIM where it was centralized in a database using the system WHONET 5.3.
Results. The high resistance rates reported especially for A. baumannii, evidenced the presence of multidrug resistant bacteria in both ICUs and wards at every studied institution.
Conclusions. The creation of a national surveillance network to improve our capabilities to detect, follow up, and control the antibiotic resistance in Colombia is urgently needed.
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References
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13. Villegas MV, Correa A, Perez F, Zuluaga T, Radice M, Gutkind G, et al. CTX-M-12 beta-lactamase in a Klebsiella pneumoniae clinical isolate in Colombia. Antimicrob Agents Chemother 2004;48:629-31.
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19. Schiappa DA, Hayden MK, Matushek MG, Hashemi FN, Sullivan J, Smith KY, et al. Ceftazidime-resistant Klebsiella pneumoniae and Escherichia coli bloodstream infection: a case-control and molecular epidemiologic investigation. J Infect Dis 1996;174:529-36.
20. Wong-Beringer A, Hindler J, Loeloff M, Queenan AM, Lee N, Peggues DA, et al. Molecular correlation for the treatment outcomes in bloodstream infections caused by Escherichia coli and Klebsiella pneumoniae with reduced susceptibility to ceftazidime. Clin Infect Dis 2002;34:135-46.
21. Livermore DM. Beta-lactamases in laboratory and clinical resistance. Clin Microbiol 1995;8:557-84.
22. Livermore DM. Multiple mechanism of antimicrobial resistance in Pseudomonas aeruginosa: Our worst nightmare? Clin Infect Dis 2002;34:634-40.
23. Higgins PG, Wisplinghoff H, Stefanik D, Seifert H. In vitro activities of beta-lactamase inhibitors clavulanic acid sulbactam, and tazobactam alone or in combination with beta-lactams against epidemiologically characterized multidrug-resistant Acinetobacter baumannii strains. Antimmicrob Agents Chemother 2004;48:1586-92.
24. Gales AC, Jones RN, Forward KR, Liñares J, Sader HS, Verhoef J. Emerging importance of multidrugresistant Acinetobacter species and Stenotrophomonas maltophilia as pathogens in seriously ill patients: geographic patterns, epidemiological features and trends in the SENTRY Antimicrobial Surveillance Program (1997-1999). Clin Infect Dis 2001;32(Suppl 2):S104-13.
25. Villegas MV, Hartstein AI. Acinetobacter outbreaks, 1977-2000. Infect Control Hosp Epidemiol 2003;24:284-95.
26. Scerpella EG, Wanger AR, Armitige L, Anderlini P, Ericsson CD. Nosocomial outbreak caused by a multiresistant clone of Acinetobacter baumannii: results of the case-control and molecular epidemiologic investigations. Infect Control Hosp Epidemiol 1995;2:92-7.
27. Chow JW, Fine MJ, Shlaes DM, 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.
28. Richet HM, Mohammed J, McDonald C, Jarvis WR, INSPEAR. Building communication networks: international network for the study and prevention of emerging antimicrobial resistance. Emerg Infect Dis
2001;7:319-22.
2. Organización Mundial de la Salud. Estrategia mundial de la OMS para contener la resistencia a los antimicrobianos. Ginebra: WHO; 2001.p.11-7.
3. Winokur PL, Canton R, Casellas JM, Legakis N. Variations in the prevalence of strains expressing an extended-spectrum beta-lactamase phenotype and characterization of isolates from Europe, the Americas, and the Western Pacific region. Clin Infect Dis 2001;32(Suppl. 2):S94-103.
4. Klaucke DN, Buehler JW, Thacker SB, Parrish RG, Tiowbridge FL, Berkelman RL. Guidelines for evaluating surveillance systems. MMWR Morb Mortal Wkly Rep 1988;37(Suppl 5):1-18.
5. World Health Organization. Surveillance standards for antimicrobial resistance. Geneva: WHO; 2002.
6. O'Brien TF, Stelling JM. WHONET: an information system for monitoring antimicrobial resistance. Emerg Infect Dis 1995:1;66.
7. Bax R, Bywater R, Cornaglia G, Goossens H, Hunter P, Isham V, et al. Surveillance of antimicrobial resistance: what, how and whither? Clin Microbiol Infect 2001;7:316-25.
8. Rossi A, Tokumoto M, Galas M, Soloaga R, Corso A. Monitoring antibiotic resistance in Argentina. The WHONET program 1995-1996. Rev Panam Salud Publica 1999;6:234-41.
9. Sader HS, Gales AC, Pfaller MA, Mendes RE, Zoccoli C, Barth A, et al. Pathogen frequency and resistance patterns in Brazilian hospitals: summary of results from three years of the SENTRY Antimicrobial Surveillance Program. Braz J Infect Dis 2001;5:200-14.
10. Valdivieso F, Trucco O, Prado V, Diaz MC, Ojeda A. Antimicrobial resistance of agents causing urinary tract infections in 11 Chilean hospitals. PRONARES project. Rev Med Chil 1999;127:1033-40.
11. Comegna M, Guzmán BM, Carmona O, Molina M, Grupo Colaborativo Venezolano de Resistencia Bacteriana. Resistencia bacteriana a los antimicrobianos en Venezuela-Nuevos hallazgos. Bol Soc Ven Microb 2000;20:58-63
12. Villegas MV, Correa A, Perez F, Miranda MC, Zuluaga T, Quinn JP, et al. Prevalence and characterization of extended-spectrum beta-lactamases in Klebsiella pneumoniae and Escherichia coli isolates from Colombian hospitals. Diagn Microbiol Infect Dis 2004;49:217-22.
13. Villegas MV, Correa A, Perez F, Zuluaga T, Radice M, Gutkind G, et al. CTX-M-12 beta-lactamase in a Klebsiella pneumoniae clinical isolate in Colombia. Antimicrob Agents Chemother 2004;48:629-31.
14. Centers for Disease Control and Prevention (CDC). Laboratory capacity to detect antimicrobial resistance 1998. MMWR Morb Mortal Wkly Rep 2000;48:1167-71.
15. NCCLS. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard M7-A6. 6th edition. Vol. 23. Wayne PA: National Committee for Clinical Laboratory Standards; 2003.
16. Sader HS, Jones RN, Gales AC, Silva JB, Pignatari AC, SENTRY Participants Group (Latin America). SENTRY antimicrobial surveinllance program report: Latin American and Brazilian results for 1997 through 2001. Braz J Infect Dis 2004;8:25-79.
17. Mandel GL, Bennett JE, Dolin R. Principles and practices of infectious diseases. 6th edition. New York: Churchill Livingston Inc; 2005.
18. Naumovski L, Quinn JP, Miyashiro D, Patel M, Bush K, Singer SB, et al. Outbreak of ceftazidime resistance due to a novel extended-spectrum b-lactamase in isolates from cancer patients. Antimicrob Agents Chemother 1992;36:1991-6.
19. Schiappa DA, Hayden MK, Matushek MG, Hashemi FN, Sullivan J, Smith KY, et al. Ceftazidime-resistant Klebsiella pneumoniae and Escherichia coli bloodstream infection: a case-control and molecular epidemiologic investigation. J Infect Dis 1996;174:529-36.
20. Wong-Beringer A, Hindler J, Loeloff M, Queenan AM, Lee N, Peggues DA, et al. Molecular correlation for the treatment outcomes in bloodstream infections caused by Escherichia coli and Klebsiella pneumoniae with reduced susceptibility to ceftazidime. Clin Infect Dis 2002;34:135-46.
21. Livermore DM. Beta-lactamases in laboratory and clinical resistance. Clin Microbiol 1995;8:557-84.
22. Livermore DM. Multiple mechanism of antimicrobial resistance in Pseudomonas aeruginosa: Our worst nightmare? Clin Infect Dis 2002;34:634-40.
23. Higgins PG, Wisplinghoff H, Stefanik D, Seifert H. In vitro activities of beta-lactamase inhibitors clavulanic acid sulbactam, and tazobactam alone or in combination with beta-lactams against epidemiologically characterized multidrug-resistant Acinetobacter baumannii strains. Antimmicrob Agents Chemother 2004;48:1586-92.
24. Gales AC, Jones RN, Forward KR, Liñares J, Sader HS, Verhoef J. Emerging importance of multidrugresistant Acinetobacter species and Stenotrophomonas maltophilia as pathogens in seriously ill patients: geographic patterns, epidemiological features and trends in the SENTRY Antimicrobial Surveillance Program (1997-1999). Clin Infect Dis 2001;32(Suppl 2):S104-13.
25. Villegas MV, Hartstein AI. Acinetobacter outbreaks, 1977-2000. Infect Control Hosp Epidemiol 2003;24:284-95.
26. Scerpella EG, Wanger AR, Armitige L, Anderlini P, Ericsson CD. Nosocomial outbreak caused by a multiresistant clone of Acinetobacter baumannii: results of the case-control and molecular epidemiologic investigations. Infect Control Hosp Epidemiol 1995;2:92-7.
27. Chow JW, Fine MJ, Shlaes DM, 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.
28. Richet HM, Mohammed J, McDonald C, Jarvis WR, INSPEAR. Building communication networks: international network for the study and prevention of emerging antimicrobial resistance. Emerg Infect Dis
2001;7:319-22.
How to Cite
1.
Miranda MC, Pérez F, Zuluaga T, Olivera M del R, Correa A, Reyes SL, et al. Antimicrobial resistance in Gram negative bacteria isolated from intensive care units of Colombian hospitals, WHONET 2003, 2004 and 2005. Biomed. [Internet]. 2006 Sep. 1 [cited 2025 Apr. 4];26(3):424-33. Available from: https://revistabiomedicaorg.biteca.online/index.php/biomedica/article/view/361
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