Detección de B-lactamasas de expectro extendido y carbapenemasas en bacilos gram negativos aislados en pacientes del Hospital Manuel Ygnacio Monteros-Loja desde julio a noviembre del 2013
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2015
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La resistencia antibiótica representa un problema a nivel mundial, no solo en cuanto a su diagnóstico y descubrimiento, sino también en cuanto a su manejo y control. En los últimos años la resistencia a los antimicrobianos es aún más preocupante debido a la sorprendente rapidez con la se convirtió de un fenómeno localizado o de laboratorio a una epidemia mundial. Uno de los mecanismos de resistencia con mayor trascendencia clínica es la producción de β-lactamasas, enzimas que inhabilitan a los antibióticos β-lactámicos. El objetivo de este trabajo fue caracterizar fenotípicamente y analizar los mecanismos de resistencia bacteriana mediados por BLEE y carbapenemasas en bacilos Gram negativos, para ello se analizaron 540 aislamientos provenientes de diferentes muestras clínicas de pacientes que concurrieron al Hospital “Manuel Ygnacio Monteros” durante el período julio-noviembre 2013 en base a las recomendaciones del Clinical and Laboratory Standard Institute 2012. De las muestras analizadas el 37,8% mostraron resistencia a C3G, y de éstas 26,4% corresponden a cepas productoras de BLEE; por otro lado, el 11,2% mostró resistencia a carbapenémicos, y de éstas el 1,6% corresponden a cepas productoras de carbapenemasas. La presencia de BLEE se determinó con mayor frecuencia en E.coli (69,9%), mientras que la mayor frecuencia de carbapenemasas se registró en P. aeruginosa (55,6%). Los resultados denotan una alta prevalencia de cepas productoras de β-lactamasas en dicha entidad de salud a nivel intrahospitalario y ambulatorio, mientras que los microorganismos productores de carbapenamasas se presentaron únicamente a nivel intrahospitalario.
Antimicrobial resistance is a problem all over the world, not only in relation to its diagnosis but also in relation to its control and management. In the last ten years, the concern on antimicrobial resistance increases because the surprisingly velocity with which it quickly, from a laboratory located phenomenon, became a worldwide epidemic. One of the mechanisms of resistance with greater clinical significance is the production of β-lactamases, enzymes that inactivate the βlactam antibiotics. The aim of this study was to characterize phenotypically and to analyze the mechanisms of bacterial resistance mediated by ESBL and carbapenemases in Gram-negative bacilli. For this, 540 isolates obtained from different clinical samples of patients attended the hospital Manuel Ygnacio Monteros between July and November 2013 were analyzed following the 2012 CLSI recommendations. From all the analyzed strains, 37.8% showed to be resistant to C3G and 26.4% from these strains were ESBL producers. On the other hand, 11.2% showed resistance to carbapenems being 1.6% were carbapenemases producing strains. ESBL production was most frequent in E coli (69.69%) while the highest frequency of carbapenemases was found in P. aeruginosa (55.6%). The obtained results show a high prevalence of beta lactamase producer strains in this hospital in intra-hospitalary and ambulatory patients, whereas microorganisms producing carbapenemases where exclusively of intra-hospitalary origin.
Antimicrobial resistance is a problem all over the world, not only in relation to its diagnosis but also in relation to its control and management. In the last ten years, the concern on antimicrobial resistance increases because the surprisingly velocity with which it quickly, from a laboratory located phenomenon, became a worldwide epidemic. One of the mechanisms of resistance with greater clinical significance is the production of β-lactamases, enzymes that inactivate the βlactam antibiotics. The aim of this study was to characterize phenotypically and to analyze the mechanisms of bacterial resistance mediated by ESBL and carbapenemases in Gram-negative bacilli. For this, 540 isolates obtained from different clinical samples of patients attended the hospital Manuel Ygnacio Monteros between July and November 2013 were analyzed following the 2012 CLSI recommendations. From all the analyzed strains, 37.8% showed to be resistant to C3G and 26.4% from these strains were ESBL producers. On the other hand, 11.2% showed resistance to carbapenems being 1.6% were carbapenemases producing strains. ESBL production was most frequent in E coli (69.69%) while the highest frequency of carbapenemases was found in P. aeruginosa (55.6%). The obtained results show a high prevalence of beta lactamase producer strains in this hospital in intra-hospitalary and ambulatory patients, whereas microorganisms producing carbapenemases where exclusively of intra-hospitalary origin.
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Bacilos gram negativos, B-lactamasas, Antibióticos, IESS Hospital Manuel Ygnacio Monteros, Cantón Loja, Ecuador, Carbapenemasas, Epidemiología descriptiva, Estudios prospectivos