Results of the national surveillance of antimicrobial resistance of Enterobacteriaceae and Gram negative bacilli in health care-associated infections in Colombia, 2012-2014

Introduction: The Colombian National Antimicrobial Resistance Monitoring System for the surveillance of healthcare-associated infections was set up to meet this problem in the third quarter of 2012. Objective: To describe resistance profiles and laboratory-based surveillance based on the information...

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Bibliographic Details
Published in:Biomédica
Main Authors: María Victoria Ovalle, Sandra Yamile Saavedra, María Nilse González, Andrea Melissa Hidalgo, Carolina Duarte, Mauricio Beltrán
Format: Article in Journal/Newspaper
Language:English
Spanish
Published: Instituto Nacional de Salud 2017
Subjects:
Drug resistance
microbial
bacterial infections
surveillance
carbapenems
Enterobacteriaceae
Acinetobacter
Pseudomonas
Medicine
R
Arctic medicine. Tropical medicine
RC955-962
Arctic
Online Access:https://doi.org/10.7705/biomedica.v37i4.3432
https://doaj.org/article/61850d3f1e214cfe9f44c46c929a16bf
Description
Summary:Introduction: The Colombian National Antimicrobial Resistance Monitoring System for the surveillance of healthcare-associated infections was set up to meet this problem in the third quarter of 2012. Objective: To describe resistance profiles and laboratory-based surveillance based on the information collected by the System. Materials and methods: We conducted a retrospective and descriptive study of the information notified to the Colombian Public Health Surveillance System (Sivigila), and in the Whonet databases covering the period from July 2012 to December 2014 provided by the primary data-generating units in the country, as well as laboratory surveillance results from 1,642 phenotypic and genotypic tests on carbapenemase isolates (927 from Enterobacteriaceae, 614 from Pseudomonas spp. and 101 from Acinetobacter spp.). Results: There was a significant increase in Escherichia coli resistance to third-generation cephalosporins (reaching 26.3% in ICUs and 22.5% in other hospital wards), and Klebsiella pneumoniae resistance to ertapenem also increased (reaching 14.6% in ICUs). Acinetobacter baumannii carbapenem resistance exceeded 50% in ICUs whereas Pseudomonas aeruginosa had lower carbapenem resistance (38.8%). KPC (n = 574) and NDM (n=57) were the most frequently occurring carbapenemases in Enterobacteriaceae, VIM (n=229) and KPC (n=114) in P. aeruginosa, and OXA-23 in A. baumannii (n=87); several carbapenemase combinations were identified, KPC + VIM being the most common in Pseudomonas spp. and Enterobacteriaceae. Conclusion: The data from the surveillance of healthcare-associated infections revealed significant carbapenem resistance profiles and antimicrobial resistance mechanisms circulating in Colombian healthcare institutions.

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