Tendencias de los fenotipos de resistencia bacteriana en hospitales públicos y privados de alta complejidad de Colombia

Authors:
  • MOMiguel Hernando Díaz Ortega
    Miguel Hernando Díaz Ortega
  • LGLiliana Isabel Barrero Garzón
    Liliana Isabel Barrero Garzón
  • SVSandra Milena Rivera Vargas
    Sandra Milena Rivera Vargas
  • DIDaibeth Elena Henríquez Iguarán
    Daibeth Elena Henríquez Iguarán
  • MBMaría Virginia Villegas Botero
    María Virginia Villegas Botero
  • CRCarlos Gonzalo Robledo Restrepo
    Carlos Gonzalo Robledo Restrepo
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Abstract
Describe and compare the frequency of bacterial resistance phenotypes of microorganisms obtained from patients in intensive care units (ICU) and other (non-ICU) high-complexity public and private hospital services in Colombia. A retrospective observational, analytical, multicenter study was conducted. The records from January 2007 to December 2009 on bacterial isolates and bacterial resistance phenotypes of microorganisms obtained from ICU and non-ICU patients in 79 high-complexity public and private hospitals were consolidated. The information was analyzed with the WHONET(®) 5.5 (WHO) software, following the 2009 recommendations of the Clinical and Laboratory Standards Institute, and summarized on an Excel(®) spreadsheet. A descriptive analysis with the calculation of proportions was performed. The trends were analyzed with Spearman rank correlation. The 2007-2009 trends for bacterial resistance phenotypes show increased percentages of vancomycin-resistant Enterococcus faecium, imipenem-resistant Klebsiella pneumoniae, ciprofloxacin-resistant K. pneumoniae, ceftazidime-resistant Escherichia coli and cefotaxime-resistant Enterobacter cloacae (r = 1, P < 0.01), and reduced percentages of ciprofloxacin-resistant E. coli, ceftazidime-resistant K. pneumoniae, oxacillin-resistant Staphylococcus aureus, ceftazidime-resistant Pseudomonas aeruginosa, and ciprofloxacin-resistant P. aeruginosa (r = -1, P < 0.01). The trend analysis presented in this study is the baseline for establishing a national epidemiological surveillance subsystem. The trends observed reveal that bacterial resistance to antimicrobial drugs in hospitals in Colombia is a dynamic phenomenon, with evidence of the emergence of vancomycin-resistant E. faecium and imipenem-resistant K. pneumoniae phenotypes in the hospitals.