Abstract

LOPEZ-MARTINEZ, Briceida et al. Institutional vigilance of antimicrobial susceptibility in pathogens of clinical interest. Bol. Med. Hosp. Infant. Mex. [online]. 2013, vol.70, n.3, pp.222-229. ISSN 1665-1146.

Background. The increased resistance of microorganisms to antibiotics has led to an increase in morbidity and mortality from infections, increased use of antibiotics and excessive hospitalization costs. Therefore, the aim of this study was to describe the frequency of pathogens and bacterial susceptibility patterns in cultures of blood, urine and other body fluids in a tertiary pediatric hospital. We also aimed to determine the patterns of resistance in pathogens of clinical interest isolated in blood, urine and other sterile liquids in a pediatric teaching center and third-level hospital. Methods. The Institutional Antimicrobial Surveillance Program was established to monitor the predominant pathogens and antimicrobial susceptibility patterns of infections such as bacteremia, pneumonia and urinary infections. The species of each isolate was determined according to routine methodology and Vitek system from January 2010 to June 2011. Antimicrobial agents and susceptibility testing were determined using the Vitek 2XL according to the Clinical and Laboratory Standards Institute. Results. We recovered 7708 isolates from 27,209 cultures (28.3%). Gram negative represented 52.7%. A rank order showed Staphylococcus coagulase-negative , Escherichia coli, Enterococcus spp ., Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae and others. The antimicrobial susceptibility of the most frequently encountered pathogens was variable. E. coli showed the highest resistance to trimethopim-sulfamethoxazole and ampicillin-sulbactam (74 and 68%, respectively) finding the best option to be nitrofurantoin and imipenem with 84 and 100% sensitivity, respectively. Enterococcus faecium resistance was 58% vancomycin, and Streptococcus pneumoniae showed 100% sensitivity to vancomycin. Conclusions. This study emphasizes the problem of resistance and the needs to select an appropriate broad-spectrum empirical regimen guided by the knowledge of pathogen occurrences and local/regional/global resistance patterns. Such practices require the interrelation between clinical microbiology laboratories and hospital pharmacies.

Keywords : antimicrobial susceptibility; multidrug-resistant Gram-negative; Gram-positive resistant patterns.