Cross-border antibiotic resistance patterns in trauma patients

Area of Science:

• Infectious Diseases
• Public Health
• Microbiology

Background:

• Antibiotic resistance is a significant global health challenge.
• Disparities in antibiotic stewardship contribute to regional resistance patterns.
• Increased identification of resistant organisms in US-Mexico border hospitals raises concerns about cross-border transmission.

Purpose of the Study:

• To compare antibiotic resistance patterns in trauma patients admitted to hospitals along the US-Mexico border.
• To identify risk factors associated with resistant infections in this population.

Main Methods:

• Retrospective review of trauma admissions from March 2011 to August 2015.
• Inclusion criteria: cultures obtained within the first 3 days of hospitalization.
• Matched cohort subanalysis comparing Mexico and US patients to mitigate bias.

Main Results:

• Mexico patients were younger with higher injury severity and longer hospital stays, though these differences normalized in matched analysis.
• Infections and resistant infections, including gram-negative bacteria, were more common in Mexico patients.
• Extended-spectrum β-lactamase Klebsiella was identified exclusively in Mexico patients; methicillin-resistant Staphylococcus aureus was the only resistant organism in matched US patients.

Conclusions:

• Antibiotic resistance is more common in patients initially treated in Mexico healthcare facilities.
• Alternative empiric treatment strategies may be necessary for patients treated in Mexico.
• Global initiatives for antibiotic stewardship are essential to curb the rise of drug-resistant infections.