Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Bloodstream Infections in Peru and Associated...

Area of Science:

• Clinical Microbiology
• Infectious Diseases
• Public Health Surveillance

Background:

• Antimicrobial resistance (AMR) surveillance is crucial for effective treatment strategies.
• Limited data on AMR in Gram-negative bacteria (GNB) in Peru hinders public health efforts.
• Hospital-based surveillance is essential to understand local resistance patterns.

Purpose of the Study:

• To establish baseline data on AMR in key GNB bloodstream infections in Peru.
• To assess resistance patterns to third-generation cephalosporins and carbapenems.
• To evaluate the impact of AMR on clinical outcomes and empiric treatment efficacy.

Main Methods:

• A non-interventional, hospital-based surveillance study was conducted across 15 Peruvian hospitals.
• Blood culture isolates of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter spp. were collected from July 2017 to October 2019.
• Antimicrobial susceptibility testing was performed centrally, with linked clinical and epidemiological data.

Main Results:

• 59.2% of GNB isolates showed resistance to third-generation cephalosporins; 68.3% of E. coli were resistant.
• Carbapenem resistance was found in 16.5% of GNB, varying by species (0% in E. coli to 60.8% in Acinetobacter spp.).
• In-hospital mortality was 33.3%, with P. aeruginosa and carbapenem resistance as risk factors for death.

Conclusions:

• A substantial proportion of GNB bloodstream infections in Peru exhibit high-level antimicrobial resistance.
• Resistance to carbapenems and third-generation cephalosporins is prevalent, complicating treatment.
• AMR in GNB is associated with significant in-hospital mortality, underscoring the need for improved surveillance and stewardship.