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Carbapenemase-Producing Bacteria Isolated from ICU Patients of a Peruvian Government Hospital during the COVID-19
David García-Cedrón1, Magaly De La Cruz Noriega2, Luis Cabanillas-Chirinos3
1Facultad de Ciencias de la Salud, Universidad César Vallejo, Trujillo 13001, Peru.
Abstract:
Background and Objectives: In Peru, the presence of antimicrobial-resistant bacteria is a constant concern in hospitals and has likely increased in frequency during the pandemic. The objective of the study was to analyze the frequency of carbapenemase-producing bacteria resistant to two carbapenems (Imipenem and Meropenem), which were isolated from Peruvian patients in the intensive care unit of the Victor Lazarte Echegaray Hospital in Trujillo (Peru) during the COVID-19 pandemic. Materials and Methods: The biological samples of the patients hospitalized in the ICU were processed in the Microbiology Diagnostic Laboratory of the Víctor Lazarte Echegaray Hospital between May 2021 and March 2022. Antimicrobial sensitivity was determined with the automated system AutoScan-4, and for the identification of the type of carbapenemase, the RESISIT-3 O.K.N K-SET cassettes were used. Results: The results show that 76 cultures (76/129) had resistance to the two carbapenems (imipenem or meropenem), where the most frequent were Klebsiella pneuomoniae (31.6%), Pseudomonas aeruginosa (26.3%), and Acinetobacter baumannii (14.5%). Pseudomonas aeruginosa cultures showed at least three carbapenemase types (KPC, NDM, and OXA-48), while A. baumannii, Escherichia coli, and Burkholderia cepacia complex presented at least two carbapenemases (NDM and OXA-48). The carbapenemase NDM was detected in Enterobacter cloacae, Morganella morganii, and Proteus mirabilis, while KPC was present in all Klebsiella pneumoniae and Klebsiella oxytoca cultures. Conclusions: The samples from patients hospitalized in the Victor Lazarte Echegaray Hospital ICU showed a high prevalence of imipenem- and meropenem-resistant bacteria. These findings are relevant and concerning from the perspective of antibiotic-resistant bacteria monitoring, control, and disinfection. Thus, an appropriate antibiotic policy must be implemented.
Insights
Antimicrobial resistance is a significant concern, with high rates of carbapenem-resistant bacteria found in Peruvian intensive care units. This study highlights the urgent need for enhanced antibiotic stewardship and infection control measures.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Antimicrobial resistance (AMR) poses a growing threat globally, particularly in hospital settings.
- The COVID-19 pandemic may have exacerbated the prevalence of resistant bacteria in healthcare facilities.
- Carbapenemase-producing Enterobacterales (CPE) are a critical public health concern due to limited treatment options.
Purpose of the Study:
- To determine the frequency of carbapenemase-producing bacteria resistant to imipenem and meropenem.
- To analyze the types of carbapenemases detected in isolates from intensive care unit (ICU) patients.
- To assess the prevalence of multidrug-resistant organisms during the COVID-19 pandemic in Peru.
Main Methods:
- Prospective study conducted at Victor Lazarte Echegaray Hospital, Trujillo, Peru (May 2021 - March 2022).
- Analysis of biological samples from ICU patients.
- Antimicrobial susceptibility testing using the AutoScan-4 automated system.
- Carbapenemase identification using RESISIT-3 O.K.N K-SET cassettes.
Main Results:
- 76 out of 129 cultures (58.9%) exhibited resistance to imipenem or meropenem.
- The most frequent resistant bacteria were *Klebsiella pneumoniae* (31.6%), *Pseudomonas aeruginosa* (26.3%), and *Acinetobacter baumannii* (14.5%).
- *P. aeruginosa* showed KPC, NDM, and OXA-48 carbapenemases; *A. baumannii*, *E. coli*, and *B. cepacia complex* showed NDM and OXA-48.
Conclusions:
- High prevalence of imipenem- and meropenem-resistant bacteria identified in ICU patients.
- Findings underscore the critical need for robust antibiotic resistance surveillance and control strategies.
- Implementation of an effective antibiotic policy is essential to combat rising antimicrobial resistance.
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