Antimicrobial resistance of bacteria grown in the Adult Intensive Care Unit of the Hospital de la Mujer, Puebla

Abstract

The medical protocols for action against nosocomial infections in Intensive Care Units are specific in order to avoid the occurrence of multi-drug resistant microbial strains. The objective of this research was to determine the frequency of multiresistant antimicrobial strains in the Adult Intensive Care Unit (AICU) with recurrence of hospitalization. A retrospective, observational and cross-sectional study was carried out at the Hospital de la Mujer, Puebla. The cultures with positive bacterial isolation, obtained from June 21, 2015 to October 2, 2017, from female patients older than 8 years admitted to the AICU for any cause were analyzed. Frequency and proportion of susceptibility and resistance to specific antibiotics were calculated for each bacterial strain, reporting only those antimicrobials recommended by the Clinical and Laboratory Standards Institute (CLSI) for each bacterial group as based on algorithms and in the patient isolation. 214 isolates were analyzed, reporting a total of 18 bacterial species, the most frequent being Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanii, Staphylococcus aureus, Escherichia coli and Staphylococcus epidermidis. Extended Spectrum Beta-Lactamase (ESBL) producing E. coli was found in 26 % of the strains of E. coli, P. aeruginosa producing ESBL in 51 % of the isolates with a tendency to extensive drug resistance (XDR), A. baumanii, in XDR and with a tendency to pan-drug resistance (PDR) and S. aureus resistant to methicillin (MRSA) with a phenotypic pattern of in-hospital acquisition with a tendency to XDR. The isolates of pathogens of the ESKAPE group are a continuous problem in the Intensive Care Units, since the development of extensive drug resistance and pan-drug resistance are a real challenge in the treatment of these infections.