Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Bloodstream Infections in Peru and Associated Outcomes: VIRAPERU Study-Reference-Cited by-同舟云学术

Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Bloodstream Infections in Peru and Associated Outcomes: VIRAPERU Study

Published:2023-11-01 Issue:5 Volume:109 Page:1095-1106
ISSN:0002-9637
Container-title:The American Journal of Tropical Medicine and Hygiene
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Author:

Krapp Fiorella¹²,García Coralith¹³,Hinostroza Noemi⁴,Astocondor Lizeth⁴,Rondon Claudia R.⁴,Ingelbeen Brecht⁵⁶,Alpaca-Salvador Hugo A.⁷⁸,Amaro Catherine⁹,Aguado Ventura Carla¹⁰,Barco-Yaipén Evelyn¹¹,Bocangel Fernandez Cesar¹²¹³,Briones Alexander¹⁴,Burgos Antonio¹⁵,Campana Rene¹⁶,Castillo Kelly¹⁷,Castañeda-Sabogal Alex¹⁸¹⁹,Coaquira Angelica²⁰,Concha-Velasco Fátima²¹²²,Cuadros Edwin Cuaresma²³,Chincha Omayra³,Diaz Juan Carlos²⁴²⁵,Díaz Sipión Roberto²⁶,Fernandez Victor²⁷,Hueda-Zavaleta Miguel²⁸²⁹,López Enrique³⁰,Valera-Krumdieck María³¹,Vásquez Rubén³²,Vidaurre Torres Ana María³³³⁴,Villegas-Chiroque Miguel³⁵,Sarmiento Lopez Favio³⁶,Sullón Zavaleta Pedro Alberto³⁷,Sierra Chavez Elizett³⁸,Paricahua Peralta Eduardo³⁹,Peralta Córdova Teresa⁴⁰,Pino-Dueñas Jimena Edith⁴¹,Jacobs Jan²⁵

Affiliation:

1. Instituto de Medicina Tropical Alexander von Humboldt and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru;

2. Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium;

3. Department of Infectious and Tropical Diseases and Dermatology, Hospital Cayetano Heredia, Lima, Peru;

4. Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru;

5. Institute of Tropical Medicine Antwerp, Antwerp, Belgium;

6. Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, the Netherlands;

7. Servicio de Patología Clínica, Hospital III de Chimbote de EsSalud Ancash, Chimbote, Peru;

8. Escuela de Medicina, Universidad Nacional del Santa, Chimbote, Peru;

9. Departamento de Patología Clínica y Anatomía Patológica, Hospital Cayetano Heredia, Lima, Peru;

10. Laboratorio Central, Hospital Regional de Ica, Ica, Peru;

11. Departamento de Patología Clínica, Hospital Regional José Alfredo Mendoza Olavarría, Tumbes, Peru;

12. Departamento de Medicina Interna, Hospital III Goyeneche, Arequipa, Peru;

13. School of Medicine, Universidad Nacional de San Agustín, Arequipa, Peru;

14. Departamento de Patología Clínica y Anatomía Patológica, Hospital Regional de Loreto Felipe Santiago Arriola Iglesias, Iquitos, Peru;

15. Departamento de Patología Clínica y Anatomía Patológica, Hospital Regional de Pucallpa, Pucallpa, Peru;

16. Departamento de Patología Clínica y Anatomía Patológica, Hospital III Goyeneche, Arequipa, Peru;

17. Departamento de Patología Clínica y Anatomía Patológica, Hospital Belén de Trujillo, Trujillo, Peru;

18. Departamento de Medicina, Hospital Base Víctor Lazarte Echegaray de EsSalud La Libertad, Trujillo, Peru;

19. School of Medicine, Universidad Cesar Vallejo, Trujillo, Peru;

20. Departamento de Patología Clínica y Anatomía Patológica, Hospital Santa Rosa de Puerto Maldonado, Madre de Dios, Peru;

21. Departamento de Medicina, Hospital Antonio Lorena, Cusco, Peru;

22. Departamento de Medicina, Universidad Nacional San Antonio Abad del Cusco, Cusco, Peru;

23. Departamento de Ayuda al Diagnóstico y Tratamiento, Hospital III Daniel Alcides Carrión EsSalud Tacna, Tacna, Peru;

24. Departamento de Medicina, Hospital Regional de Ica, Ica, Peru;

25. School of Medicine, Universidad San Luis Gonzaga de Ica, Ica, Peru;

26. Departamento de Ayuda al Diagnóstico y Tratamiento, Hospital Regional Lambayeque, Chiclayo, Peru;

27. Departamento de Medicina Interna, Hospital Belén de Trujillo, Trujillo, Peru;

28. Departamento de Medicina, Hospital III Daniel Alcides Carrión Essalud Tacna, Tacna, Peru;

29. Facultad de Ciencias de la Salud, Universidad Privada de Tacna, Tacna, Peru;

30. Departamento de Medicina, Hospital Regional de Loreto Felipe Santiago Arriola Iglesias, Iquitos, Peru;

31. Departamento de Patología Clínica y Anatomía Patológica, Hospital María Auxiliadora, Lima, Peru;

32. Servicio de Infectología y Medicina Tropical, Hospital María Auxiliadora, Lima, Peru;

33. Departamento de Medicina, Hospital III de Chimbote EsSalud Ancash, Chimbote, Peru;

34. Facultad de Ciencias de la Salud, Universidad Cesar Vallejo, Chimbote, Peru;

35. Departamento Áreas Clínicas, Hospital Regional Lambayeque, Chiclayo, Peru;

36. Departamento de Medicina, Hospital Regional de Pucallpa, Pucallpa, Peru;

37. Departamento de Especialidades Médicas, Hospital Nacional Hipólito Unanue, Lima, Peru;

38. Departamento de Patología Clínica y Anatomía Patológica, Hospital Nacional Hipólito Unanue, Lima, Peru;

39. Departamento de Medicina, Hospital Santa Rosa de Puerto Maldonado, Madre de Dios, Peru;

40. Departamento de Ayuda al Diagnóstico y Tratamiento, Hospital Base Víctor Lazarte Echegaray de EsSalud La Libertad, Trujillo, Peru;

41. UPSS Patología Clínica, Servicio de Microbiología, Hospital Antonio Lorena Cusco, Cusco, Peru

Abstract

ABSTRACT. Surveillance of antimicrobial resistance among gram-negative bacteria (GNB) is of critical importance, but data for Peru are not available. To fill this gap, a non-interventional hospital-based surveillance study was conducted in 15 hospitals across Peru from July 2017 to October 2019. Consecutive unique blood culture isolates of key GNB (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp.) recovered from hospitalized patients were collected for centralized antimicrobial susceptibility testing, along with linked epidemiological and clinical data. A total of 449 isolates were included in the analysis. Resistance to third-generation cephalosporins (3GCs) was present in 266 (59.2%) GNB isolates. Among E. coli (n = 199), 68.3% showed 3GC resistance (i.e., above the median ratio for low- and middle-income countries in 2020 for this sustainable development goal indicator). Carbapenem resistance was present in 74 (16.5%) GNB isolates, with wide variation among species (0% in E. coli, 11.0% in K. pneumoniae, 37.0% in P. aeruginosa, and 60.8% in Acinetobacter spp. isolates). Co-resistance to carbapenems and colistin was found in seven (1.6%) GNB isolates. Empiric treatment covered the causative GNB in 63.3% of 215 cases. The in-hospital case fatality ratio was 33.3% (92/276). Pseudomonas aeruginosa species and carbapenem resistance were associated with higher risk of in-hospital death. In conclusion, an important proportion of bloodstream infections in Peru are caused by highly resistant GNB and are associated with high in-hospital mortality.

Publisher

American Society of Tropical Medicine and Hygiene

Subject

Virology,Infectious Diseases,Parasitology

Link

https://www.ajtmh.org/downloadpdf/journals/tpmd/109/5/article-p1095.xml

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