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2021, Number 1

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Rev Cub Med Int Emerg 2021; 20 (1)

Antimicrobial resistance according to microbiological map and antimicrobial consumption

Ramírez GAD, Davas SRS, Vázquez VL, Valdés GI, Rego HJJ, Martínez CR

Language: Spanish
References: 20
Page:
PDF size: 479.31 Kb.


ABSTRACT

Introduction: Public health faces a global crisis due to bacterial resistance. Antibiotics are becoming less effective in Latin America.
Objective: To characterize the behavior of antimicrobial resistance, as well as the use of antibiotics and subsequent expenditures, in a Cuban intensive care unit.
Methods: An observational, descriptive, longitudinal and retrospective study was carried out from January 2015 to December 2018, in the Intensive Care Unit at Dr. Salvador Allende Hospital in Havana, Cuba. The sample was represented by the positivity of isolates and their respective antibiograms (123 isolates). The variables analyzed were type of samples (respiratory, blood cultures, skin, catheter, cavity), isolated pathogen, percentages of resistance to the used antibiotic discs, monetary expenditure on antimicrobials, consumption of antimicrobials expressed in annual grams, and according to DDD/ATC code. The results were expressed in relative and absolute frequencies, percentages and standard deviation, as well as in tables and images.
Results: The most frequent isolates were Acinetobacter baumannii (31.7%), Pseudomona aeruginosa (18.7%) and Escherichia coli (8.1%), while the respiratory type samples yielded higher percentage (65.8%). At the end of the four years of study, it was found that 9.73 DDD / 100 bed-days of ceftriaxone had been prescribed; 7.00 DDD / 100 bed-days of meropenem; 2.99 DDD/100 bed-days of cefepime and 2.28 DDD / 100 bed-days of amikacin.
Conclusions: Antibiotic resistance in this institution is a relevant epidemiological problem due to the high incidence of multi-resistant pathogens. The most frequently prescribed antimicrobials were ceftriaxone, meropenem, and amikacin. Regarding the DDD/100 bed-days, ceftriaxone, meropenem, cefepime and amikacin stood out. 2018 was the year with the highest antibiotic intake.


REFERENCES

  1. Quizhpe A, Encalada L, Sacoto AM, Andrade D, Muñoz G, Lara MC. Uso apropiado de antibióticos y resistencia bacteriana. Cuenca- Ecuador: React Latinoamérica; 2014.

  2. World Health Organization. Antimicrobial resistance. About the UN Interagency Coordination Group on Antimicrobial Resistance. WHO; 21 septiembre 2016 [citado: 08/01/2020]. Disponible en: https://www.who.int/antimicrobial-resistance/interagency-coordination-group/about/en/

  3. Organización Mundial de la Salud. La OMS publica la lista de las bacterias para las que se necesitan emergentemente nuevos antibióticos. 2017 [citado: 12/10/2019]. Disponible en: http://www.who.int/mediacentre/news/releases/2017/bacteria-antibioticsneeded/es/

  4. Vila J, Moreno-Morales J, Ballesté-Delpierre C. Current landscape in the discovery of novel antibacterial agents. Clin Microbiol Infect. 2019;26(5):596-603. Doi: 10.1016/j.cmi.2019.09.015.

  5. Dheda K, Gumbo T, Gandhi NR, Murray M, Theron G, Udwadia Z, et al. Global control of tuberculosis: From extensively drug-resistant to untreatable tuberculosis. Lancet Respir Med. 2014 [citado: 20/10/2019];2:321-38. Disponible en: http://dx.doi.org/10.1016/S2213-2600(14)70031-1

  6. Magdariaga R. Los antibióticos son cada vez menos efectivos en América Latina. Periódico Prensa Latina. 15 febrero 2019 [citado: 12/11/2019]. Disponible en: http://www.cubadebate.cu/especiales/2019/02/15/los-antibioticos-son-cada-vez-menos-efectivos-en-america-latina/#XievYaaZLZE

  7. Al-Yamani A, Khamis F, Al-Zakwani I, Al-Noomani H, Al-Noomani J, Al-Abri S. Patterns of Antimicrobial Prescribing in a Tertiary Care Hospital in Oman. Oman Med. J. 2016;31(1):35-9.

  8. Martínez-González NA, Coenen S, Plate A, Colliers A, Rosemann T, Senn O, et al. The impact of interventions to improve the quality of prescribing and use of antibiotics in primary care patients with respiratory tract infections: a systematic review protocol. BMJ open. 2017;7(6):e016253.

  9. WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD Index 2020. [citado: 12/10/2019]. Disponible en: https://www.whocc.no/atc_ddd_index/

  10. Pacheco M, Oliva JE, Ordóñez LY, González ML. Caracterización de la resistencia antimicrobiana en las unidades de cuidados intensivos. Revista Universidad Médica Pinareña. 2016 [citado: 12/10/2019];12(1):14-24. Disponible en: http://www.revgaleno.sld.cu/index.php/ump/article/view/184/html

  11. Gómez-González JF, Sánchez-Duque JA. Perfil microbiológico y resistencia bacteriana en una unidad de cuidados intensivos de Pereira, Colombia, 2015. MÉD.UIS. 2018 [citado: 12/10/2019];31(2):9-15. Disponible en: http://dx.doi.org/10.18273/revmed.v31n2-2018001

  12. Yaneth-Giovanetti MC, Morales-Parra GI, Armenta-Quintero C. Perfil de resistencia bacteriana en hospitales y clínicas en el departamento del Cesar (Colombia). Medicina & Laboratorio. 2017;23:387-98.

  13. Vega EM, Fontana D, Iturrieta M, Segovia L, Rodríguez G, Agüero S. Consumo de antimicrobianos en la Unidad de Terapia Intensiva del Hospital Dr. Guillermo Rawson-San Juan, Argentina. Rev Chilena Infectol. 2015 [citado: 12/10/2019];32(3):259-65. Disponible en: https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0716-10182015000400001

  14. Paz Acuña M, Cifuentes M, Silva F, Rojas Á, Cerda J, Labarca J. Incidencia de bacterias multi-resistentes en unidades de cuidados intensivos de hospitales chilenos. Rev Chilena Infectol. 2017;34(6):570-5.

  15. Hechavarria Soulary JC, Suárez Domínguez R, Armaignac Ferrer G, Del Pozo Hessing C. Infección nosocomial en la Unidad de Cuidados Intensivos. MEDISAN; 2001 [citado: 12/10/2019];5(4). Disponible en: http://www.bvs.sld.cu/revistas/san/vol5_4_01/san02401.htm

  16. Pérez Estrada FA, Martínez Rodríguez I, Rojas Borroto CA, Mato Hernández Y, Pérez Roman E. Infección nosocomial en unidades de cuidados intensivos. Rev Cub Med Int Emerg. 2014;13(2):116-25.

  17. Guzmmán-Terán C, Rodríguez-Rodríguez V, Calderón-Rangel A. Análisis de usos y resistencia a antibióticos en una UCI de Montería, Colombia. Rev. Méd. Risaralda. 2018;24(2):75-80.

  18. Grau S, Fondevilla E, Mojal S, Palomar M, Vallès J, Gudiol F, VINCat Antimicrobial Group. Antibiotic consumption at 46 VINCat hospitals from 2007 to 2009, stratifed by hospital size and clinical services. Enferm Infecc Microbiol Clin. 2012;30(Suppl 3):43-51.

  19. Wirtz VJ, Mol P, Verdijk J, Stichele R, Taxis K. Use of antibacterial fixed-dose combinations in the private sector in eight Latin American Countries between 1999 and 2009. Tropical Medicine and International Health. 2013;18(4):416-25.

  20. Rodríguez-Ganen O, Asbun-Bojalil J. Vigilancia del consumo de antimicrobianos en hospitales de México: situación actual y guía práctica para su implementación. Rev Panam Salud Pública. 2012;32(5):381-6.




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