TY - JOUR
T1 - Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Bloodstream Infections in Peru and Associated Outcomes
T2 - VIRAPERU Study
AU - Krapp, Fiorella
AU - Garcıa, Coralith
AU - Hinostroza, Noemi
AU - Astocondor, Lizeth
AU - Rondon, Claudia R.
AU - Ingelbeen, Brecht
AU - Alpaca-Salvador, Hugo A.
AU - Amaro, Catherine
AU - Ventura, Carla Aguado
AU - Barco-Yaipen, Evelyn
AU - Fernandez, Cesar Bocangel
AU - Briones, Alexander
AU - Burgos, Antonio
AU - Campana, Rene
AU - Castillo, Kelly
AU - Castañeda-Sabogal, Alex
AU - Coaquira, Angelica
AU - Concha-Velasco, Fatima
AU - Cuadros, Edwin Cuaresma
AU - Chincha, Omayra
AU - Diaz, Juan Carlos
AU - Sipion, Roberto Dıaz
AU - Fernandez, Victor
AU - Hueda-Zavaleta, Miguel
AU - Lopez, Enrique
AU - Valera-Krumdieck, Marıa
AU - Vasquez, Ruben
AU - Vidaurre Torres, Ana Marıa
AU - Villegas-Chiroque, Miguel
AU - Lopez, Favio Sarmiento
AU - Sullon Zavaleta, Pedro Alberto
AU - Chavez, Elizett Sierra
AU - Peralta, Eduardo Paricahua
AU - Cordova, Teresa Peralta
AU - Pino-Dueñas, Jimena Edith
AU - Jacobs, Jan
N1 - Publisher Copyright:
© 2023 American Society of Tropical Medicine and Hygiene. All rights reserved.
PY - 2023/11
Y1 - 2023/11
N2 - 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 5 199), 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.
AB - 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 5 199), 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.
UR - http://www.scopus.com/inward/record.url?scp=85176495333&partnerID=8YFLogxK
U2 - 10.4269/ajtmh.22-0556
DO - 10.4269/ajtmh.22-0556
M3 - Article
C2 - 37722663
AN - SCOPUS:85176495333
SN - 0002-9637
VL - 109
SP - 1095
EP - 1106
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 5
ER -