Evolución de la Resistencia a los antibióticos en una zona rural de Ecuador
Palabras clave:
resistencia a los antibióticos, laboratorio, aislamiento
Resumen
La resistencia a los antibióticos sigue siendo uno de los más importantes problemas de salud global a la fecha. La resistencia a los antibióticos en América Latina, representa uno de los grandes retos de la medicina actual debido a los diversos mecanismos de resistencia bacteriana y el incremento de los mismos a nivel mundial.
Analizamos las tasas de resistencia a los antibióticos en aislamientos bacterianos de pacientes que asistieron a dos hospitales de la región rural de Ecuador desde el año 2017 hasta el año 2018. Un total de 907 cultivos bacterianos fueron analizados, los cuales se obtuvieron desde el 1 de enero 2017 al 31 de diciembre 2018 y se evaluaron frente a 33 tipos de antibióticos diferentes.
Más de la mitad de los aislamientos donde se identificaron enterobacterias, fueron resistentes a ampicilina (79.8%), ampicilina/sulbactam (57.5%), amoxicilina/ácido clavulánico (62.6%).
El Staphylococcus aureus presentó (55.4%) de resistencia a la oxacilina.
Se concluye que existen altas tasas de resistencia a los antibióticos en zonas rurales del Ecuador, que siguen los patrones mundiales de resistencia ya publicados, y que tanto los médicos como los sistemas de salud deberían tomar en cuenta al crear normativas y políticas para el uso racional de antibióticos.
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29. Sader HS, Jones RN, Andrade-Baiocchi S, Biedenbach DJ; SENTRY ParticipantsGroup (Latin America). Four-year evaluation of frequency of occurrence and antimicrobial susceptibility patterns of bacteria from bloodstream infections in Latin American medical centers. DiagnMicrobiol Infect Dis. 2002; 44:273-80.
30. Rossi F, Baquero F, Hsueh PR, Paterson DL, Bochicchio GV, Snyder TA,Satishchandran V, McCarroll K, DiNubile MJ, Chow JW. In vitro susceptibilities of aerobic and facultatively anaerobic Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2004 results from SMART (Study for Monitoring Antimicrobial Resistance Trends). J Antimicrob Chemother. 2006; 58:205-10.
2. WHO. Worldwide country situation analysis : Worldwide country situation analysis : World Heal Organ 20 Ave Appia, 1211 Geneva 27, Switz. 2015;(April):1-50. http://www.who.int/drugresistance/documents/situationanalysis/en/.
3. Fair RJ, Tor Y. Perspectives in Medicinal Chemistry Antibiotics and Bacterial Resistance in the 21st Century. Perspect Medicin Chem. 2014:25-64. doi:10.4137/PMC.S14459.Received
4. Martínez JL, Baquero F. Emergence and spread of antibiotic resistance: Setting a parameter space. Ups J Med Sci. 2014;119(2):68-77. doi:10.3109/03009734.2014.901444
5. Nadimpalli M, Delarocque-Astagneau E, Love DC, et al. Combating Global Antibiotic Resistance: Emerging One Health Concerns in Lower-and Middle-Income Countries. Clin Infect Dis. 2018;66(6):963-969. doi:10.1093/cid/cix879
6. Bonelli R, Meurer B, Picao R, et al. Antimicrobial resistance among Enterobacteriaceae in South America: History, current dissemination status and associated socioeceonomix factors. Drug Resistant updates. 2014; 17(1-2):24-36. doi: 10.1016/j.drup.2014.02.001
7. Santa-Ana-Tellez Y, Mantel-Teeuwisse AK, Dreser A, Leufkens HGM, Wirtz VJ. Impact of Over-the-Counter Restrictions on Antibiotic Consumption in Brazil and Mexico. PLoS One. 2013;8(10):6-11. doi:10.1371/journal.pone.0075550
8. Wirtz VJ, Herrera-Patino JJ, Santa-Ana-Tellez Y, Dreser A, Elseviers M, Vander Stichele RH. Analysing policy interventions to prohibit over-the-counter antibiotic sales in four Latin American countries. Trop Med Int Heal. 2013;18(6):665-673. doi:10.1111/tmi.12096
9. Jacobs TG, Robertson J, van den Ham HA, Iwamoto K, Bak Pedersen H, Mantel-Teeuwisse AK. Assessing the impact of law enforcement to reduce over-the-counter (OTC) sales of antibiotics in low- and middle-income countries; a systematic literature review. BMC Health Serv Res. 2019;19(1):536. doi:10.1186/s12913-019-4359-8
10. Auta A, Hadi MA, Oga E, et al. Global access to antibiotics without prescription in community pharmacies: A systematic review and meta-analysis. J Infect. 2019;78(1):8-18. doi:10.1016/j.jinf.2018.07.001
11. Celi Y, Rubio V, Camacho M. "Perspectiva històrica del origen evolutivo de la reisstencia a los antibióticos". Rev Colomb. Biotecnol. Vol XIX No.2 diciembre 2017; 105-117. doi: 10.15446/rev.colomb.biote.v19n2.69501
12. Sánchez Choez X, Armijos Acurio ML, Jimbo Sotomayor RE. “Appropriateness and adequacy of antibiotic prescription for upper respiratory tract infections in ambulatory health care centers in Ecuador.” BMC Pharmacol Toxicol. 2018;19(1):1-11. doi:10.1186/s40360-018-0237-y
13. Eckhardt M, Santillán D, Faresjö T, Forsberg BC, Falk M. Universal health coverage in rural Ecuador: A cross-sectional study of perceived emergencies. West J Emerg Med. 2018;19(5):889-900. doi:10.5811/westjem.2018.6.38410
14. Central Intelligence Agency. South America :: Ecuador— The World Factbook - Central Intelligence Agency. CIA.gov. 2019. https://www.cia.gov/library/publications/the-world-factbook/geos/pe.html%0Ahttps://www.cia.gov/library/publications/the-world-factbook/geos/br.html.
15. Intituto Nacional de Investigación en Salud Pública INSPI Dr. Leopoldo Izquieta Pérez. Centro de referencia nacional de resistencia a los antimicrobianos. Datos de resistencia bacteriana Ecuador. 2017
16. Centers for Disease Control and Prevention. Biggest Threats and Data | Antibiotic/Antimicrobial Resistance | CDC. Novemb 26, 2018. 2018:1. https://www.cdc.gov/drugresistance/biggest_threats.html.
17. Thakuria B, Lahon K. The beta lactam antibiotics as an empirical therapy in a developing country: An update on their current status and recommendations to counter the resistance against them. J Clin Diagnostic Res. 2013;7(6):1207-1214. doi:10.7860/JCDR/2013/5239.3052
18. Fernandes R, Amador P, Prudêncio C. β-Lactams: Chemical structure, mode of action and mechanisms of resistance. Rev Med Microbiol. 2013;24(1):7-17. doi:10.1097/MRM.0b013e3283587727
19. Paterson DL, Bonomo RA. Clinical Update Extended-Spectrum Beta-Lactamases : a Clinical Update. Clin Microbiol Rev. 2005;18(4):657-686. doi:10.1128/CMR.18.4.657
20. Philippon A, Slama P, Dény P, Labia R. A Structure-Based Classification of Class A beta-Lactamases , a Broadly. Clin Microbiol Rev. 2016;29(1):29-57. doi:10.1128/CMR.00019-15.Address
21. Sheu CC, Chang YT, Lin SY, Chen YH, Hsueh PR. Infections caused by carbapenem-resistant Enterobacteriaceae: An update on therapeutic options. Front Microbiol. 2019;10(JAN). doi:10.3389/fmicb.2019.00080
22. Meletis G. Carbapenem resistance: overview of the problem and future perspectives. Ther Adv Infect Dis. 2016;3(1):15-21. doi:10.1177/2049936115621709
23. Perez F, El Chakhtoura NG, Papp-Wallace KM, Wilson BM, Bonomo RA. Treatment options for infections caused by carbapenem-resistant Enterobacteriaceae. Expert Opin Pharmacother. 2016;17(6):761-781. doi:10.1517/14656566.2016.1145658
24. Lee DS, Lee SJ, Choe HS, Giacobbe DR. Community-Acquired Urinary Tract Infection by Escherichia coli in the Era of Antibiotic Resistance. Biomed Res Int. 2018;2018. doi:10.1155/2018/7656752
25. Chu CM, Lowder JL. Diagnosis and treatment of urinary tract infections across age groups. Am J Obstet Gynecol. 2018;219(1):40-51. doi:10.1016/j.ajog.2017.12.231
26. Bush K, Bradford PA. b -Lactams and b -Lactamase Inhibitors: An Overview. 2016; (Table 1).
27. Larco D, Frecuencia y susceptibilidad microbiana en aislamientos urinarios de bacterias productoras de BLEE en dos hospitales regionales de Ecuador. Práctica Familiar Rural. Junio 2019.
28. Gaus D, Herrera Ramírez D, Larco D. MRSA infected wounds in a community hospital in rural tropical Ecuador. Práctica Familiar Rural. 2018 marzo; 3(1)
29. Sader HS, Jones RN, Andrade-Baiocchi S, Biedenbach DJ; SENTRY ParticipantsGroup (Latin America). Four-year evaluation of frequency of occurrence and antimicrobial susceptibility patterns of bacteria from bloodstream infections in Latin American medical centers. DiagnMicrobiol Infect Dis. 2002; 44:273-80.
30. Rossi F, Baquero F, Hsueh PR, Paterson DL, Bochicchio GV, Snyder TA,Satishchandran V, McCarroll K, DiNubile MJ, Chow JW. In vitro susceptibilities of aerobic and facultatively anaerobic Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2004 results from SMART (Study for Monitoring Antimicrobial Resistance Trends). J Antimicrob Chemother. 2006; 58:205-10.
Publicado
2020-02-28
Cómo citar
1.
Ross J, Larco D, Colon O, Coalson J, Gaus D, Taylor K, Lee S. Evolución de la Resistencia a los antibióticos en una zona rural de Ecuador. PFR [Internet]. 28 de febrero de 2020 [citado 22 de diciembre de 2024];5(1). Disponible en: https://practicafamiliarrural.org/index.php/pfr/article/view/144
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