Prevalence and antimicrobial resistance of Escherichia coli in a Tertiary-level hospital
pdf

Keywords

E. coli
multiresistant
ESBL

Abstract

This study was designed to achieve more effective treatment for patients and to encourage the development of new antibiotics, specifically targeting multidrug-resistant Escherichia coli. This bacterium is one of the primary causative agents of hospital-acquired infections (HAI). It is classified as a critical priority pathogen for the development of new antibiotics according to the World Health Organization (2024). In this study, 76 isolates from four bacterial genera were analyzed. E. coli was identified as the most prevalent infectious agent with 52% of the isolates, followed by Klebsiella pneumoniae (20%), Pseudomonas aeruginosa (12%), and Acinetobacter baumannii (16%). Internal Medicine was the hospital department with the highest frequency of E. coli infections. Sixty-five percent of the samples were derived from urine. This bacterium was more prevalent in females (57.5%) than in males (42.5%). The highest resistance rates were observed for Ampicillin and Ciprofloxacin, with 90% and 77.5% respectively, while the lowest resistance was found for the Carbapenems Ertapenem, Meropenem, and Aminoglycoside Amikacin, with 22.5%. Twenty-two point five percent of the E. coli isolates were classified as resistant, and 77.5% as multidrug-resistant. Sixty-two point five percent were extended-spectrum beta-lactamase (ESBL) producers. All of these isolates resisted Ampicillin, while 4% were resistant to Ertapenem, Meropenem, and Amikacin. E. coli was identified as the primary causative pathogen of HAI in the Hospital under study and demonstrated resistance to most currently prescribed antibiotics

https://doi.org/10.82082/2421-4248/jpmh2026.67.1.3572
pdf

References

Salam MA, Al-Amin MY, Salam MT, Pawar JS, Akhter N, Rabaan AA, Alqumber MAA. Antimicrobial Resistance: A Growing Serious Threat for Global Public Health. Healthcare (Basel) 2023;5;11(13):1946. https://doi.org/10.3390/healthcare11131946.

The review on antimicrobial resistance: tackling drug-resistant infections globally: final report and recommendations. Available at: https://amr-review.org/. Accessed on: 28/11/2024.

Ranjbar R, Alam M. Antimicrobial Resistance Collaborators (2022). Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Evid Based Nurs 2023;27:ebnurs-2022-103540. https://doi.org/10.1136/ebnurs-2022-103540.

Riley LW. Distinguishing Pathovars from Nonpathovars: Escherichia coli. Microbiol Spectr 2020;8(4). https://doi.org/10.1128/microbiolspec.AME-0014-2020.

Wasiński B. Extra-intestinal pathogenic Escherichia coli – threat connected with food-borne infections. Annals of Agricultural and Environmental Medicine 2019;26(4):532-7. https://doi.org/10.26444/aaem/111724.

Guevara JA, Maldonado MR, Valadez ME, Muro R, Matsumata IR. Resistencia bacteriana: organismos del grupo ESKAPE. ENF INF MICROBIOL 2021;41(3):111-7. https://www.medigraphic.com/pdfs/micro/ei-2021/ei213e.pdf.

Organización Mundial de la Salud. La OMS pone al día la lista de bacterias farmacorresistentes más peligrosas para la salud humana. Available at: https://www.who.int/es/news/item/17-05-2024-who-updates-list-of-drug-resistant-bacteria-most-threatening-to-human-health. Accessed on: 18/05/2024.

Cinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing. 31st ed. CLSI supplement M100. Avaiable at: https://clsi.org/about/press-releases/clsi-publishes-m100-performance-standards-for-antimicrobial-susceptibility-testing-31st-edition/. Accessed on: 29/04/2022.

Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, Harbarth S, Hindler JF, Kahlmeter G, Olsson-Liljequist B, Paterson DL, Rice LB, Stelling J, Struelens MJ, Vatopoulos A, Weber JT, Monnet DL. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012;18(3):268-81. https://doi.org/10.1111/j.1469-0691.2011.03570.x.

Arias R, Rosado U, Vargas A, Grajales C. Los microorganismos causantes de infecciones nosocomiales en el Instituto Mexicano del Seguro Social. Rev Med Inst Mex Seguro Soc 2016;54(1):20-4. https://www.medigraphic.com/pdfs/imss/im-2016/im161d.pdf.

Secretaría de salud. Boletín Infecciones Asociadas a la Atención de la Salud Red Hospitalaria de Vigilancia Epidemiológica (RHOVE). Julio-Agosto 2023. Available at: https://www.gob.mx/salud/acciones-y-programas/boletin-epidemiologico-rhove-2023-341707. Accessed on: 23/07/2024.

Servicios de Salud-Secretaría de Salud. Boletín infecciones Asociadas a la Atención de la Salud Red Hospitalaria de Vigilancia Epidemiológico (RHOVE). Febrero 2025. Available at: https://saludsinaloa.gob.mx/index.php/rhove-red-de-vigilancia-epidemiologica-hospitalaria. Accessed on: 02/03/2025

Hernández JE, Sánchez G, Castruita DST, González AI, Acevedo E, Díaz TA, Barrientos MG, Cisneros JM. Patrón de sensibilidad de E. coli en el Centro Médico Nacional del Bajío. Rev Med Inst Mex Seguro Soc 2022;60(5):503-510.

Chuquisapon J, Valencia E, Sevilla C, Barrón HJ. Filogenia y resistencia antimicrobiana de cepas de Escherichia coli productoras de betalactamasas de espectro extendido en pacientes con cáncer hospitalizados en Perú. Biomédica 2022;42:470-8. https://doi.org/10.7705/biomedica.6263.

López GI. Perfil de resistencia antimicrobiana de Escherichia coli y Klebsiella pneumoniae en pacientes que acudieron al Hospital de Norte durante diciembre 2022 - abril 2023. Rev cient UNITEPC 2023;10(2):8-16. https://doi.org/10.36716/unitepc.v10i2.627.

Orrego CP, Henao CP, Cardona, JA. Prevalencia de infección urinaria, uropatógenos y perfil de susceptibilidad antimicrobiana. Acta méd colomb 2014;39(4):352-8. http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S012024482014000400008&lng=en&tlng=es.

López B, Alcázar V, Castellanos M, Franco, MIl, Jimenez, Y, De León, A, Mejía, ME, Pichardo L, Tapia ML, Moreno S, Calderón E. Vigilancia institucional de la susceptibilidad antimicrobiana en patógenos de interés clínico. Bol med Hosp Infant México 2013;70(3):222-9. http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S166511462013000300006&lng=es&tlng=es.

Universidad Nacional Autónoma de México. Plan Universitario de Control de la Resistencia Antimicrobiana (PUCRA), Segundo Reporte de los Hospitales de la Red del PUCRA: Resistencia antimicrobiana y consumo de antimicrobianos. Available at: http://www.puis.unam.mx/divulgacion/docs/pucra23.pdf. Accessed on 23/09/2024.

Garza E, Morfín R, Mendoza S, Bocanegra P, Flores S, Rodríguez E, Ponce A, Sanchez D, Franco R, Arroyo S, Velázquez C, Rojas F, Quintanilla LJ, Maldonado JY, Martínez R, Ostos HL, Gomez A, Jaime JL, Avilés LK, Feliciano JM, Peña CD, Couoh CA, Molina A, Vázquez EG, Rincón J, Rivera R, Galindo A, Martínez A, Mora JP, Corte RE, López I, Monroy VA, Barajas JM, Morales CT, Aguirre E, Coronado M, Rosales AA, Ayala MD, Sida S, Pérez BA, Navarro A, Juárez GE, Cetina CM, Mena JP, Canizales J, Moreno MI, Romero D, Arévalo A, Cobos DI, Aguilar G, Silva J, Camacho A. A snapshot of antimicrobial resistance in Mexico. Results from 47 centers from 20 states during a six-month period. PLoS One 2019;26;14(3):e0209865. https://doi.org/10.1371/journal.pone.0209865.

Organización Mundial de la Salud. Resistencia a los antimicrobianos. Available at: https://www.who.int/es/news-room/fact-sheets/detail/antimicrobial-resistance. Accessed on: 18/06/2024.

Organización Mundial de la Salud. Resistencia a los antimicrobianos. Available at: https://www.who.int/es/news-room/fact-sheets/detail/antimicrobial-resistance#:~:text=En%202019%20se%20incluy%C3%B3%20en,meticilina%20(SARM)%20y%20E. Accessed on: 21/11/2024.

Rendón MMA, Reyes AA, Rosas BJB, Rodríguez F. Infecciones de vías urinarias. Patrón de resistencia in vitro de E. coli y E. coli ESBL a Quinolonas, Trimetoprima-Sulfametoxazol y nitrofurantoína. Med Int Mex 2012;28(5):434-9. https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=37284.

García A, García E, Hernández A, Ruiz J, Yague G, Herrero JA, Gómez J. Bacteriemias por Escherichia coli productor de betalactamasas de espectro extendido (BLEE): significación clínica y perspectivas actuales. Rev Esp Quimioter 2011; 24(2):57-66. https://seq.es/wp-content/uploads/2011/06/garcia.pdf.

Peralta G, Lamelo M, Alvarez P, Velasco M, Delgado A, Horcajada JP, Montero M, Roiz MP, Fariñas MC, Alonso J, Martínez LM, Gutiérrez-Macías A, Alava JA, Rodríguez A, Fleites A, Navarro V, Sirvent E, Capdevila JA; SEMI- BLEE STUDY GROUP. Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study. BMC Infect Dis 2012;5;12:245. https://doi.org/10.1186/1471-2334-12-245.

Uribe MJ, Ahumada YP, Díaz SP, Eslava CA, Reyes JE, Báez ME, Osuna I, Delgado F. High prevalence of multidrug-resistant Escherichia coli isolates from children with and without diarrhoea and their susceptibility to the antibacterial activity of extracts/fractions of fruits native to Mexico. J Med Microbiol 2017;66(7):972-80. https://doi.org/10.1099/jmm.0.000548.

Jaqueti J, Molina L, Limón A, García I. Antimicrobial susceptibility in urinary tract infections caused by ESBL- and non-ESBL-producing Enterobacteriaceae in hospitalized/outpatient-, sex-, age-matched patients. Rev Esp Quimioter 2018;31(1):63-5.

Sociedad Española de Medicina de Urgencias y Emergencias. Las bacterias multirresistentes ya causan 700.000 muertes cada año en el mundo. Available at: https://www.semes.org/las-bacterias-multirresistentes-ya-causan-700-000-muertes-cada-ano-en-el-mundo/. Accessed on: 25/11/2024.

Díaz P, Bello H, Domínguez Y, Trabal N, Mella M, Zemelman Z, González R. Resistencia a Gentamicina, Amikacina y Ciprofloxacina en cepas hospitalarias de Klebsiella pneumoniae subespecie pneumoniae productoras de ß-lactamasas de espectro extendido. Rev Med Chile 2004;132(10):1173-8. https://dx.doi.org/10.4067/S0034-98872004001000003.