Endemic tendencies and bacterial resistance markers in third-level hospitals in Bogotá, Colombia

Determining antimicrobial resistance profiles and endemic channels in 14 third-level hospitals. A high complexity hospital network was created between 2001 and 2003 in Bogotá, Colombia, comprising 14 hospitals belonging to the Bogotá Bacterial Resistance Control Group (BBRCG) and a database was established from participating institutions' microbiology laboratory data (using automated and manual methods) using BacLink 2.0 and Whonet 5.3. Isolate susceptibility profiles were determined according to NCCLS (2003). A descriptive analysis was made of the different resistance markers and such resistance's endemic channel was determined for all hospitals using a 25% to 75% range for every month during the study period. 84,664 isolates were analysed, the most frequently found being Escherichia coli, Staphylococcus aureus, coagulase negative Staphylococcus, Klebsiella pneumoniae and Pseudomonas aeruginosa. S. aureus resistance to oxacillin in 2001, 2002 and 2003 was 41%, 48% and 48%, respectively, Staphylococcus coagulasa negative resistance to oxacillin 75%, 73% and 72%, E. faecium resistance to vancomycin was 14%, 9%, 3%, K. pneumoniae resistance to third-generation cephalosporins 37%, 25% and 23%, P. aeruginosa resistance to imipenem 24%, 22% and 17%, P. aeruginosa resistance to ciprofloxacin 46%, 46% and 35% and A. baumannii resistance to imipenem 11%, 29% and 39%, respectively. The problem of bacterial resistance became evident in the endemic channels; this was centred on the presence of oxacillin-resistant S. aureus and a marked increase in A. baumanni resistance to imipenem. High resistance levels were observed in epidemiologic impact markers, especially in Intensive Care Units.