Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Bloodstream Infections in Peru and Associated Outcomes: VIRAPERU Study
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 u...
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| Veröffentlicht in: | The American journal of tropical medicine and hygiene 2023-11, Vol.109 (5), p.1095-1106 |
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| creator | Krapp, Fiorella García, Coralith Hinostroza, Noemi Astocondor, Lizeth Rondon, Claudia R Ingelbeen, Brecht Alpaca-Salvador, Hugo A Amaro, Catherine Aguado Ventura, Carla Barco-Yaipén, Evelyn Bocangel Fernandez, Cesar Briones, Alexander Burgos, Antonio Campana, Rene Castillo, Kelly Castañeda-Sabogal, Alex Coaquira, Angelica Concha-Velasco, Fátima Cuadros, Edwin Cuaresma Chincha, Omayra Diaz, Juan Carlos Díaz Sipión, Roberto Fernandez, Victor Hueda-Zavaleta, Miguel López, Enrique Valera-Krumdieck, María Vásquez, Rubén Vidaurre Torres, Ana María Villegas-Chiroque, Miguel Sarmiento Lopez, Favio Sullón Zavaleta, Pedro Alberto Sierra Chavez, Elizett Paricahua Peralta, Eduardo Peralta Córdova, Teresa Pino-Dueñas, Jimena Edith Jacobs, Jan |
| description | 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 = 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. |
| doi_str_mv | 10.4269/ajtmh.22-0556 |
| format | Article |
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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 = 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.</description><identifier>ISSN: 0002-9637</identifier><identifier>EISSN: 1476-1645</identifier><identifier>DOI: 10.4269/ajtmh.22-0556</identifier><identifier>PMID: 37722663</identifier><language>eng</language><publisher>United States: Institute of Tropical Medicine</publisher><subject>Anti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Antimicrobial agents ; Carbapenems ; Drug resistance ; Drug Resistance, Bacterial ; E coli ; Escherichia coli ; Gram-Negative Bacteria ; Gram-Negative Bacterial Infections - drug therapy ; Gram-Negative Bacterial Infections - epidemiology ; Gram-Negative Bacterial Infections - microbiology ; Hospital Mortality ; Humans ; Klebsiella pneumoniae ; Microbial Sensitivity Tests ; Peru - epidemiology ; Prevalence ; Pseudomonas aeruginosa ; Sepsis - drug therapy ; Surveillance</subject><ispartof>The American journal of tropical medicine and hygiene, 2023-11, Vol.109 (5), p.1095-1106</ispartof><rights>Copyright Institute of Tropical Medicine Nov 2023</rights><rights>The author(s) 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-f3c973d6506fd6117b895c746101d0388ef125470380b2c97f125fa9165ca42d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622474/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622474/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37722663$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Krapp, Fiorella</creatorcontrib><creatorcontrib>García, Coralith</creatorcontrib><creatorcontrib>Hinostroza, Noemi</creatorcontrib><creatorcontrib>Astocondor, Lizeth</creatorcontrib><creatorcontrib>Rondon, Claudia R</creatorcontrib><creatorcontrib>Ingelbeen, Brecht</creatorcontrib><creatorcontrib>Alpaca-Salvador, Hugo A</creatorcontrib><creatorcontrib>Amaro, Catherine</creatorcontrib><creatorcontrib>Aguado Ventura, Carla</creatorcontrib><creatorcontrib>Barco-Yaipén, Evelyn</creatorcontrib><creatorcontrib>Bocangel Fernandez, Cesar</creatorcontrib><creatorcontrib>Briones, Alexander</creatorcontrib><creatorcontrib>Burgos, Antonio</creatorcontrib><creatorcontrib>Campana, Rene</creatorcontrib><creatorcontrib>Castillo, Kelly</creatorcontrib><creatorcontrib>Castañeda-Sabogal, Alex</creatorcontrib><creatorcontrib>Coaquira, Angelica</creatorcontrib><creatorcontrib>Concha-Velasco, Fátima</creatorcontrib><creatorcontrib>Cuadros, Edwin Cuaresma</creatorcontrib><creatorcontrib>Chincha, Omayra</creatorcontrib><creatorcontrib>Diaz, Juan Carlos</creatorcontrib><creatorcontrib>Díaz Sipión, Roberto</creatorcontrib><creatorcontrib>Fernandez, Victor</creatorcontrib><creatorcontrib>Hueda-Zavaleta, Miguel</creatorcontrib><creatorcontrib>López, Enrique</creatorcontrib><creatorcontrib>Valera-Krumdieck, María</creatorcontrib><creatorcontrib>Vásquez, Rubén</creatorcontrib><creatorcontrib>Vidaurre Torres, Ana María</creatorcontrib><creatorcontrib>Villegas-Chiroque, Miguel</creatorcontrib><creatorcontrib>Sarmiento Lopez, Favio</creatorcontrib><creatorcontrib>Sullón Zavaleta, Pedro Alberto</creatorcontrib><creatorcontrib>Sierra Chavez, Elizett</creatorcontrib><creatorcontrib>Paricahua Peralta, Eduardo</creatorcontrib><creatorcontrib>Peralta Córdova, Teresa</creatorcontrib><creatorcontrib>Pino-Dueñas, Jimena Edith</creatorcontrib><creatorcontrib>Jacobs, Jan</creatorcontrib><title>Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Bloodstream Infections in Peru and Associated Outcomes: VIRAPERU Study</title><title>The American journal of tropical medicine and hygiene</title><addtitle>Am J Trop Med Hyg</addtitle><description>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 = 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.</description><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antimicrobial agents</subject><subject>Carbapenems</subject><subject>Drug resistance</subject><subject>Drug Resistance, Bacterial</subject><subject>E coli</subject><subject>Escherichia coli</subject><subject>Gram-Negative Bacteria</subject><subject>Gram-Negative Bacterial Infections - drug therapy</subject><subject>Gram-Negative Bacterial Infections - epidemiology</subject><subject>Gram-Negative Bacterial Infections - microbiology</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Klebsiella pneumoniae</subject><subject>Microbial Sensitivity Tests</subject><subject>Peru - epidemiology</subject><subject>Prevalence</subject><subject>Pseudomonas aeruginosa</subject><subject>Sepsis - 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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 = 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.</abstract><cop>United States</cop><pub>Institute of Tropical Medicine</pub><pmid>37722663</pmid><doi>10.4269/ajtmh.22-0556</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10622474 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Antimicrobial agents Carbapenems Drug resistance Drug Resistance, Bacterial E coli Escherichia coli Gram-Negative Bacteria Gram-Negative Bacterial Infections - drug therapy Gram-Negative Bacterial Infections - epidemiology Gram-Negative Bacterial Infections - microbiology Hospital Mortality Humans Klebsiella pneumoniae Microbial Sensitivity Tests Peru - epidemiology Prevalence Pseudomonas aeruginosa Sepsis - drug therapy Surveillance |
| title | Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Bloodstream Infections in Peru and Associated Outcomes: VIRAPERU Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-26T06%3A47%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prevalence%20of%20Antimicrobial%20Resistance%20in%20Gram-Negative%20Bacteria%20Bloodstream%20Infections%20in%20Peru%20and%20Associated%20Outcomes:%20VIRAPERU%20Study&rft.jtitle=The%20American%20journal%20of%20tropical%20medicine%20and%20hygiene&rft.au=Krapp,%20Fiorella&rft.date=2023-11-01&rft.volume=109&rft.issue=5&rft.spage=1095&rft.epage=1106&rft.pages=1095-1106&rft.issn=0002-9637&rft.eissn=1476-1645&rft_id=info:doi/10.4269/ajtmh.22-0556&rft_dat=%3Cproquest_pubme%3E2866379486%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2888354540&rft_id=info:pmid/37722663&rfr_iscdi=true |