Resistencia antimicrobiana en infecciones asociadas con la atención de la salud.
The article focuses on antimicrobial resistance in healthcare-associated infections in a tertiary hospital of the Mexican Institute of Social Security (IMSS) in Puebla. An observational and retrospective study was conducted with 557 patients, where it was identified that the most common resistance m...
| Publicado en: | Medicina Interna de México Vol. 41; no. 12; pp. 732 - 742 |
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| Autores principales: | , , , |
| Formato: | Artículo |
| Publicado: |
Colegio de Medicina Interna de Mexico
dic2025
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| Sumario: | The article focuses on antimicrobial resistance in healthcare-associated infections in a tertiary hospital of the Mexican Institute of Social Security (IMSS) in Puebla. An observational and retrospective study was conducted with 557 patients, where it was identified that the most common resistance mechanism was extended-spectrum beta-lactamase, especially in Escherichia coli. Additionally, high resistance was reported in Enterococcus faecium and Staphylococcus epidermidis to several antibiotics. The authors conclude that it is crucial to implement continuous epidemiological surveillance and comprehensive strategies to address this public health issue, considering the genetic plasticity of microorganisms and the associated risk factors. OBJETIVO: Describir el comportamiento de la resistencia antimicrobiana en las infecciones asociadas con la atención médica, en un hospital terciario del Instituto Mexicano del Seguro Social (IMSS) en Puebla. MATERIALES Y MÉTODOS: Estudio observacional, retrospectivo y unicéntrico efectuado en el Hospital de Especialidades del Centro Médico Nacional General de División Manuel Ávila Camacho, IMSS, Puebla, en pacientes con diagnóstico confirmado de infecciones asociadas con la atención médica, de uno y otro sexo, de cualquier edad. El análisis de supervivencia se efectuó mediante curvas de Kaplan-Meier, con estratificación por tipo de microorganismo y resistencia. RESULTADOS: En 557 pacientes estudiados el mecanismo de resistencia antimicrobiana más frecuente fue por betalactamasas de espectro extendido positivo (n = 34; 6.1%). Estas se detectaron en siete casos (1.2%). Escherichia coli mostró 27 casos de betalactamasas de espectro extendido positivo. Enterococcus faecium reportó alta resistencia a ampicilina (n = 8), ciprofloxacina (n = 9), eritromicina (n = 8) y vancomicina (n = 7). S epidermidis fue la especie de Staphylococcus con resistencia más frecuente, especialmente a clindamicina (n = 31), ciprofloxacina (n = 27), eritromicina (n = 26), levofloxacina (n = 29) y oxacilina (n = 34). Entre los gérmenes gramnegativos, Acinetobacter baumannii fue resistente a ceftazidima (n = 6), ceftriaxona (n = 8), ciprofloxacina (n = 7), gentamicina (n = 8), imipenem (n = 7) y meropenem (n = 8). CONCLUSIONES: El estudio destaca la necesidad de la vigilancia epidemiológica continua y un enfoque integral para evitar y tratar la resistencia antimicrobiana, considerando la plasticidad genética de los microorganismos y los factores de riesgo asociados. OBJECTIVE: To describe antimicrobial resistance behavior in healthcare-associated infections in a tertiary Mexican Social Security Institute (IMSS) hospital in Puebla. MATERIALS AND METHODS: An observational, retrospective, single-center study conducted at the Specialty Hospital of the Manuel Ávila Camacho National General Medical Center of the IMSS in Puebla. The study included patients of either sex and of any age with a confirmed diagnosis of healthcare-associated infections. Survival analysis was performed using Kaplan-Meier curves, stratified by type of microorganism and resistance. RESULTS: Of the 557 patients studied, the most frequent antimicrobial resistance mechanism was positive extended-spectrum beta-lactamase (n = 34; 6.1%). Beta-lactamases were detected in seven cases (1.2%). There were 27 cases of extendedspectrum beta-lactamase positivity in Escherichia coli. Enterococcus faecium exhibited high resistance to ampicillin (n = 8), ciprofloxacin (n = 9), erythromycin (n = 8), and vancomycin (n = 7). Staphylococcus epidermidis exhibited the highest frequency of resistance, particularly to clindamycin (n = 31), ciprofloxacin (n = 27), erythromycin (n = 26), levofloxacin (n = 29), and oxacillin (n = 34). Among gram-negative bacteria, Acinetobacter baumannii exhibited resistance to ceftazidime (n = 6), ceftriaxone (n = 8), ciprofloxacin (n = 7), gentamicin (n = 8), imipenem (n = 7), and meropenem (n = 8). CONCLUSIONS: This study underscores the importance of ongoing epidemiological surveillance and a holistic approach to preventing and treating antimicrobial resistance, taking into account the genetic flexibility of microorganisms and related risk factors. |
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