Extended-spectrum beta-lactamase-producing Enterobacteriaceae isolated in blood cultures of patients treated in different hospital areas

Abstract

Antimicrobial resistance caused by extended-spectrum β-lactamase (ESBL)-producing members of the Enterobacteriaceae family is a global public health problem. ESBLs are enzymes that confer resistance to first, second, third and fourth generation penicillins and cephalosporins, which are expressed in greater proportion in gram-negative bacteria. Objective: To characterize ESBL-producing Enterobacteriaceae in blood cultures of patients treated in different areas of the Isidro Ayora General Hospital in Loja, period 2019-2020. Materials and methods: Quantitative, descriptive, cross-sectional documentary study. The sample consisted of 114 isolates. Results: The most frequent variables of the study were female sex (54.4%), adult age group (39.5%) with a mean age of 45 years. The prevalent bacterial species were Klebsiella spp., (43.9%) and Escherichia. coli (39.5%), followed by Enterobacter spp., (6.1%), Salmonella spp., (3.5%), Citrobacter freundii (2.6%), Proteus mirabilis (1.8%), Morganella morganii (1.8%) and Serratia marcescens (0.9%). According to antimicrobial susceptibility, there was high resistance to all tested beta-lactams, while sensitivity to aminoglycosides, fluoroquinolones and carbapenems was present. The predominant species were Klebsiella spp., in Hospitalization and Escherichia coli in Emergency. Of all the species Klebsiella spp., and Escherichia coli are ESBL (32.5%). Conclusions: Antimicrobial resistance caused by ESBL-producing Enterobacteriaceae is considered a serious health problem. Therefore, it is important to evaluate and establish ESBL prevention, control, and dissemination measures to reduce drug resistance and provide effective treatment.