Characterization of Carbapenemase-producing Enterobacteriaceae, from clinical isolates from the Homero Castanier Crespo Hospital, Azogues-Ecuador

Abstract

Introduction. Antibiotic resistance constitutes an increasingly important global problem. The excessive and irrational use of antibiotics triggers the development of resistant strains such as carbapenemase-producing Enterobacteriaceae (CPE), reducing the treatment options available in the clinical field. This emergence of new strains resistant to almost all antimicrobial agents is a result of their inappropriate use, self-medication, and therapeutic non-compliance. In addition to increasing rates of resistance to carbapenems, emergencies with highly resistant microorganisms have been demonstrated during the COVID-19 pandemic, which may be related to increased use of broad-spectrum antibiotics by patients. Objective. Characterize carbapenemase-producing Enterobacteriaceae, based on their frequency in hospital areas and type of sample in patients who were admitted to the Homero Castanier Crespo Hospital (HHCC) in the city of Azogues, Ecuador, period January 2020 to April 2022. Methodology. It is a positivist study with a quantitative, cross-sectional, descriptive, documentary-type approach. Results. 2021 was the year with the highest incidence of CLD 69.6%, the most affected age group was adults (30-59 years) with 54.9% and it occurred most frequently in males 76.5%. The presence of CLD was more common in samples of endotracheal secretion from the intensive care unit area 70.1%, the etiological agent with the highest incidence was Klebsiella pneumoniae 90.19%. All clinical isolates were resistant to beta-lactams, the antibiotics with the best sensitivity 96% were gentamicin and amikacin Conclusion. The results demonstrate an increase in infections by carbapenemase-producing Enterobacteriaceae and Klebsiella pneumoniae was the most prevalent bacterial species. Among these isolates, 100% resistance to beta-lactam antibiotics was determined, including carbapenems that are considered last-line, which highlights the importance of adequate management of antimicrobial resistance.​