Antimicrobial susceptibility in blood and urine samples at a third level national hospital in Lima-Peru 2011-2014

Abstract

Background: The antimicrobial resistance map is a tool that allows to know the characteristics of microorganisms, its realization is necessary because the microorganisms are in constant change as a result of the exposure to antimicrobial therapy, which leads to modifications of antimicrobial susceptibility. At the national level, there are no updated reports on antimicrobial susceptibility, which is the reason this study is proposed; it allows to know the new patterns of antimicrobial resistance and implement treatment regimens of greater effectiveness for an adequate management of infections, avoiding inappropriate drug prescriptions, dosage and/or duration. Methods & Materials: A descriptive observational study was performed, 9662 samples of uroculture and blood culture were obtained between 2011 and 2014. The most prevalent microorganisms were selected for each year of each type of sample and 8045 samples were analyzed. Sample source, care service, Gram staining, microorganism, antimicrobials and antimicrobial susceptibility were taken as variables. Frequency distribution tables were used for univariate analysis and double-entry tables were used to associate them. Results: The majority of urine cultures and blood cultures were from patients of outpatient services and emergency room, 5840 (72.60%). The sample type that was most frequently analyzed was the urine sample, 6064 (75.38%). Of the microorganisms isolated, 5644 (70.16%) were Gram negative and 1006 (16.59%) were Gram positive.). The production of ESBL was evaluted in all the samples, 629 (12.21%%) of these were ESBL positive, of which 77.55%. were samples from outpatient services. There is a tendency to decrease antimicrobial susceptibility with regard to antimicrobials such as ciprofloxacin, norfloxacin, amikacin and gentamicin (p < 0.05). Conclusion: Antimicrobial susceptibility tends to decrese and is lower than other countries. Most microorganisms isolated were Gram negative. ESBL-producing microorganisms are derived in a large percentage of samples from outipatient services.