Phenotypic characterization of enterobacterales producing extended-spectrum beta-lactamases and carbapenemases at the Isidro Ayora General Hospital in the city of Loja, Ecuador

Abstract

Introduction: Bacterial resistance generates problems at the hospital and economic level, since it causes epidemiological outbreaks in health centers. This means greater economic investment by the State, conducting studies, acquiring medicines, hiring personnel, among others. Studies have determined that the increase in beta-lactamase and carbapenemase-producing bacteria is significant. Currently there is an increase of 2 to 10%. In Europe, it is estimated that the mortality rate due to these bacteria is 25,000 people per year, and it is estimated that by 2050 this rate could increase to 10 million deaths, which would mean a pandemic. In this context, the objective of the present study is to phenotypically characterize Enterobacterales in stool samples and rectal swabs from hospitalized and outpatient patients at the Isidro Ayora General Hospital, in the city of Loja. Materials and methods: The first phase of the research process began with the collection of stool samples or rectal swabs from patients in the hospitalization and outpatient consultation area of the Isidro Ayora General Hospital in the city of Loja. Results: The incidence of beta-lactamase-producing Enterobacterales in a population of 321 patients was: Escherichia coli 73.7% (42/57); Klebsiella pneumoniae 7.0% (4/57); Klebsiella oxytoca, Klebsiella ozaenae and Klebsiella sp with 3.5% (2/57), respectively; and other enterobacteria with 8.8% (5/57). The incidence of carbapenemase-producing Enterobacterales was 0.6% (2/321). Discussion: It constitutes a pioneering study in the city of Loja that will contribute to the Epidemiological Surveillance System, to the scientific, academic field and connection with Society. Conclusions: It is relevant to create an updated database to determine methods that allow controlling the spread of multidrug resistance.