A snapshot of antimicrobial resistance in Mexico. Results from 47 centers from 20 states during a six-month period

Abstract

AimWe aimed to assess the resistance rates of antimicrobial-resistant, in bacterial pathogens of epidemiological importance in 47 Mexican centers.Material and methodsIn this retrospective study, we included a stratified sample of 47 centers, covering 20 Mexican states. Selected isolates considered as potential causatives of disease collected over a 6-month period were included. Laboratories employed their usual methods to perform microbiological studies. The results were deposited into a database and analyzed with the WHONET 5.6 software.ResultsIn this 6-month study, a total of 22,943 strains were included. Regarding Gram-negatives, carbapenem resistance was detected in ≤ 3% in Escherichia coli, 12.5% in Klebsiella sp. and Enterobacter sp., and up to 40% in Pseudomonas aeruginosa; in the latter, the resistance rate for piperacillin-tazobactam (TZP) was as high as 19.1%. In Acinetobacter sp., resistance rates for cefepime, ciprofloxacin, meropenem, and TZP were higher than 50%. Regarding Gram-positives, methicillin resistance in Staphylococcus aureus (MRSA) was as high as 21.4%, and vancomycin (VAN) resistance reached up to 21% in Enterococcus faecium. Acinetobacter sp. presented the highest multidrug resistance (53%) followed by Klebsiella sp. (22.6%) and E. coli (19.4%).ConclusionThe multidrug resistance of Acinetobacter sp., Klebsiella sp. and E. coli and the carbapenem resistance in specific groups of enterobacteria deserve special attention in Mexico. Vancomycin-resistant enterococci (VRE) and MRSA are common in our hospitals. Our results present valuable information for the implementation of measures to control drug resistance.

Antimicrobial resistance and antibiotic consumption in Mexican hospitals

“…This problem has been favored by the increased consumption of carbapenems. 8 For Staphylococcus aureus, the resistance levels were similar to other reports worldwide and the Mexican Network for the Research and Surveillance of Drug Resistance, 9,7 with good susceptibility to cotrimoxazole and rifampicin, and resistance to oxacillin in around 20%. According to the antibiotic consumption data of our network, vancomycin was the 3 rd most prescribed antimicrobial.…”

“…Another Mexican surveillance network recently published their results of antimicrobial resistance in isolates from a 6-month period including 47 laboratories, they found a high resistance level to all antibiotics tested for Acinetobacter baumannii, but also, information of susceptibility to colistin and tigecycline is lacking. 7 When analyzing the resistance in Pseudomonas aeruginosa isolates, there was a great variability, with a wide range of antimicrobial resistance percentages in different hospitals. The higher resistance was observed to carbapenems, with an intermediate median percentage of resistance to first line antimicrobials (piperacillin/tazobactam, cefepime, and cetazidime).…”

“…13 Resistance in Gram-negative bacilli is higher than in similar reports from Mexico a few years ago, 14 and similar to the recent study from the Mexican Network for the Research and Surveillance of Drug Resistance. 7 The limited therapeutic options available lead to an increased and continuous use of carbapenems, with the consequent antibiotic consumption and selection of a new threat: carbapenem resistant Enterobacteriaceae and Gram-negative, non-fermenting bacilli. In a global point-prevalence study including adult hospitals in 53 studies the top three antibiotics prescribed worldwide were penicillins with β-lactamase inhibitors, third-generation cephalosporins, and fluoroquinolones.…”

High prevalence of t895 and t9364 spa types of methicillin-resistant Staphylococcus aureus in a tertiary-care hospital in Mexico: different lineages of clonal complex 5

“…In Mexico, there are a limited number of studies about MRSA and the available information shows an increase in the prevalence of MRSA ranging from 7 to 53% between 1989 and 2017 [ 15 , 23 – 25 ]. In our study, the prevalence of MRSA identified by molecular methods was higher than the prevalence identified by the oxacillin resistance phenotype, which has been the most used method in our country [ 17 , 25 , 26 ]. The 26.7% prevalence registered in our study is higher than that reported, between January and June 2018, in 47 hospitals in 20 states of Mexico (21.4%) [ 26 ], a study that did not include information from the state of San Luis Potosi.…”

“…In our study, the prevalence of MRSA identified by molecular methods was higher than the prevalence identified by the oxacillin resistance phenotype, which has been the most used method in our country [17,25,26]. The 26.7% prevalence registered in our study is higher than that reported, between January and June 2018, in 47 hospitals in 20 states of Mexico (21.4%) [26], a study that did not include information from the state of San Luis Potosi. In a previous study, performed between 2005 and 2006 in six Mexican hospitals, the prevalence of MRSA ranged from 1 to 43%.…”