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

AIM: We aimed to assess the resistance rates of antimicrobial-resistant, in bacterial pathogens of epidemiological importance in 47 Mexican centers. MATERIAL AND METHODS: In 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. RESULTS: In 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%). CONCLUSION: The 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.

Association between Candida biofilm-forming bloodstream isolates and the clinical evolution in patients with candidemia: An observational nine-year single center study in Mexico / Asociación entre aislamientos sanguíneos de Candida formadores de biopelícula y la evolución clínica en pacientes con candidemia: un estudio observacional monocéntrico de nueve años en México

Background. Candidemia is one of the most common nosocomial infections globally and it is associated with considerable excess mortality and costs. Abreast, biofilm-forming strains are associated with even higher mortality rates and poor prognosis for the patient. Aims. To evaluate a possible association between the biofilm-forming capability of Candida bloodstream isolates and the clinical evolution in patients with candidemia. Methods. An observational, retrospective study was conducted at a tertiary care university hospital during 9 years (2006-2015). The biofilm quantitation of the Candida bloodstream isolates was determined by crystal violet staining and XTT reduction assay. Results. A total of 218 cases of candidemia had been diagnosed and 89 isolates were obtained. The mortality rate was 36% and the main risk factors were antibiotic exposure and the use of catheters. Candida tropicalis (52.8%) was the most frequent species, followed by Candida albicans (30.4%), Candida parapsilosis sensu stricto (10.1%), Candida orthopsilosis (3.4%), Candida krusei (2.2%) and Candida glabrata sensu stricto (1.1%). All the strains were biofilm producers, which is an important contribution to the patient's mortality. C. tropicalis showed the highest production of biomass biofilm, whereas C. glabrata exhibited the highest metabolic activity. Conclusions. This study contributes to expand the knowledge about the local epidemiology of candidemia and highlights the impact of Candida biofilm on patient's outcome (AU)

Antecedentes. La candidemia es una de las infecciones nosocomiales más frecuentes globalmente y se encuentra asociada con una elevada mortalidad y coste económico. Las cepas productoras de biopelícula se asocian con elevadas tasas de mortalidad y mal pronóstico para el paciente. Objetivos. Evaluar una posible asociación entre la capacidad de formación de biopelícula de aislamientos sanguíneos de Candida y la evolución clínica de pacientes con candidemia. Métodos. Durante 9 años (2006-2015) se ha llevado a cabo un estudio observacional y retrospectivo en un hospital universitario de tercer nivel de atención. La cuantificación de biopelícula de los aislamientos sanguíneos de Candida se determinó por tinción con cristal violeta y ensayo de reducción de XTT. Resultados. Se diagnosticó un total de 218 casos de candidemia y se obtuvieron 89 aislamientos. La tasa de mortalidad fue del 36% y los principales factores de riesgo fueron la exposición a antibióticos y el uso de catéteres. Candida tropicalis (52,8%) fue la especie más frecuente, seguida por Candida albicans (30,4%), Candida parapsilosis sensu stricto (10,1%), Candida orthopsilosis (3,4%), Candida krusei (2,2%) y Candida glabrata sensu stricto (1,1%). Todas las cepas produjeron biopelícula, una contribución importante a la mortalidad de los pacientes. C. tropicalis mostró la producción más alta de biomasa de biopelícula, mientras que C. glabrata exhibió la actividad metabólica más alta. onclusiones. Este estudio contribuye a expandir el conocimiento de la epidemiología local de la candidemia y resalta el impacto de las biopelículas de Candida en el pronóstico del paciente (AU)

Association between Candida biofilm-forming bloodstream isolates and the clinical evolution in patients with candidemia: An observational nine-year single center study in Mexico.

BACKGROUND: Candidemia is one of the most common nosocomial infections globally and it is associated with considerable excess mortality and costs. Abreast, biofilm-forming strains are associated with even higher mortality rates and poor prognosis for the patient. AIMS: To evaluate a possible association between the biofilm-forming capability of Candida bloodstream isolates and the clinical evolution in patients with candidemia. METHODS: An observational, retrospective study was conducted at a tertiary care university hospital during 9 years (2006-2015). The biofilm quantitation of the Candida bloodstream isolates was determined by crystal violet staining and XTT reduction assay. RESULTS: A total of 218 cases of candidemia had been diagnosed and 89 isolates were obtained. The mortality rate was 36% and the main risk factors were antibiotic exposure and the use of catheters. Candida tropicalis (52.8%) was the most frequent species, followed by Candida albicans (30.4%), Candida parapsilosis sensu stricto (10.1%), Candida orthopsilosis (3.4%), Candida krusei (2.2%) and Candida glabrata sensu stricto (1.1%). All the strains were biofilm producers, which is an important contribution to the patient's mortality. C. tropicalis showed the highest production of biomass biofilm, whereas C. glabrata exhibited the highest metabolic activity. CONCLUSIONS: This study contributes to expand the knowledge about the local epidemiology of candidemia and highlights the impact of Candida biofilm on patient's outcome.