Incidence of Multidrug-Resistant Enterobacteriaceae in Intensive Care Units of the Abel Santamaría Cuadrado Hospital
Keywords:
CUIDADOS CRÍTICOS; ENTEROBACTERIACEAE; FARMACORRESISTENCIA MICROBIANA; UNIDADES DE CUIDADOS INTENSIVOS.; CRITICAL CARE; ENTEROBACTERIACEAE; DRUG RESISTANCE, MICROBIAL; INTENSIVE CARE UNITS.; CUIDADOS CRÍTICOS; ENTEROBACTERIACEAE; FARMACORRESISTÊNCIA; RESISTÊNCIA MICROBIANA A MEDICAMENTOS; UNIDADES DE TERAPIA INTENSIVA.Abstract
Introduction: healthcare-associated infections play a predominant role in global sepsis scenarios.
Objective: to assess the incidence of multidrug-resistant Enterobacteriaceae isolated in the intensive care units (ICUs) of Abel Santamaría Cuadrado Hospital.
Methods: an observational, analytical, prospective cross-sectional study was conducted in the Microbiology Laboratory of the “Abel Santamaría Cuadrado” General Teaching Hospital of Pinar del Río from January 2022 to July 2024. Absolute and relative frequencies were calculated.
Results: a total of 209 microbiological samples from ICU patients were analyzed. Of these, 15,79 % were negative and 17,22 % were contaminated. Enterobacteriaceae were identified in 94 cases (44,98 %), with Enterobacter being the most frequent genus (42 isolates), particularly Enterobacter gergoviae (28 cases, 29,79 %) and Pantoea agglomerans (18 cases, 19,15 %). High resistance rates were observed: 100 % of isolates were resistant to penicillins and 96,8 % to first- and second-generation cephalosporins. The lowest resistance was noted against penicillin–β-lactamase inhibitor combinations. Escherichia, Klebsiella, and Providencia showed complete resistance to cephalosporins, whereas Enterobacter exhibited no resistance to third-generation cephalosporins and Klebsiella showed no resistance to penicillins combined with inhibitors—findings that reveal critical resistance patterns to guide empirical antibiotic therapy.
Conclusions: there is substantial antimicrobial resistance—particularly to penicillins and cephalosporins—in the ICU setting. Knowledge of local resistance profiles guides clinicians in empirical treatment, supports clinical decision-making, and contributes to the development of context-specific antimicrobial stewardship policies.
Downloads
References
1. Giono Cerezo S, Santos Preciado J, Morfín Otero M. Resistencia antimicrobiana. Importancia y esfuerzos por contenerla. Gac Med Mex. [Internet]. 2020[citado 05/11/2025]; 156(2): 172-180. Disponible en: https://doi.org/10.24875/gmm.20005624
2. Cutié Aragón Y, Bello Fernández F, Pacheco Pérez Y, Matos L, R. Resistencia antimicrobiana en pacientes ingresados en la unidad de cuidados intensivos. Rev Electron Zoilo [Internet]. 2022[citado 05/11/2025]; 47(2): e3035. Disponible en: http://revzoilomarinello.sld.cu/index.php/zmv/article/view/3035
3. Tusa Torres A. Indicadores de resistencia antimicrobiana en la unidad de cuidados intensivos en un hospital de Quito, Ecuador. INSPILIP [Internet]. 2021[citado 05/11/2025]; 5(2). Disponiebele en: https://www.inspilip.gob.ec/index.php/inspi/article/view/43
4. Aucanshala Quitio C. Identificación de resistencia a los antibióticos en el área de neonatología del hospital general docente ambato. Repositorio de Tesis [Internet]. 2021[citado 05/11/2025]. Disponible en: http://dspace.espoch.edu.ec/bitstream/123456789/15413/1/56T01020.pdf
5. Bullón Palomino J, Vásquez Cervantes P. Revisión sistemática de tesis universitarias peruanas relacionadas a la resistencia antimicrobiana de enterobacterias. Período 2010-2020. Universidad Nacional Mayor de San Marcos [Internet]. 2021[citado 05/11/2025]. Disponible en: http://cybertesis.unmsm.edu.pe/bitstream/handle/20.500.12672/17403/Bullon_pj.pdf?sequence=1&isAllowed=y
6. Goyes Baca M, Sacon-Espinoza M, Poveda Paredes F. Manejo del sistema de salud de Ecuador frente a la resistencia antimicrobiana. Revista de Información Científica [Internet]. 2023[citado 05/11/2025]; 102. Disponible en: https://www.redalyc.org/articulo.oa?id=551774301005
7. Cinca Irache S, Manzanares Otal S. Prevalencia de bacterias multirresistentes en las unidades de cuidados intensivos. Revista saniaria de innvestigativa [Internet]. 2021[citado 5 abr 2023]; 2(10). Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=8163682
8. do Nascimento Santos F, da silva Roque M, et al. Colonización por ESKAPES y características clínicas de pacientes en estado. Enfermería Glob [Internet]. 2020;19(3):214-54. 2020[citado 05/11/2025]; 19(59). Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412020000300214
9. Garnacho Montero J, Amaya Villar R. El problema de a multiresistencia en bacilos gramnegativos en las unidades de cuidados intensivos: estrategias de ratamiento y prevención. Med Intensiva [Internet]. 2022[citado 05/11/2025]; 46(6): 326-35. https://www.medintensiva.org/es-linkresolver-el-problema-multi-resistencia-bacilos-gram-negativos-S0210569121002837
10. Aleidan F, Alkhelaifi H. Incidence and risk factors of carbapenem-resistant Enterobacteriaceae infection in intensive care units: a matched case–control study. Expert Review of Anti-infective Therapy [Internet]. 2021[citado 05/11/2025]; 19(3). Disponible en: https://doi.org/10.1080/14787210.2020.1822736
11. Rodríguez Pérez M, González Perdomo J, Rodríguez Martínez M. Mapa Microbiológico – 2020 del Instituto de Hematología e Inmunología de Cuba. Rev Cubana Hematol Inmunol Hemoter [Internet]. 2022[citado 05/11/2025]; 38(1): e1580. Disponible en: https://revhematologia.sld.cu/index.php/hih/article/view/1580
12. Zafar Iqbal Mirza S, Estévez González R, Serrano Romero de Ávila V. Factores predictivos de bacteriemia en los pacientes atendidos en el servicio de urgencias por infección. Rev Esp Quimioter [Internet]. 2022[citado 05/11/2025]; 33: 32-43. Disponible en: https://seq.es/wp-content/uploads/2019/11/julian29nov2019.pdf
13. Finello M, Suasnabar D, García M, Díaz M, Richetta L, Toranzo A. Características clínicas y microbiológicas de infecciones del torrente sanguíneo en pacientes adultos neutropénicos. Rev Argentina Microb [Internet]. 2021[citado 05/11/2025]; 53(3): 183-193. Disponible en: https://doi.org/10.1016/j.ram.2020.11.001
14. Guaraca Pomagualli J. Análisis de los tratamientos farmacológicos antibacterianos en función de los cultivos y antibiogramas realizados a pacientes de la unidad de cuidados intensivos y hospitalización del hospital San Juan Riobamba. Repositorio de Tesis [Internet]. 2024[citado 05/11/2025]. Disponible en: http://dspace.espoch.edu.ec/handle/123456789/22621
15. Béjar Camapaza EA. Evaluación de la resistencia antibiótica en pacientes hospitalizados en áreas críticas del Hospital Nacional Adolfo Guevara Velazco, periodo enero-junio 2021. Repos Tesis - UNMSM [Internet]. 2022 [citado 05/11/2025]. Disponible en: https://cybertesis.unmsm.edu.pe/handle/20.500.12672/18652
16. Wu A, Chang H, Wang N, Sun F, Liu C. Clinical and molecular characteristics and risk factors for patients acquiring carbapenemase-producing and non-carbapenemase-producing carbapenem-nonsusceptible Enterobacterales bacteremia. J Microbiol Immunol Infect.[Internet]. 2022[citado 05/11/2025]; 55(6). 1229-38. Disponible en: https://doi.org/10.1016/j.jmii.2021.10.008
17. Noriega Campos E, Dreke Fernández R. Incidencia y causas de sepsis en una unidad de cuidados intensivos quirúrgicos. Rev Cuba Hig Epidemiol[Internet]. 2020[citado 05/11/2025]; 57: e727. Disponible en: https://revepidemiologia.sld.cu/index.php/hie/article/view/727
18. Betancourt GdJ, Pérez A, Reyes G. Comportamiento de las infecciones nosocomiales en una unidad de cuidados intensivos. Rev Cuba Med Intensiva Emerg [Internet]. 2021 [citado 05/11/2025]; 20(2). Disponible en: https://revmie.sld.cu/index.php/mie/article/view/768.
19. Cabrera Rodríguez L, Miralles Suarez A, Ones Roque R, Torres Herrera Y. Variación de la susceptibilidad a antimicrobianos en aislados clínicos de Klebsiella pneumoniae y Escherichia coli de pacientes hospitalizados. Rev Cuba Med Tropical [Internet]. 2022[citado 05/11/2025]; 74(3). Disponible en: https://revmedtropical.sld.cu/index.php/medtropical/article/view/921
20. Hoo G, Cai Y, Quek Y, Teo J, Choudhury S. Predictors and Outcomes of Healthcare-Associated Infections Caused by Carbapenem-Nonsusceptible Enterobacterales: A Parallel Matched Case-Control Study. Front Cell Infect Microbiol [Internet]. 2022[citado 05/11/2025]; 12. Disponible en: https://www.frontiersin.org/articles/10.3389/fcimb.2022.719421
21. Chilon Chavez M, Muñoz Inga J, Silva Díaz H, Chilon Chavez M. Perfil microbiológico de microorganismos aislados de pacientes en unidades de cuidados intensivos de un Hospital de Lambayeque, Perú 2019-2020. Rev Fac Med Humana. [Internet]. 2022[citado 05/11/2025]; 22(2). Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S2308-05312022000200335
22. Zanabria Alvarez JE. Factores asociados a la adquisición de infecciones por enterobacterias resistentes a carbapenémicos en la unidad de cuidados intensivos en un hospital del cusco,2022. Universidad Nacional de San Antonio Abad del Curso Repositorio de Tesis [Internet]. 2023[citado 05/11/2025]. Disponible en: http://hdl.handle.net/20.500.12918/8043
23. Chávez Trávez E. Métodos microbiológicos para la detección de enterobacterales productoras de blee y carbapenemasas en pacientes ingresados en el hospital de Tena. Repositorio de Tesis[Internet]. 2024[citado 05/11/2025]. Disponible en: https://repositorio.uta.edu.ec/handle/123456789/43034
24. Cohen M, Amity K, Katz D, Lazarovitch T. The epidemiology of carbapenem resistant Enterobacter spp: A case-case-control matched analysis. Infect Control Hosp Epidemiol.[Internet]. 2021[citado 05/11/2025]; 42(6): 754-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33228816/
25. Chuah C, Gani Y, Sim B, Chidambaram S. Risk factors of carbapenem-resistant Enterobacteriaceae infection and colonisation: a Malaysian tertiary care hospital based case-control study. J R Coll Physicians Edinb.[Internet]. 2021[citado 05/11/2025]; 51(1): 24-30. Disponible en: https://journals.sagepub.com/doi/abs/10.4997/jrcpe.2021.107
26. Despotovic A, Milosevic B, Milosevic I, Mitrovic N, Cirkovic A, Jovanovic S. Hospital-acquired infections in the adult intensive care unit-Epidemiology, antimicrobial resistance patterns, and risk factors for acquisition and mortality. Am J Infect Control.[Internet]. 2020[citado 05/11/2025]; 48(10): 1211-5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32093978/
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Miguel Luis González Martínez
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who have publications with this journal agree to the following terms: Authors will retain their copyrights and grant the journal the right of first publication of their work, which will be publication of their work, which will be simultaneously subject to the Creative Commons Attribution License (CC-BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g.: deposit it in an institutional telematic archive or publish it in a volume). Likewise, and according to the recommendations of the Medical Sciences Editorial (ECIMED), authors must declare in each article their contribution according to the CRediT taxonomy (contributor roles). This taxonomy includes 14 roles, which can be used to represent the tasks typically performed by contributors in scientific academic production. It should be consulted in monograph) whenever initial publication in this journal is indicated. Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which may produce interesting exchanges and increase citations of the published work. (See The effect of open access). https://casrai.org/credit/
