Correlación negativa entre la viruluencia y la resistencia multidroga en infecciones intrahospitalarias y adquiridas en la comunidad por Proteus mirabilis, en el Oriente de Venezuela

Negative correlation between virulence and multidrug resistance in intrahospital and community acquired infections by Proteus mirabilis, in Eastern Venezuela.

  • Hectorina Rodulfo Tecnologico de Monterrey
  • Milagro Horta Universidad de Oriente
  • Genova Mata Universidad de Oriente
  • Rafela Gutiérrez Universidad de Oriente
  • Yarmilia González Universidad de Oriente
  • Elvia Michelli Universidad de Oriente
  • Militza Guzman Universidad de Oriente
  • Dianny Martínez Hospital Universitario “Antonio Patricio de Alcalá”
  • Ashutosh Sharma Tecnologico de Monterrey
  • Marcos De Donato Tecnologico de Monterrey
Palabras clave: Proteus, MDR, virulencia, resistencia, antimicrobianos

Resumen

Este es el primer reporte para Venezuela de virulencia/pato-genicidad y factores de resistencia en infecciones intrahospitalarias (IAAS) y adquiridas en la comunidad (IAC) por P. mirabilis en dos hospitales principales del oriente de Venezuela. Se determinaron factores de virulencia como la moti-lidad, formación de biopelícula y resistencia al suero humano normal (RSHN). La susceptibilidad a los antimicrobianos permitió clasificar los aislamientos en resistentes, multirresistentes (MDR) y extensivamente resistentes a fármacos (XDR). Se identificó P. mirabilis en IAAS en ambos hospitales principalmente a partir de secreciones, mientras que algunos IAC se identificaron en orina y secreciones. Se identificaron motilidades “twitching” y “swarming”, biopelículas y RSHN en muchos de los aislamientos. Once antimicrobianos mostraron frecuencias de resistencia del 22 al 54% en uno o ambos hospitales. En estos hospitales se encontró una alta frecuencia de aislamientos MDR (60,6 a 56,5%). En un hospital se encontraron cepas que portaban genes blaCTX-M y blaTEM con una frecuencia del 27,0%. También encontramos que la frecuencia de MDR fue menor en las cepas con tres o más factores de virulencia en comparación con aquellas con menos factores. Las bacterias con “swarming” mostraron una probabilidad 5,85 veces menor de ser MDR, y aquellas con “twitching”, una proba-bilidad 7,52 veces menor. Las infecciones por cepas de P. mirabilis MDR/XDR en IAAS y IAC representan un problema de salud pública que requiere medidas de control y prevención efectivas para reducir su potencial propagación y per-sistencia en la población.

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Publicado
2021-03-22
Cómo citar
Rodulfo, H., Horta, M., Mata, G., Gutiérrez, R., González, Y., Michelli, E., Guzman, M., Martínez, D., Sharma, A., & De Donato, M. (2021). Correlación negativa entre la viruluencia y la resistencia multidroga en infecciones intrahospitalarias y adquiridas en la comunidad por Proteus mirabilis, en el Oriente de Venezuela: Negative correlation between virulence and multidrug resistance in intrahospital and community acquired infections by Proteus mirabilis, in Eastern Venezuela. Investigación Clínica, 62(1), 37-51. https://doi.org/10.22209/IC.v62n1a04
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