Betalactamasas de espectro extendido en bacilos Gram negativos: caracterización y prevalencia por tipo de infección. Revisión Sistemática

• Jocelyn Loor-Moreira Universidad Estatal del Sur de Manabí. Facultad de Ciencias de la Salud. Carrera de Laboratorio Clínico. Jipijapa-Manabí. Ecuador https://orcid.org/0000-0002-6738-7479
• Cristina Parraga-Roca Universidad Estatal del Sur de Manabí. Facultad Ciencias de la Salud. Carrera de Laboratorio Clínico. Jipijapa-Manabí. Ecuador
• Elsa Noralma Lucas Párrales Universidad Estatal del Sur de Manabí. Facultad Ciencias de la Salud. Carrera de Laboratorio Clínico. Jipijapa-Manabí. Ecuador

DOI: https://doi.org/10.5281/zenodo.5529681

Palabras clave: betalactamasas, Enterobacteriaceae, infecciones, prevalencia, caracterización

Resumen

Los bacilos Gram negativos que producen β-lactamasas de espectro extendido son patógenos que representan una problemática, debido a la escasa alternativa de tratamiento y por las diversas infecciones que provocan, destacando la situación con elevado interés epidemiológico, por la creciente prevalencia. El objetivo de esta revisión fue evaluar betalactamasas de espectro extendido en bacilos Gram negativos, su caracterización y prevalencia por tipo de infección. Se realizaron búsquedas en las bases de datos Medline, PubMed, SciELO, Free Medical Journals, Cochrane Library y Google académico, de los últimos 3 años de publicación, incluyendo artículos en español e inglés y se analizaron 104 artículos. Las infecciones por gramnegativos productores de BLEE incluyen: infección de vías urinarias, gastrointestinales, intraabdominales, nosocomiales, infecciones del torrente sanguíneo, neumonía y meningitis. Las características fenotípicas de las BLEE comprenden principalmente las enzimas CTX-M, TEM y SHV. En América Latina se ha excedido el 30% en la prevalencia de Escherichia coli productora de BLEE. La resistencia dada por BLEE por Gram negativos, son resultado de la presencia de enzimas de clase A que promueven diversas infecciones, generando un problema para el personal médico al sugerir un tratamiento, debido a las consecuencias que este podría generar a futuro.

Citas

Sutherland T, Mpirimbanyi C, Nziyomaze E, Niyomugabo J-P, Niyonsenga Z, Muvunyi CM, et al. Widespread antimicrobial resistance among bacterial infections in a Rwandan referral hospital. PLoS One [Internet]. 2019;14(8):e0221121. Disponible en: https://doi.org/10.1371/journal.pone.0221121. DOI: 10.1371/journal.pone.0221121 PMID 31443107 PMCID PMC6707788

Uc-Cachón AH, Gracida-Osorno C, Luna-Chi IG, Jiménez-Guillermo JG, Molina-Salinas GM. High Prevalence of Antimicrobial Resistance Among Gram-Negative Isolated Bacilli in Intensive Care Units at a Tertiary-Care Hospital in Yucatán Mexico. Medicina (B Aires). 2019;55(9):588. Disponible en: https://www.mdpi.com/1648-9144/55/9/588 DOI: 10.3390/medicina55090588 PMID 31540314 PMCID PMC6780114

Gupta V, Ye G, Olesky M, Lawrence K, Murray J, Yu K. Trends in resistant Enterobacteriaceae and Acinetobacter species in hospitalized patients in the United States: 2013–2017. BMC Infect Dis [Internet]. 2019;19(1):742. Disponible en: https://doi.org/10.1186/s12879-019-4387-3 DOI: 10.1186/s12879-019-4387-3 PMID 31443635 PMCID PMC6708167

Ross J, Larco D, Colon O, Coalson J, Gaus D, Taylor K, et al. Índices de resistencia a los antibióticos en aislamientos clínicos en Santo Domingo, Ecuador. Práctica Fam Rural [Internet]. 2020;5(1). Disponible en: https://doi.org/10.23936/pfr.v5i1.144 DOI: 10.23936/pfr.v5i1.144

Ugwu MC, Shariff M, Nnajide CM, Beri K, Okezie UM, Iroha IR, et al. Phenotypic and Molecular Characterization of β-Lactamases among Enterobacterial Uropathogens in Southeastern Nigeria. Can J Infect Dis Med Microbiol [Internet]. 2020;2020:5843904. Disponible en: https://doi.org/10.1155/2020/5843904 DOI: 10.1155/2020/5843904 PMID 32184910 PMCID PMC7060859

MacVane SH. Antimicrobial Resistance in the Intensive Care Unit: A Focus on Gram-Negative Bacterial Infections. J Intensive Care Med [Internet]. 2016;32(1):25-37. Disponible en: https://doi.org/10.1177/0885066615619895 DOI: 10.1177/0885066615619895 PMID 26772199

Khanna NR, Gerriets V. Beta Lactamase Inhibitors. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557592/

Latorre-Barragan MF, Zurita-Leal AC, Gudiño Gomezjurado ME. Resistencia de los antibióticos ß-lactámicos en países latinoamericanos. Medwave. 2019;19(10):e7729. Spanish. Disponible en: https://www.medwave.cl/link.cgi/Medwave/PuestaDia/Practica/7729.act DOI: 10.5867/medwave.2019.10.7729 PMID 31821318

Karen B. Past and Present Perspectives on β-Lactamases. Antimicrob Agents Chemother [Internet]. 2021;62(10):e01076-18. Disponible en: https://doi.org/10.1128/AAC.01076-18 DOI: 10.1128/AAC.01076-18 PMID 30061284 PMCID PMC6153792

Tooke CL, Hinchliffe P, Bragginton EC, Colenso CK, Hirvonen VHA, Takebayashi Y, et al. β-Lactamases and β-Lactamase Inhibitors in the 21st Century. J Mol Biol [Internet]. 2019;431(18):3472-500. Disponible en: https://www.sciencedirect.com/science/article/pii/S0022283619301822 DOI: 10.1016/j.jmb.2019.04.002 PMID 30959050 PMCID PMC6723624

Hu YJ, Ogyu A, Cowling BJ, Fukuda K, Pang HH. Available evidence of antibiotic resistance from extended-spectrum β-lactamase-producing Enterobacteriaceae in paediatric patients in 20 countries: a systematic review and meta-analysis. Bull World Health Organ. 2019;97(7):486-501B. DOI: 10.2471/BLT.18.225698. Erratum in: Bull World Health Organ. 2019;97(8):580. PMID 31258218 PMCID PMC6593334

Breijyeh Z, Jubeh B, Karaman R. Resistance of Gram-Negative Bacteria to Current Antibacterial Agents and Approaches to Resolve It. Molecules. 2020;25(6):1340. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144564/ DOI: 10.3390/molecules25061340 PMID 32187986 PMCID PMC7144564

Ogawara H. Comparison of Antibiotic Resistance Mechanisms in Antibiotic-Producing and Pathogenic Bacteria. Molecules. 2019;24(19):3430. Disponible en: https://www.mdpi.com/1420-3049/24/19/3430 DOI: 10.3390/molecules24193430 PMID 31546630 PMCID PMC6804068

Serra Valdés MÁ. La resistencia microbiana en el contexto actual y la importancia del conocimiento y aplicación en la política antimicrobiana. Rev Habanera Ciencias Médicas. 2017;16(3):402-19. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1729-519X2017000300011

Mulani MS, Kamble EE, Kumkar SN, Tawre MS, Pardesi KR. Emerging Strategies to Combat ESKAPE Pathogens in the Era of Antimicrobial Resistance: A Review. Front Microbiol [Internet]. 2019;10:539. Disponible en: https://www.frontiersin.org/article/10.3389/fmicb.2019.00539. DOI: 10.3389/fmicb.2019.00539 PMID 30988669 PMCID PMC6452778

Vock I, Aguilar-Bultet L, Egli A, Tamma PD, Tschudin-Sutter S. Independent, external validation of clinical prediction rules for the identification of extended-spectrum β-lactamase-producing Enterobacterales, University Hospital Basel, Switzerland, January 2010 to December 2016. Eurosurveillance [Internet]. 2020;25(26):1900317. Disponible en: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.26.1900317. DOI: 10.2807/1560-7917.ES.2020.25.26.1900317 PMID 32643598 PMCID PMC7346366

Ouchar Mahamat O, Lounnas M, Hide M, Dumont Y, Tidjani A, Kamougam K, et al. High prevalence and characterization of extended-spectrum ß-lactamase producing Enterobacteriaceae in Chadian hospitals. BMC Infect Dis [Internet]. 2019;19(1):205. Disponible en: https://doi.org/10.1186/s12879-019-3838-1. DOI: 10.1186/s12879-019-3838-1 PMID 30819135 PMCID PMC6396450

Ljungquist O, Schönbeck M, Riesbeck K, Tham J. Risk factors associated with prolonged intestinal colonization of ESBL-producing Enterobacteriaceae - a prospective cohort study. Infect Drug Resist. 2019;12:2637-2648. Disponible en: https://www.dovepress.com/risk-factors-associated-with-prolonged-intestinal-colonization-of-esbl-peer-reviewed-fulltext-article-IDR. DOI: 10.2147/IDR.S205163 PMID 31693716 PMCID PMC6716591

Aworh MK, Kwaga J, Okolocha E, Mba N, Thakur S. Prevalence and risk factors for multi-drug resistant Escherichia coli among poultry workers in the Federal Capital Territory, Abuja, Nigeria. PLoS One [Internet]. 2019;14(11):e0225379. Disponible en: https://doi.org/10.1371/journal.pone.0225379. DOI: 10.1371/journal.pone.0225379 PMID 31751388 PMCID PMC6872178

Klibi A, Jouini A, Boubaker El Andolsi R, Kmiha S, Ben Hamda C, Ghedira K, et al. Epidemiology of β-Lactamase-Producing Staphylococci and Gram Negative Bacteria as Cause of Clinical Bovine Mastitis in Tunisia. Biomed Res Int [Internet]. 2019;2019:2165316. Disponible en: https://doi.org/10.1155/2019/2165316. DOI: 10.1155/2019/2165316 PMID 31534954 PMCID PMC6732581

Bubpamala J, Khuntayaporn P, Thirapanmethee K, Montakantikul P, Santanirand P, Chomnawang MT. Phenotypic and genotypic characterizations of extended-spectrum beta-lactamase-producing Escherichia coli in Thailand. Infect Drug Resist. 2018;11:2151-2157. Disponible en: https://www.dovepress.com/phenotypic-and-genotypic-characterizations-of-extended-spectrum-beta-l-peer-reviewed-fulltext-article-IDR. DOI: 10.2147/IDR.S174506 PMID 30464558 PMCID PMC6223337

Falconí Sarmiento A, Nolasco Mejia M, Bedoya Rozas A, Amaro Giraldo C, Málaga G. Frecuencia y factores de riesgo para bacteriemia por enterobacterias productoras de betalactamasa de espectro extendido en pacientes de un hospital público de Lima, Perú. Rev Peru Med Exp Salud Publica [Internet]. 2018;35(1):62-7. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1726-46342018000100010. DOI: 10.17843/rpmesp.2018.351.3601 PMID 29924279

Ludden C, Decano AG, Jamrozy D, Pickard D, Morris D, Parkhill J, et al. Genomic surveillance of Escherichia coli ST131 identifies local expansion and serial replacement of subclones. Microb Genomics [Internet]. 2020;6(4):e000352. Disponible en: https://www.microbiologyresearch.org/content/journal/mgen/10.1099/mgen.0.000352. DOI: 10.1099/mgen.0.000352 PMID 32213258 PMCID PMC7276707

Latorre-Barragan MF, Zurita-Leal AC, Gudiño Gomezjurado ME. Resistencia de los antibióticos ß-lactámicos en países latinoamericanos. MedWave. 2019;19(10):e7729. Spanish. Disponible en: https://www.medwave.cl/link.cgi/Medwave/PuestaDia/Practica/7729.act DOI: 10.5867/medwave.2019.10.7729 PMID 31821318

Pachay Solórzano JW. Las infecciones bacterianas y su resistencia a los antibióticos. Caso de estudio: Hospital Oncológico Dr. Julio Villacreses Colmont Solca, Portoviejo. Rev Univ y Soc. 2018;10(5):219-23. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2218-36202018000500219

Jaimes-Vélez AM, Solís-Ayala E. Administración previa de antibiótico como factor asociado con infección urinaria por E. coli productora de BLEE de origen comunitario en pacientes diabéticos. Med Int Mex. 2017;33(5):605-611. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=76649

Gonzales E, Patiño L, Ore E, Martínez V, Moreno S, Cruzado NB, et al. B-lactamasas de espectro extendido tipo CTX-M en aislamientos clínicos de Escherichia coli y Klebsiella pneumoniae en el Instituto Nacional de Salud del Niño-Breña, Lima, Perú. Rev Medica Hered [Internet]. 2019;30(4):242-8. Disponible en: http://www.scielo.org.pe/scielo.php?pid=S1018-130X2019000400005&script=sci_arttext&tlng=en DOI: 10.20453/rmh.v30i4.3659

De Angelis G, Del Giacomo P, Posteraro B, Sanguinetti M, Tumbarello M. Molecular Mechanisms, Epidemiology, and Clinical Importance of β-Lactam Resistance in Enterobacteriaceae. Int J Mol Sci. 2020;21(14):2090. Disponible en: https://www.mdpi.com/1422-0067/21/14/5090 DOI: 10.3390/ijms21145090 PMID 32708513 PMCID PMC7404273

Solís Bustos MD, Cruz Celi LV. Incidencia de microorganismos Cepa BLEE asociada a factores de riesgo séptico en pacientes con infecciones del tracto urinario en el servicio de UCI en un hospital de segundo nivel “Hospital General IESS Ceibos” [Internet]. [Grado en Medicina]. Guayaquil-Guayas. Ecuador: Universidad Católica de Santiago de Guayaquil; 2020. Disponible en: http://repositorio.ucsg.edu.ec/handle/3317/14965

Beyene D, Bitew A, Fantew S, Mihret A, Evans M. Multidrug-resistant profile and prevalence of extended spectrum β-lactamase and carbapenemase production in fermentative Gram-negative bacilli recovered from patients and specimens referred to National Reference Laboratory, Addis Ababa, Ethiopia. PLoS One [Internet]. 2019;14(9):e0222911. Disponible en: https://doi.org/10.1371/journal.pone.0222911 DOI: 10.1371/journal.pone.0222911 PMID 31553773 PMCID PMC6760794

Malekjamshidi MR, Zandi H, Eftekhar F. Prevalence of extended-spectrum β-lactamase and integron gene carriage in multidrug-resistant Klebsiella species isolated from outpatients in Yazd, Iran. Iran J Med Sci [Internet]. 2020;45(1):23-31. Disponible en: https://ijms.sums.ac.ir/article_45334.html DOI: 10.30476/ijms.2019.45334 PMID 32038056 PMCID PMC6983277

Sheu C-C, Lin S-Y, Chang Y-T, Lee C-Y, Chen Y-H, Hsueh P-R. Management of infections caused by extended-spectrum β–lactamase-producing Enterobacteriaceae: current evidence and future prospects. Expert Rev Anti Infect Ther [Internet]. 2018;16(3):205-18. Disponible en: https://doi.org/10.1080/14787210.2018.1436966 DOI: 10.1080/14787210.2018.1436966 PMID 29402125

Rada AM, Hernández-Gómez C, Restrepo E, Villegas MV. Distribution and molecular characterization of beta-lactamases in Gram negative bacteria in Colombia (2001-2016). Biomedica [Internet]. 2019;39(Suppl 1):199-220. Disponible en: https://doi.org/10.7705/biomedica.v39i3.4351 DOI: 10.7705/biomedica.v39i3.4351 PMID 31529860

Sawa T, Kooguchi K, Moriyama K. Molecular diversity of extended-spectrum β-lactamases and carbapenemases, and antimicrobial resistance. J Intensive Care [Internet]. 2020;8(1):13. Disponible en: https://doi.org/10.1186/s40560-020-0429-6 DOI: 10.1186/s40560-020-0429-6 PMID 32015881

Lacava-Pereira J, Martins-Volcão L, Baracy-Klafke G, Stone-Vieira R, Vitola-Gonçalves C, Bastos-Ramis I, et al. Antimicrobial Resistance and Molecular Characterization of Extended-Spectrum β-Lactamases of Escherichia coli and Klebsiella spp. Isolates from Urinary Tract Infections in Southern Brazil. Microb Drug Resist [Internet]. 2018;25(2):173-81. Disponible en: https://doi.org/10.1089/mdr.2018.0046 DOI: 10.1089/mdr.2018.0046 PMID 30133334

Pourakbari B, Mamishi S, Shokrollahi MR, Heydari H, Mahmoudi S, Banar M, et al. Molecular characteristics and antibiotic resistance profiles of Escherichia coli strains isolated from urinary tract infections in children admitted to children’s referral hospital of Qom, Iran. Ann Ig [Internet]. 2019;31(3):252-62. Disponible en: http://www.seu-roma.it/riviste/annali_igiene/open_access/articoli/31-03-07-Pourakbari.pdf DOI: 10.7416/ai.2019.2288 PMID 31069370

Galindo-Méndez M. Caracterización molecular y patrón de susceptibilidad antimicrobiana de Escherichia coli productora de β-lactamasas de espectro extendido en infección del tracto urinario adquirida en la comunidad. Rev Chil Infectol [Internet]. 2018;35(1):29-35. Disponible en: https://www.revinf.cl/index.php/revinf/article/view/19 DOI: 10.4067/s0716-10182018000100029 PMID 29652969

Toy T, Pak GD, Duc TP, Campbell JI, El Tayeb MA, Von Kalckreuth V, et al. Multicountry Distribution and Characterization of Extended-spectrum β-Lactamase–associated Gram-negative Bacteria From Bloodstream Infections in Sub-Saharan Africa. Clin Infect Dis [Internet]. 2019;69(Suppl 6):S449-58. Disponible en: https://doi.org/10.1093/cid/ciz450 DOI: 10.1093/cid/ciz450 PMID 31665776 PMCID PMC6821266

Daga AP, Koga VL, Soncini JGM, de Matos CM, Perugini MRE, Pelisson M, et al. Escherichia coli Bloodstream Infections in Patients at a University Hospital: Virulence Factors and Clinical Characteristics. Front Cell Infect Microbiol [Internet]. 2019;9:191. Disponible en: https://www.frontiersin.org/article/10.3389/fcimb.2019.00191 DOI: 10.3389/fcimb.2019.00191 PMID 31245301 PMCID PMC6563721

Satlin MJ, Chavda KD, Baker TM, Chen L, Shashkina E, Soave R, et al. Colonization With Levofloxacin-resistant Extended-spectrum β-Lactamase-producing Enterobacteriaceae and Risk of Bacteremia in Hematopoietic Stem Cell Transplant Recipients. Clin Infect Dis [Internet]. 2018;67(11):1720-8. Disponible en: https://doi.org/10.1093/cid/ciy363 DOI: 10.1093/cid/ciy363 PMID 29701766 PMCID PMC6233682

Otter JA, Natale A, Batra R, Tosas Auguet O, Dyakova E, Goldenberg SD, et al. Individual- and community-level risk factors for ESBL Enterobacteriaceae colonization identified by universal admission screening in London. Clin Microbiol Infect [Internet]. 2019;25(10):1259-65. Disponible en: https://doi.org/10.1016/j.cmi.2019.02.026 DOI: 10.1016/j.cmi.2019.02.026 PMID 30849431

La Combe B, Clermont O, Messika J, Eveillard M, Kouatchet A, Lasocki S, et al. Pneumonia-Specific Escherichia coli with Distinct Phylogenetic and Virulence Profiles, France, 2012–2014. Emerg Infect Dis J [Internet]. 2019;25(4):710. Disponible en: https://wwwnc.cdc.gov/eid/article/25/4/18-0944_article DOI: 10.3201/eid2504.180944 PMID 30882313 PMCID PMC6433033

Xu H, Huo C, Sun Y, Zhou Y, Xiong Y, Zhao Z, et al. Emergence and molecular characterization of multidrug-resistant Klebsiella pneumoniae isolates harboring blaCTX-M-15 extended-spectrum β-lactamases causing ventilator-associated pneumonia in China. Infect Drug Resist [Internet]. 2019;12:33-43. Disponible en: http://dx.doi.org/10.2147/IDR.S189494 DOI: 10.2147/IDR.S189494 PMID 30588046 PMCID PMC6304254

Zeynudin A, Pritsch M, Schubert S, Messerer M, Liegl G, Hoelscher M, et al. Prevalence and antibiotic susceptibility pattern of CTX-M type extended-spectrum β-lactamases among clinical isolates of gram-negative bacilli in Jimma, Ethiopia. BMC Infect Dis [Internet]. 2018;18(1):524. Disponible en: https://doi.org/10.1186/s12879-018-3436-7. DOI: 10.1186/s12879-018-3436-7 PMID 30342476 PMCID PMC6196031

Guglietta A. Recurrent urinary tract infections in women: risk factors, etiology, pathogenesis and prophylaxis. Future Microbiol [Internet]. 2017;12(3):239-46. Disponible en: https://doi.org/10.2217/fmb-2016-0145 DOI: 10.2217/fmb-2016-0145 PMID 28262045

Mortazavi-Tabatabaei SAR, Ghaderkhani J, Nazari A, Sayehmiri K, Sayehmiri F, Pakzad I. Pattern of Antibacterial Resistance in Urinary Tract Infections: A Systematic Review and Meta-analysis. Int J Prev Med. 2019;10:169. DOI: 10.4103/ijpvm.IJPVM_419_17 PMID 32133087 PMCID PMC6826787

Gajdács M, Burián K, Terhes G. Resistance Levels and Epidemiology of Non-Fermenting Gram-Negative Bacteria in Urinary Tract Infections of Inpatients and Outpatients (RENFUTI): A 10-Year Epidemiological Snapshot. Antibiotics. 2019;8(3):143. Disponible en: https://www.mdpi.com/2079-6382/8/3/143 DOI: 10.3390/antibiotics8030143 PMID 31505817 PMCID PMC6784256

Gomila A, Shaw E, Carratalà J, Leibovici L, Tebé C, Wiegand I, et al. Predictive factors for multidrug-resistant gram-negative bacteria among hospitalised patients with complicated urinary tract infections. Antimicrob Resist Infect Control [Internet]. 2018;7(1):111. Disponible en: https://doi.org/10.1186/s13756-018-0401-6 DOI: 10.1186/s13756-018-0401-6 PMID 30220999 PMCID PMC6137881

Albaramki JH, Abdelghani T, Dalaeen A, Khdair Ahmad F, Alassaf A, Odeh R, et al. Urinary tract infection caused by extended-spectrum β-lactamase-producing bacteria: Risk factors and antibiotic resistance. Pediatr Int [Internet]. 2019;61(11):1127-32. Disponible en: https://doi.org/10.1111/ped.13911. DOI: 10.1111/ped.13911 PMID 31206219

Horie A, Nariai A, Katou F, Abe Y, Saito Y, Koike D, et al. Increased community-acquired upper urinary tract infections caused by extended-spectrum beta-lactamase-producing Escherichia coli in children and the efficacy of flomoxef and cefmetazole. Clin Exp Nephrol [Internet]. 2019;23(11):1306-14. Disponible en: https://doi.org/10.1007/s10157-019-01775-w. DOI: 10.1007/s10157-019-01775-w PMID 31428892 PMCID PMC6797641

Będzichowska A, Przekora J, Stapińska-Syniec A, Guzek A, Murawski P, Jobs K, et al. Frequency of infections caused by ESBL-producing bacteria in pediatric ward – single center five-year observation. Arch Med Sci [Internet]. 2019;15(3):688-93. Disponible en: https://doi.org/10.5114/aoms.2017.72407. DOI: 10.5114/aoms.2017.72407 PMID 31110535 PMCID: PMC6524197

Goyal D, Dean N, Neill S, Jones P, Dascomb K. Risk Factors for Community-Acquired Extended-Spectrum Beta-Lactamase–Producing Enterobacteriaceae Infections—A Retrospective Study of Symptomatic Urinary Tract Infections. Open Forum Infect Dis [Internet]. 2019;6(2):ofy357. Disponible en: https://doi.org/10.1093/ofid/ofy357. DOI: 10.1093/ofid/ofy357 PMID 30775401 PMCID: PMC6366654

Trecarichi EM, Giuliano G, Cattaneo C, Ballanti S, Criscuolo M, Candoni A, et al. Bloodstream infections caused by Escherichia coli in onco-haematological patients: Risk factors and mortality in an Italian prospective survey. PLoS One [Internet]. 2019;14(10):e0224465. Disponible en: https://doi.org/10.1371/journal.pone.0224465. DOI: 10.1371/journal.pone.0224465 PMID 31661507 PMCID PMC6818756

Jarlier V, Diaz Högberg L, Heuer OE, Campos J, Eckmanns T, Giske CG, et al. Strong correlation between the rates of intrinsically antibiotic-resistant species and the rates of acquired resistance in Gram-negative species causing bacteraemia, EU/EEA, 2016. Eurosurveillance [Internet]. 2019;24(33):1800538. Disponible en: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2019.24.33.1800538. DOI: 10.2807/1560-7917.ES.2019.24.33.1800538 PMID 31431208 PMCID: PMC6702794

Restrepo-Álvarez CA, Bernal E, Ascuntar-Tello J, Jaimes F. Análisis clínico y microbiológico de la sepsis grave y el choque séptico por Escherichia coli en Medellín, Colombia. Rev Chil infectología [Internet]. 2019;36(4):447-54. Disponible en: https://www.revinf.cl/index.php/revinf/article/view/535. DOI: 10.4067/s0716-10182019000400447 PMID 31859768

Liu J, Du S-X, Zhang J-N, Liu S-H, Zhou Y-Y, Wang X-R. Spreading of extended-spectrum β-lactamase-producing Escherichia coli ST131 and Klebsiella pneumoniae ST11 in patients with pneumonia: a molecular epidemiological study. Chin Med J (Engl) [Internet]. 2019;132(16). Disponible en: https://journals.lww.com/cmj/Fulltext/2019/08200/Spreading_of_extended_spectrum.2.aspx. DOI: 10.1097/CM9.0000000000000368 PMID 31408445 PMCID PMC6708689

Tural Kara T, Erat T, Yahşi A, Özdemir H, İleri T, İnce E, et al. Bloodstream infections in pediatric hematology/oncology patients: Six years’ experience of a single center in turkey. Turkish J Med Sci [Internet]. 2019;49(4):1157-64. Disponible en: https://journals.tubitak.gov.tr/medical/issues/sag-19-49-4/sag-49-4-28-1812-101.pdf. DOI: 10.3906/sag-1812-101 PMID 31342734 PMCID PMC7018311

Mert D, Ceken S, Iskender G, Iskender D, Merdin A, Duygu F, et al. Epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies. J Infect Dev Ctries [Internet]. 2019;13(08):727-35. Disponible en: https://jidc.org/index.php/journal/article/view/32069257. DOI: 10.3855/jidc.11457 PMID 32069257

Grasselli G, Scaravilli V, Alagna L, Bombino M, De Falco S, Bandera A, et al. Gastrointestinal colonization with multidrug-resistant Gram-negative bacteria during extracorporeal membrane oxygenation: effect on the risk of subsequent infections and impact on patient outcome. Ann Intensive Care [Internet]. 2019;9(1):141. Disponible en: https://doi.org/10.1186/s13613-019-0615-7. DOI: 10.1186/s13613-019-0615-7 PMID 31853672 PMCID PMC6920277

Linzitto OR, Tunes M del L. Revisión sobre bacterias Gram negativas de importancia clínica. Rev Enfermedades Infecc Emergentes [Internet]. 2019;14:28-31. Disponible en: http://sedici.unlp.edu.ar/handle/10915/90195.

Veliz-Mero NA, Peñaherrera-Alcívar MVP, Alcívar-Cedeño AE, Acosta-Castro FE, Ávila-Piguave YP, Hernández-Macías SJ. Diagnóstico y tratamiento de infecciones gastrointestinales en niños. RECIMUNDO [Internet]. 2019;3(2). Disponible en: https://recimundo.com/index.php/es/article/view/489. DOI: 10.26820/recimundo/3.(2).abril.2019.1021-1047

Centeno S D, Salvatierra R G, Calle E S. Detección de fenotipos de resistencia ACCSuT, BLEE y AmpC en cepas de Salmonella enterica aisladas de infecciones en animales. Rev Investig Vet del Perú [Internet]. 2018;29(2):580-7. Disponible en: https://revistasinvestigacion.unmsm.edu.pe/index.php/veterinaria/article/view/14491. DOI: 10.15381/rivep.v29i2.14491

Alqarni A, Kantor E, Grall N, Tanaka S, Zappella N, Godement M, et al. Clinical characteristics and prognosis of bacteraemia during postoperative intra-abdominal infections. Crit Care [Internet]. 2018;22(1):175. Disponible en: https://doi.org/10.1186/s13054-018-2099-5. DOI: 10.1186/s13054-018-2099-5 PMID 29980218 PMCID PMC6035454

Yoon YK, Kim J, Moon C, Lee MS, Hur J, Lee H, et al. Antimicrobial Susceptibility of Microorganisms Isolated from Patients with Intraabdominal Infection in Korea: a Multicenter Study. J Korean Med Sci [Internet]. 2019;34(47). Disponible en: https://doi.org/10.3346/jkms.2019.34.e309. DOI: 10.3346/jkms.2019.34.e309 PMID 31808326 PMCID PMC6900408

Ponce-de-Leon A, Rodríguez-Noriega E, Morfín-Otero R, Cornejo-Juárez DP, Tinoco JC, Martínez-Gamboa A, et al. Antimicrobial susceptibility of gram-negative bacilli isolated from intra-abdominal and urinary-tract infections in Mexico from 2009 to 2015: Results from the Study for Monitoring Antimicrobial Resistance Trends (SMART). PLoS One [Internet]. 2018;13(6):e0198621. Disponible en: https://doi.org/10.1371/journal.pone.0198621. DOI: 10.1371/journal.pone.0198621 PMID 29927958 PMCID PMC6013120

Clara L, Rodríguez VM, Saúl P, Domínguez C, Esteban M. Intra-abdominal infections. Update and recommendations. Medicina (B Aires) [Internet]. 2018;78(6):417-26. Disponible en: http://www.medicinabuenosaires.com/PMID/30504109.pdf. PMID 30504109

Escolà-Vergé L, Pigrau C, Almirante B. Ceftolozane/tazobactam for the treatment of complicated intra-abdominal and urinary tract infections: Current perspectives and place in therapy. Infect Drug Resist [Internet]. 2019;12:1853-67. Disponible en: http://doi.org/10.2147/IDR.S180905. DOI: 10.2147/IDR.S180905 PMID 31308706 PMCID PMC6613001

Cantón R, Loza E, Aznar J, Castillo FJ, Cercenado E, Fraile-Ribot PA, et al. Monitoring the antimicrobial susceptibility of gram-negative organisms involved in intraabdominal and urinary tract infections recovered during the SMART study (Spain, 2016 and 2017). Rev Esp Quimioter [Internet]. 2019;32(2):145-55. Disponible en: https://seq.es/abstract/february-13-2/ PMID 30761824 PMCID PMC6441989

Sudhaharan S, Kanne P, Vemu L, Chavali P, Desmukha SR, Nagari B. Bacteriological profile of intra-abdominal infections in a tertiary care hospital. Iran J Microbiol [Internet]. 2018;10(4):208-14. Disponible en: https://ijm.tums.ac.ir/index.php/ijm/article/view/1638 PMID 30483371 PMCID PMC6243144

Assegu Fenta D, Lemma K, Tadele H, Tadesse BT, Derese B. Antimicrobial sensitivity profile and bacterial isolates among suspected pyogenic meningitis patients attending at Hawassa University Hospital: Cross-sectional study. BMC Microbiol [Internet]. 2020;20(1):125. Disponible en: https://doi.org/10.1186/s12866-020-01808-5. DOI: 10.1186/s12866-020-01808-5 PMID 32429892 PMCID PMC7238580

Xu M, Fu Y, Fang Y, Xu H, Kong H, Liu Y, et al. High prevalence of KPC-2-producing hypervirulent Klebsiella pneumoniae causing meningitis in Eastern China. Infect Drug Resist [Internet]. 2019;12:641-53. Disponible en: http://dx.doi.org/10.2147/IDR.S191892. DOI: 10.2147/IDR.S191892 PMID 30936727 PMCID PMC6430001

Zhao Z, Hua X, Yu J, Zhang H, Li J, Li Z. Duration of empirical therapy in neonatal bacterial meningitis with third generation cephalosporin: A multicenter retrospective study. Arch Med Sci [Internet]. 2019;15(6):1482-9. Disponible en: https://doi.org/10.5114/aoms.2018.76938. DOI: 10.5114/aoms.2018.76938 PMID 31749877 PMCID PMC6855170

Mercado MC, Guerrero-Becerra M, Gutiérrez-Oliva L, Martínez-Arce PA, Merlo-Palomera M, Arredondo-Navarro LÁ. Experience in the treatment of meningitis associated with health care in pediatric patients. Rev Mex Neurocienc. 2019;20(6). Disponible en: https://www.revmexneurociencia.com/frame_esp.php?id=64# DOI: 10.24875/rmn.m19000050

Bichon A, Aubry C, Dubourg G, Drouet H, Lagier J-C, Raoult D, et al. Escherichia coli spontaneous community-acquired meningitis in adults: A case report and literature review. Int J Infect Dis [Internet]. 2018;67:70-4. Disponible en: https://doi.org/10.1016/j.ijid.2017.12.003. DOI: 10.1016/j.ijid.2017.12.003 PMID 29225070

Cillóniz C, Dominedò C, Torres A. Multidrug Resistant Gram-Negative Bacteria in Community-Acquired Pneumonia. Crit Care [Internet]. 2019;23(1):79. Disponible en: https://doi.org/10.1186/s13054-019-2371-3. DOI: 10.1186/s13054-019-2371-3 PMID 30850010 PMCID PMC6408800

Cillóniz C, Menendez R, García-Vidal C, Pericas JM, Torres A. Defining Community-Acquired Pneumonia as a Public Health Threat: Arguments in Favor from Spanish Investigators. Med Sci [Internet]. 2020;8(1):6. Disponible en: https://www.mdpi.com/2076-3271/8/1/6. DOI: https://doi.org/10.3390/medsci8010006 PMID 31991843 PMCID PMC7151587

Juan C-H, Fang S-Y, Chou C-H, Tsai T-Y, Lin Y-T. Clinical characteristics of patients with pneumonia caused by Klebsiella pneumoniae in Taiwan and prevalence of antimicrobial-resistant and hypervirulent strains: a retrospective study. Antimicrob Resist Infect Control [Internet]. 2020;9(1):4. Disponible en: https://doi.org/10.1186/s13756-019-0660-x. DOI: 10.1186/s13756-019-0660-x PMID 31911832 PMCID PMC6942382

Pérez Verea L, Rodríguez Méndez A, Caro Rodríguez A, Olivera Reyes Y, Fernández Ferrer A. Neumonía adquirida en la comunidad. Rev Cuba Med Intensiva y Emergencias [Internet]. 2019;18(2). Disponible en: http://www.revmie.sld.cu/index.php/mie/article/view/478

Purba AK, Ascobat P, Muchtar A, Wulandari L, Rosyid AN, Purwono PB, et al. Multidrug-resistant infections among hospitalized adults with community-acquired pneumonia in an Indonesian tertiary referral hospital. Infect Drug Resist [Internet]. 2019;12:3663-75. Disponible en: http://doi.org/10.2147/IDR.S217842. DOI: 10.2147/IDR.S217842 PMID 31819549 PMCID: PMC6883944

Sarda C, Fazal F, Rello J. Management of ventilator-associated pneumonia (VAP) caused by resistant gram-negative bacteria: which is the best strategy to treat? Expert Rev Respir Med [Internet]. 2019;13(8):787-98. Disponible en: https://doi.org/10.1080/17476348.2019.1632195. DOI: 10.1080/17476348.2019.1632195 PMID 31210549

Cillóniz C, Dominedò C, Torres A. An overview of guidelines for the management of hospital-acquired and ventilator-associated pneumonia caused by multidrug-resistant Gram-negative bacteria. Curr Opin Infect Dis [Internet]. 2019;32(6):656-62. Disponible en: https://journals.lww.com/co-infectiousdiseases/Fulltext/2019/12000/An_overview_of_guidelines_for_the_management_of.18.aspx. DOI: 10.1097/QCO.0000000000000596 PMID 31567412

Inghammar M, Borand L, Goyet S, Rammaert B, Te V, Lorn Try P, et al. Community-acquired pneumonia and Gram-negative bacilli in Cambodia—incidence, risk factors and clinical characteristics. Trans R Soc Trop Med Hyg [Internet]. 2018;112(2):57-63. Disponible en: https://doi.org/10.1093/trstmh/try022. DOI: 10.1093/trstmh/try022 PMID 29579302 PMCID: PMC6018679

Ashurst JV, Dawson A. Klebsiella Pneumonia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK519004/

Baidya A, Kodan P, Fazal F, Tsering S, Ramesh Menon P, Jorwal P, et al. Stenotrophomonas maltophilia: More than just a colonizer! Indian J Crit Care Med [Internet]. 2019;23(9):434-6. Disponible en: https://www.ijccm.org/abstractArticleContentBrowse/IJCCM/64/23/9/16800/abstractArticle/Article. DOI: 10.5005/jp-journals-10071-23241 PMID 31645832 PMCID PMC6775712

Imoto W, Yamada K, Yamairi K, Shibata W, Namikawa H, Yukawa S, et al. Clinical Characteristics of Rapidly Progressive Fatal Hemorrhagic Pneumonia Caused by Stenotrophomonas maltophilia. Intern Med [Internet]. 2020;59(2):193-8. Disponible en: https://www.jstage.jst.go.jp/article/internalmedicine/59/2/59_3358-19/_article. DOI: 10.2169/internalmedicine.3358-19 PMID 31941869 PMCID PMC7008057

Gajdács M, Urbán E. Prevalence and Antibiotic Resistance of Stenotrophomonas maltophilia in Respiratory Tract Samples: A 10-Year Epidemiological Snapshot. Heal Serv Res Manag Epidemiol [Internet]. 2019;6:2333392819870774. Disponible en: https://doi.org/10.1177/2333392819870774. DOI: 10.1177/2333392819870774 PMID 31453265 PMCID PMC6698998

Ozuna M, Vester L, Jiménez J. Implementación de medidas preventivas de las Infecciones Asociadas a la Atención de Salud (IAAS) en un departamento de cuidados intensivos pediátricos. Rev Científica en Ciencias la Salud [Internet]. 2019;1(2):79-89. Disponible en: http://www.upacifico.edu.py:8040/index.php/PublicacionesUP_Salud/article/view/28

De Oliveira PMN, Buonora SN, Souza CLP, Júnior RS, Da Silva TC, Bom GJT, et al. Surveillance of multidrug-resistant bacteria in pediatric and neonatal intensive care units in Rio de Janeiro State, Brazil. Rev Soc Bras Med Trop [Internet]. 2019;52:e20190205. Disponible en: https://www.scielo.br/j/rsbmt/a/NQtPsTkc5CFz3P8xMy9zYZx/?lang=en# DOI: 10.1590/0037-8682-0205-2019 PMID 31508783

Alnimr AM, Alamri AM. Antimicrobial activity of cephalosporin–beta-lactamase inhibitor combinations against drug-susceptible and drug-resistant Pseudomonas aeruginosa strains. J Taibah Univ Med Sci [Internet]. 2020;15(3):203-10. Disponible en: https://www.sciencedirect.com/science/article/pii/S1658361220300640 DOI: 10.1016/j.jtumed.2020.04.004 PMID 32647515 PMCID PMC7335999

Pedrozo-Torres ME, Vázquez FA, Holt N, Cabello MÁ, Samudio M, Baruja D, et al. Brote en simultáneo de Pseudomona aeruginosa y Klebsiella pneumoniae BLEE en una Unidad de Cuidados Intensivos Neonatal de Asunción, Paraguay. Memorias del Inst Investig en Ciencias la Salud [Internet]. 2019;17(1):59-68. Disponible en: http://scielo.iics.una.py/scielo.php?script=sci_arttext&pid=S1812-95282019000100059. DOI: 10.18004/mem.iics/1812-9528/2019.017(01)59-068

Paz-Zarza VM, Mangwani-Mordani S, Martínez-Maldonado A, Álvarez-Hernández D, Solano-Georgina SG, Vázquez-López R. Pseudomonas aeruginosa: Pathogenicity and antimicrobial resistance in urinary tract infection. Rev Chil Infectol [Internet]. 2019;36(2):180-9. Disponible en: https://www.revinf.cl/index.php/revinf/article/view/420/171 DOI: 10.4067/S0716-10182019000200180 PMID 31344154

Čiginskienė A, Dambrauskienė A, Rello J, Adukauskienė D. Ventilator-Associated Pneumonia due to Drug-Resistant Acinetobacter baumannii: Risk Factors and Mortality Relation with Resistance Profiles, and Independent Predictors of In-Hospital Mortality. Medicina (Kaunas). 2019;55(2):49. DOI: 10.3390/medicina55020049 PMID 30781896 PMCID PMC6410055

Ren J, Li X, Wang L, Liu M, Zheng K, Wang Y. Risk Factors and Drug Resistance of the MDR Acinetobacter baumannii in Pneumonia Patients in ICU. Open Med (Warsaw, Poland). 2019;14:772-7. DOI: 10.1515/med-2019-0090 PMID 31667355 PMCID PMC6814959

Ibrahim ME. Prevalence of Acinetobacter baumannii in Saudi Arabia: risk factors, antimicrobial resistance patterns and mechanisms of carbapenem resistance. Ann Clin Microbiol Antimicrob [Internet]. 2019;18(1):1. Disponible en: https://doi.org/10.1186/s12941-018-0301-x. DOI: 10.1186/s12941-018-0301-x PMID 30606201 PMCID PMC6317247

Torres ED, Domínguez MJ, Buenfil VL, Cicero AM. Características clínicas y microbiológicas de pacientes con infecciones asociadas a los cuidados de la salud en un hospital de alta especialidad de Yucatán. Enf Inf Microbiol [Internet]. 2018;28(2):44-9. Disponible en: https://www.medigraphic.com/pdfs/micro/ei-2018/ei182c.pdf.

Grupo GERMEN. Información de Instituciones Hospitalarias y Laboratorios Clínicos de Medellín y los municipios de Itagüí, Envigado, Bello, Rionegro y La Ceja del Tambo. [citado el 30 de Julio de 2020]. 2020. Grupo GERMEN. Colombia. Disponible en: http://www.grupogermen.org/pdf/escherichia_coli_12_14.pdf

Oliveira J, Reygaert WC. Gram Negative Bacteria. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538213/

Hews CL, Cho T, Rowley G, Raivio TL. Maintaining Integrity Under Stress: Envelope Stress Response Regulation of Pathogenesis in Gram-Negative Bacteria. Front Cell Infect Microbiol [Internet]. 2019;9:313. Disponible en: https://www.frontiersin.org/article/10.3389/fcimb.2019.00313. DOI: 10.3389/fcimb.2019.00313 PMID 31552196 PMCID PMC6737893

Khyade VB, Almugada BS, Ali NO, Ahmed AB, Ahmed EL. Prevalence and antibiotics susceptibility patterns of carbapenem resistant Enterobacteriaceae. J Bacteriol Mycol [Internet]. 2018;6(3):187-90. Disponible en: https://medcraveonline.com/JBMOA/prevalence-and-antibiotics-susceptibility-patterns-of-carbapenem-resistant-enterobacteriaceae.html DOI: 10.15406/jbmoa.2018.06.00201

de Oliveira MS, Oshiro-Junior JA, Sato MR, Conceição MM, Medeiros AC. Polymeric Nanoparticle Associated with Ceftriaxone and Extract of Schinopsis Brasiliensis Engler against Multiresistant Enterobacteria. Pharmaceutics [Internet]. 2020;12(8):695. Disponible en: https://www.mdpi.com/1999-4923/12/8/695 DOI: 10.3390/pharmaceutics12080695 PMID 32718016 PMCID PMC7463453

Yauri M, Rodríguez M, Alcocer I. Diseminación clonal de KPC-2 en Klebsiella pneumoniae resistente a carbapenémicos. Infectio [Internet]. 2020;24(1):42-9. Disponible en: https://www.revistainfectio.org/index.php/infectio/article/view/826 DOI: 10.22354/in.v24i1.826

Bitew A. High Prevalence of Multi-Drug Resistance and Extended Spectrum Beta Lactamase Production in Non-Fermenting Gram-Negative Bacilli in Ethiopia. Infect Dis Res Treat [Internet]. 2019;12:1178633719884951. Disponible en: https://doi.org/10.1177/1178633719884951. DOI: 10.1177/1178633719884951 PMID 31723320 PMCID PMC6836305

El Chakhtoura NG, Saade E, Iovleva A, Yasmin M, Wilson B, Perez F, et al. Therapies for multidrug resistant and extensively drug-resistant non-fermenting gram-negative bacteria causing nosocomial infections: a perilous journey toward ‘molecularly targeted’ therapy. Expert Rev Anti Infect Ther [Internet]. 2018;16(2):89-110. Disponible en: https://doi.org/10.1080/14787210.2018.1425139. DOI: 10.1080/14787210.2018.1425139 PMID 29310479 PMCID PMC6093184

Harding CM, Hennon SW, Feldman MF. Uncovering the mechanisms of Acinetobacter baumannii virulence. Nat Rev Microbiol [Internet]. 2018;16(2):91-102. Disponible en: https://doi.org/10.1038/nrmicro.2017.148 DOI: 10.1038/nrmicro.2017.148 PMID 29249812 PMCID PMC6571207