Frequency of Gram-Negative Bacteria at the Military Medical Center in Guatemala
Author(s)
Sebastian Medina1, ALFONSO ROSADO, MBA,MD,PhD2, LOURDES GARCIA, MBA,MD2, Jorge Kuffaty, MD3, ADRIANA MORERA, MD4, Claudia C. Beltran, MSc, MD3, Luis D. Gonzalez, MD5;
1MSD, Sr. Specialist research management, Bogota, Colombia, 2Links & Links SA de CV, Mexico City, Mexico, 3MSD, Bogota, Colombia, 4MSD, San Jose, Costa Rica, 5Hospital Centro Medico Militar, Guatemala, Guatemala
1MSD, Sr. Specialist research management, Bogota, Colombia, 2Links & Links SA de CV, Mexico City, Mexico, 3MSD, Bogota, Colombia, 4MSD, San Jose, Costa Rica, 5Hospital Centro Medico Militar, Guatemala, Guatemala
Presentation Documents
OBJECTIVES: Identify the distribution of carbapenemases in carbapenem-resistant Gram-negative bacteria, their association with comorbidities, and other factors at the Military Medical Center in Guatemala.
METHODS: A non-interventional, prospective, descriptive study was conducted on clinical isolates collected over 12 months (55% male; 54.9 yrs AVG). 450 Gram-negative isolates were collected. 120 showed resistance to carbapenems, and 111 were positive for carbapenemase and analyzed using PCR to identify carbapenemase type. Comorbidities, use of medical devices, ICU stay, and other factors were considered. Collection was sequential.
RESULTS: Bacteria with carbapenemases: Klebsiella sp. 41 (37%), Escherichia coli 36 (32%), P. aeruginosa 21 (19%), Enterobacter sp. 4%, Acinetobacter baumannii 3%, Enterobacteriaceae 2%, Proteus sp. 0.5%, Proteus mirabilis 2% and Providencia stuart 0.5%. These carbapenemases were identified (pheno-genotype): Klebsiella sp. blaNDM (33), blaOXA-48 (22), blaIMP (1); Escherichia coli blaNDM (24), blaIMP (1), KPC (1), blaOXA-48 (1); P. aeruginosa blaVIM (8), KPC (8), blaIMP (5), blaOXA-48 (2); Enterobacter sp. blaNDM (3), KPC (1); Acinetobacter baumannii blaNDM (3); Enterobacteriaceae blaNDM (2). Only blaOXA-48 was present across multiple bacterial species. Key comorbidities associated with carbapenemases: Immunosuppression: blaNDM (6), blaIMP (1), blaOXA-48 (4); Cardiovascular: blaNDM (14), blaIMP (10), blaVIM (1), KPC (5), blaOXA-48 (2); Metabolic: blaNDM (34), blaIMP (4), blaVIM (2), KPC (7), blaOXA-48 (13); Oncologic: blaNDM (7), blaVIM (1), KPC (1), blaOXA-48 (3). Prolonged ICU stays and invasive medical devices were strongly associated with blaNDM. blaNDM showed mortality of 20.5%, and blaOXA-48 of 21.1%. Main sample origin: urine, secretions and respiratory 72.5%.
CONCLUSIONS: This study highlights the predominance of blaNDM and blaOXA-48 in Klebsiella sp. and Escherichia coli, associated with specific comorbidities, invasive medical devices, and prolonged ICU stays.
METHODS: A non-interventional, prospective, descriptive study was conducted on clinical isolates collected over 12 months (55% male; 54.9 yrs AVG). 450 Gram-negative isolates were collected. 120 showed resistance to carbapenems, and 111 were positive for carbapenemase and analyzed using PCR to identify carbapenemase type. Comorbidities, use of medical devices, ICU stay, and other factors were considered. Collection was sequential.
RESULTS: Bacteria with carbapenemases: Klebsiella sp. 41 (37%), Escherichia coli 36 (32%), P. aeruginosa 21 (19%), Enterobacter sp. 4%, Acinetobacter baumannii 3%, Enterobacteriaceae 2%, Proteus sp. 0.5%, Proteus mirabilis 2% and Providencia stuart 0.5%. These carbapenemases were identified (pheno-genotype): Klebsiella sp. blaNDM (33), blaOXA-48 (22), blaIMP (1); Escherichia coli blaNDM (24), blaIMP (1), KPC (1), blaOXA-48 (1); P. aeruginosa blaVIM (8), KPC (8), blaIMP (5), blaOXA-48 (2); Enterobacter sp. blaNDM (3), KPC (1); Acinetobacter baumannii blaNDM (3); Enterobacteriaceae blaNDM (2). Only blaOXA-48 was present across multiple bacterial species. Key comorbidities associated with carbapenemases: Immunosuppression: blaNDM (6), blaIMP (1), blaOXA-48 (4); Cardiovascular: blaNDM (14), blaIMP (10), blaVIM (1), KPC (5), blaOXA-48 (2); Metabolic: blaNDM (34), blaIMP (4), blaVIM (2), KPC (7), blaOXA-48 (13); Oncologic: blaNDM (7), blaVIM (1), KPC (1), blaOXA-48 (3). Prolonged ICU stays and invasive medical devices were strongly associated with blaNDM. blaNDM showed mortality of 20.5%, and blaOXA-48 of 21.1%. Main sample origin: urine, secretions and respiratory 72.5%.
CONCLUSIONS: This study highlights the predominance of blaNDM and blaOXA-48 in Klebsiella sp. and Escherichia coli, associated with specific comorbidities, invasive medical devices, and prolonged ICU stays.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH112
Topic
Epidemiology & Public Health
Disease
SDC: Infectious Disease (non-vaccine)