Abstract
BackgroundAntimicrobial resistance is an ecological and multicausal problem. Infections caused by extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E) can be acquired and transmitted in the community. Data on community-associated ESBL-E infections/colonizations in Colombia are scarce. Georeferencing tools can be used to study the dynamics of antimicrobial resistance at the community level.MethodsWe conducted a study of geographic mapping using modern tools based on geographic information systems (GIS). Two study centers from the city of Pereira, Colombia were involved. The records of patients who had ESBL-producing Enterobacteriaceae were reviewed. Antimicrobial susceptibility testing and phenotypic detection of ESBL was done according to CLSI standards.ResultsA population of 415 patients with community-acquired infections/colonizations and 77 hospital discharges were obtained. Geographic distribution was established and heat maps were created. Several hotspots were evidenced in some geographical areas of the south-west and north-east of the city. Many of the affected areas were near tertiary hospitals, rivers, and poultry industry areas.ConclusionsThere are foci of antimicrobial resistance at the community level. This was demonstrated in the case of antimicrobial resistance caused by ESBL in a city in Colombia. Causality with tertiary hospitals in the city, some rivers and the poultry industry is proposed as an explanation of the evidenced phenomenon. Geographic mapping tools are useful for monitoring antimicrobial resistance in the community.
Highlights
Antimicrobial resistance is an ecological and multicausal problem
Reports on Extended spectrum β-lactamase (ESBL) producing E. coli infections occurring among patients without previous exposure to health care started to appear at the beginning of the twenty-first century [6]
Norman et al identified 1399 subjects with ESBL-producing Enterobacteriaceae (ESBL-E) infection living in the metropolitan area of Leeds and Bradford from samples that were taken at the University Hospital of Leeds and the University Hospital of Bradford and isolates originated at the community level
Summary
Infections caused by extendedspectrum β-lactamase producing Enterobacteriaceae (ESBL-E) can be acquired and transmitted in the community. Data on community-associated ESBL-E infections/colonizations in Colombia are scarce. Georeferencing tools can be used to study the dynamics of antimicrobial resistance at the community level. Antimicrobial resistance is an ecological problem that occurs worldwide and has been associated with increased resistance in both hospital-acquired and communityacquired infections [1]. Production of an ESBL by gram-negative bacteria is defined by reduced susceptibility to one or more of the following agents: ceftazidime, cefotaxime, ceftriaxone, cefpodoxime or aztreonam, and by potentiation of the activity of these agents in the presence of clavulanic acid [6]. Most studies on antimicrobial resistance have focused on hospital-acquired infections [7,8,9]. Reports on ESBL producing E. coli infections occurring among patients without previous exposure to health care started to appear at the beginning of the twenty-first century [6]
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