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Increase resistance towards colistin in carbapenem-resistant Enterobacteriaceae strains in a tertiary hospital, Quito, Ecuador

Abstract:

The aim of the current study was to present the increased resistance in carbapenem-resistant Enterobacteriaceae strains towards colistin. An observational, descriptive study, based on the analysis of microbiological reports of carbapenemase-producing strains from 2015 to June 2018 in the Microbiology Department of the Hospital de Especialidades de las Fuerzas Armadas N°1 in Quito, Ecuador, was carried out. Between 2015 and June 2018, carbapenemase-producing strains infected 67 patients, in total. Among them, males (57.89% to 81.82%), and people older than 60 years (57.33% to 90.91%), were mostly affected by the infection. Further, the most frequent pathogen isolated was Klebsiella pneumoniae (57.69% to 93.33%), followed by K. oxytoca, Enterobacter cloacae, Escherichia coli, Citrobacter freundii, and Serratia marcescens. However, a reduction in the number of patients affected through the years, 24 in 2015, 19 in 2016, 13 in 2017, and 11 in 2018, was witnessed. In all the isolates, carbapenemase blaKPC- type producing strains with 100 % resistance towards aminopenicillins alone or combined with beta-lactamase inhibitors, ureidopenicillin, cephalosporins, ciprofloxacin, and carbapenems, were discovered. On the contrary, aminoglycosides and colistin exhibited variable resistance patterns. In the current investigation, emerging resistance to colistin in K. pneumoniae in 2017 and 2018 was observed, upon being compared with the year 2015 and 2016. The observations, in the current study, are similar to other reports that show the emerging resistance to colistin. However, more studies are required to determine the impact of this problem in public health.