Resistencia antimicrobiana. Importancia y esfuerzos por contenerla / Antimicrobial resistance. Its importance and efforts to control it

Resumen La Organización Mundial de la Salud estima que en 2050 la resistencia bacteriana ocasionará 10 millones de muertes. Como parte del Plan de Acción Mundial sobre la Resistencia a los Antimicrobianos propuso redes de laboratorios especializados, para conservar cepas y optimizar el uso de los antimicrobianos. En un estudio de 2019 se identificó que las principales bacterias del grupo ESKAPE (con alta resistencia a los antibióticos más usados) que causan infecciones en hospitales de México son Klebsiella spp. resistentes a múltiples fármacos (MDR) y productoras de betalactamasa de espectro extendido (BLEE), Enterobacter spp. BLEE, Acinetobacter baumannii, Pseudomonas aeruginosa MDR, Staphylococcus aureus meticilinorresistente y Enterococcus faecium resistente a vancomicina. Con la información de resistencia a los fármacos se recomiendan esquemas para tratar la infección causada por Helicobacter pylori, relacionado con el desarrollo de cáncer y cuya prevalencia en la población adulta de Latinoamérica se estima es de entre 60 y 70 %.

Abstract The World Health Organization estimates that bacterial resistance will cause 10 million deaths by 2050. As part of the Global Action Plan on Antimicrobial Resistance, it proposed networks of specialized laboratories in order to preserve strains and optimize the use of antimicrobials. In a 2019 study, the main bacteria of the ESKAPE group (which are highly-resistant to the most widely used antibiotics) that cause infections in Mexican hospitals were identified to be multidrug-resistant (MDR) and extended spectrum beta-lactamase (ESBL)-producing Klebsiella spp., ESBL-producing Enterobacter spp., Acinetobacter baumannii, MDR Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium. With information on drug resistance, regimens are recommended to treat infection caused by Helicobacter pylori, a pathogen related to the development of cancer and whose prevalence in the adult population of Latin America is estimated to range between 60 and 70%.

Infection of pregnant women with hepatitis B and C viruses and risks for vertical transmission

Pregnant women infected with hepatitis B and C viruses pose a risk for infecting their newborn infants by vertical transmission. We studied 6,253 pregnant women aged 12-49 years for infection with hepatitis b (HBV) and C (HCV) viruses. Infection was diagnosed by measuring IgC antibodies against HBC, HBs, HBe, as well as IgM-HBc and HCV viral antigens with commercially avalible immunoassay kits. HBV infection was detected in 113 cases (1.8 percent), and prevalence was signficantly higher (2.4 percent) in a group of women with a high-risk pregnancy who were attending a perinatology hospital than in healthy pregnant women (1.67 percent, p<0.05). Infection with HBV was significantly higher in women older than 30 years old (p<0.05). HBsAg was found in blood, colostrum and vaginal exudate of two pregnant women; HBsAg was detected in the gastric aspirate but not in the blood of the two newborn infants. HBeAg and IgM-HBc were not detected in any of the smples. DNA-HBV was detected in serum of seven women, and DNA-HBV was detected in the gastric aspiratwe of only one of the newborns. HCV infection was diagnosed in three out of 111 women with markers for HBV infection (2.7 percent), and in 6 out of 1,000 women without these markers (0.6 percent). Anti-HCV antibodies were found in the serum of six of their infants during up to six months of age. Infants were monitored for one year and none of them developed any sign of hepatic disease. These results ksuggest that special attention should be paid to women older than 30 years and with a high-risk pregnanacy, as they are at a higher risk of HBV and HCB infections