ABSTRACT
INTRODUCTION: Carbapenem-resistant gram-negative bacilli are a worldwide concern because of high morbidity and mortality rates. Additionally, the increasing prevalence of these bacteria is dangerous. To investigate the extent of antimicrobial resistance and prioritize the utility of novel drugs, we evaluated the molecular characteristics and antimicrobial susceptibility profiles of carbapenem-resistant Enterobacterales, Pseudomonas aeruginosa and Acinetobacter baumannii in Ecuador in 2022. METHODS: Ninety-five clinical isolates of carbapenem non-susceptible gram-negative bacilli were collected from six hospitals in Ecuador. Carbapenem resistance was confirmed with meropenem disk diffusion assays following Clinical Laboratory Standard Institute guidelines. Carbapenemase production was tested using a modified carbapenemase inactivation method. Antimicrobial susceptibility was tested with a disk diffusion assay, the Vitek 2 System, and gradient diffusion strips. Broth microdilution assays were used to assess colistin susceptibility. All the isolates were screened for the blaKPC, blaNDM, blaOXA-48, blaVIM and blaIMP genes. In addition, A. baumannii isolates were screened for the blaOXA-23, blaOXA-58 and blaOXA-24/40 genes. RESULTS: Carbapenemase production was observed in 96.84% of the isolates. The blaKPC, blaNDM and blaOXA-48 genes were detected in Enterobacterales, with blaKPC being predominant. The blaVIM gene was detected in P. aeruginosa, and blaOXA-24/40 predominated in A. baumannii. Most of the isolates showed co-resistance to aminoglycosides, fluoroquinolones, and trimethoprim/sulfamethoxazole. Both ceftazidime/avibactam and meropenem/vaborbactam were active against carbapenem-resistant gram-negative bacilli that produce serin-carbapenemases. CONCLUSION: The epidemiology of carbapenem resistance in Ecuador is dominated by carbapenemase-producing K. pneumoniae harbouring blaKPC. Extensively drug resistant (XDR) P. aeruginosa and A. baumannii were identified, and their identification revealed the urgent need to implement strategies to reduce the dissemination of these strains.
Subject(s)
Carbapenems , beta-Lactamases , Humans , Carbapenems/pharmacology , Meropenem , Molecular Epidemiology , Ecuador/epidemiology , Microbial Sensitivity Tests , beta-Lactamases/genetics , Bacterial Proteins/genetics , Anti-Bacterial Agents/pharmacology , Gram-Negative Bacteria/genetics , Klebsiella pneumoniae/genetics , Pseudomonas aeruginosa/geneticsABSTRACT
Resumen El objetivo del estudio fue identificar la presencia de daño muscular en deportistas de la Provincia de Azuay, Ecuador, a través de la medición de la actividad enzimática. Para esto se realizó una investigación clínica, descriptiva y de corte transversal en 220 deportistas con edades comprendidas entre 14 y 18 años (media 17,3 años), predominantemente del sexo masculino (64,1%), pertenecientes a 11 disciplinas deportivas, a quienes se les determinaron los valores sanguíneos de lactato deshidrogenasa, creatina quinasa y creatina quinasa isoenzima MB. Los principales resultados mostraron, que con un tiempo de práctica deportiva entre uno y tres años (39,1%) y con una frecuencia de entrenamiento de tres veces por semana (54,5%), predominaron los deportistas con valores normales de los marcadores musculares. La natación fue el deporte en el cual se identificó un mayor número de atletas con alteraciones de los valores séricos de creatina quinasa y creatina quinasa isoenzima MB. Se concluye que el sexo femenino, la práctica de actividad física sistemática por un período menor de un año y con una frecuencia de entrenamiento inferior a tres veces por semana fueron las características generales que no provocaron aumento de los valores séricos de los marcadores de daño muscular identificados.
Abstract The objective of the study was to identify the presence of muscle damage in athletes from the Azuay Province, Ecuador, by measuring enzyme activity. To this aim, a clinical, descriptive and cross-sectional investigation was carried out on 220 athletes aged between 14 and 18 years (average 17.3 years), predominantly male (64.1%), belonging to 11 sports disciplines, whose blood values for lactate dehydrogenase, creatine kinase and creatine kinase isoenzyme MB were determined. The main results showed that, with a length of sports practice between one and three years (39.1%) and a training frecuency of three times per week (54.5%), athletes with normal values of muscle markers predominated. Swimming was the sport in which a greater number of athletes with alterations in serum creatine kinase and preparatocreatine kinase isoenzyme MB values were identified. It is concluded that female sex and the practice of systematic physical activity for a period of less than one year and with a training frequency less than three times a week were the general characteristics that had a negative impact on the serum values of the identified muscle damage markers.
Resumo O objetivo do estudo foi identificar a presença de lesão muscular em atletas da Província de Azuay, Equador, por meio da medição da atividade enzimática. Para isso foi realizada uma pesquisa clínica, descritiva e transversal em 220 atletas com idades entre 14 e 18 anos (média de 17,3 anos), predominantemente do sexo masculino (64,1%), pertencentes a 11 modalidades esportivas cujos valores sanguíneos para lactato desidrogenase, creatina quinase e creatina quinase isoenzima MB foram determinados. Os principais resultados mostraram que com tempo de prática esportiva entre um e três anos (39,1%) e com frequência de três vezes por semana (54,5%), predominaram os atletas com valores normais dos marcadores musculares. A natação foi o esporte em que se identificou maior número de atletas com alterações nos valores séricos de creatina quinase e creatina quinase isoenzima MB. Conclui-se que o sexo feminino, a prática de atividade física sistemática por período inferior a um ano e com frequência de treinamento inferior a três vezes por semana foram as características gerais que não produziram aumento dos valores séricos dos marcadores de lesão muscular identificados.
