Hospital-based surveillance of antimicrobial resistance in gram-negative bacteria in Peru

The global emergence of antimicrobial resistance has been recognized as a major threat to human kind. Although antimicrobial resistance is a global problem, low and middle income countries, are disproportionally affected by this threat. Peru, a middle-income country, has one of the highest rates of resistance to third-generation cephalosporins among Gram-negative bacteria in Latin-American and worldwide. Importantly, these rates are representative of hospitals from Lima, while the situation of antimicrobial resistance in other regions of the country is unknown. The focus of this doctoral proposal is to conduct a hospital-based surveillance to obtain a well-rounded assessment of the current situation of antimicrobial resistance in Peru. In this sense, an operational, microbiological and epidemiological surveillance will be conducted on Gram-negative bloodstream infections across different regions of Peru. Additionally, the recent emergence of carbapenem-resistant K. pneumoniae in a teaching hospital in Lima will be studied using whole genome sequencing -a highly sensitive molecular method-, to obtain information needed to guide infection control strategies to contain the dissemination of this threat within this and other hospitals in Peru. Altogether, the information obtained by this study will be valuable for improving patient care and guiding local and national strategies on antimicrobial stewardship, infection control and containment of antimicrobial resistance.