Prevalence of antimicrobial resistance in gram-negative bacteria bloodstream infections in Peru and associated outcomes: VIRAPERU Study

Fiorella Krapp; Coralith García; Noemi Hinostroza; Lizeth Astocondor; Claudia R Rondon; Brecht Ingelbeen; Hugo A Alpaca-Salvador; Catherine Amaro; Carla Aguado Ventura; Evelyn Barco-Yaipén; Cesar Bocangel Fernandez; Alexander Briones; Antonio Burgos; Rene Campana; Kelly Castillo; Alex Castañeda-Sabogal; Angelica Coaquira; Fátima Concha-Velasco; Edwin Cuaresma Cuadros; Omayra Chincha; Juan Carlos Diaz; Roberto Díaz Sipión; Victor Fernandez; Miguel Hueda-Zavaleta; Enrique López; María Valera-Krumdieck; Rubén Vásquez; Ana María Vidaurre Torres; Miguel Villegas-Chiroque; Favio Sarmiento Lopez; Pedro Alberto Sullón Zavaleta; Elizett Sierra Chavez; Eduardo Paricahua Peralta; Teresa Peralta Córdova; Jimena Edith Pino-Dueñas; Jan Jacobs

doi:10.4269/ajtmh.22-0556

Prevalence of antimicrobial resistance in gram-negative bacteria bloodstream infections in Peru and associated outcomes: VIRAPERU Study

Fiorella Krapp, Coralith García, Noemi Hinostroza, Lizeth Astocondor, Claudia R Rondon, Brecht Ingelbeen, Hugo A Alpaca-Salvador, Catherine Amaro, Carla Aguado Ventura, Evelyn Barco-Yaipén, Cesar Bocangel Fernandez, Alexander Briones, Antonio Burgos, Rene Campana, Kelly Castillo, Alex Castañeda-Sabogal, Angelica Coaquira, Fátima Concha-Velasco, Edwin Cuaresma Cuadros, Omayra ChinchaJuan Carlos Diaz, Roberto Díaz Sipión, Victor Fernandez, Miguel Hueda-Zavaleta, Enrique López, María Valera-Krumdieck, Rubén Vásquez, Ana María Vidaurre Torres, Miguel Villegas-Chiroque, Favio Sarmiento Lopez, Pedro Alberto Sullón Zavaleta, Elizett Sierra Chavez, Eduardo Paricahua Peralta, Teresa Peralta Córdova, Jimena Edith Pino-Dueñas, Jan Jacobs

Tropical Bacteriology

Research output: Contribution to journal › A1: Web of Science-article › peer-review

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Abstract

Surveillance of antimicrobial resistance among gram-negative bacteria (GNB) is of critical importance, but data for Peru are not available. To fill this gap, a non-interventional hospital-based surveillance study was conducted in 15 hospitals across Peru from July 2017 to October 2019. Consecutive unique blood culture isolates of key GNB (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp.) recovered from hospitalized patients were collected for centralized antimicrobial susceptibility testing, along with linked epidemiological and clinical data. A total of 449 isolates were included in the analysis. Resistance to third-generation cephalosporins (3GCs) was present in 266 (59.2%) GNB isolates. Among E. coli (n = 199), 68.3% showed 3GC resistance (i.e., above the median ratio for low- and middle-income countries in 2020 for this sustainable development goal indicator). Carbapenem resistance was present in 74 (16.5%) GNB isolates, with wide variation among species (0% in E. coli, 11.0% in K. pneumoniae, 37.0% in P. aeruginosa, and 60.8% in Acinetobacter spp. isolates). Co-resistance to carbapenems and colistin was found in seven (1.6%) GNB isolates. Empiric treatment covered the causative GNB in 63.3% of 215 cases. The in-hospital case fatality ratio was 33.3% (92/276). Pseudomonas aeruginosa species and carbapenem resistance were associated with higher risk of in-hospital death. In conclusion, an important proportion of bloodstream infections in Peru are caused by highly resistant GNB and are associated with high in-hospital mortality.

Original language	English
Journal	American Journal of Tropical Medicine and Hygiene
Volume	109
Issue number	5
Pages (from-to)	1095-1106
Number of pages	12
ISSN	0002-9637
DOIs	https://doi.org/10.4269/ajtmh.22-0556
Publication status	Published - 2023

Keywords

Anti-Bacterial Agents/pharmacology
Carbapenems
Drug Resistance, Bacterial
Escherichia coli
Gram-Negative Bacteria
Gram-Negative Bacterial Infections/drug therapy
Hospital Mortality
Humans
Klebsiella pneumoniae
Microbial Sensitivity Tests
Peru/epidemiology
Prevalence
Pseudomonas aeruginosa
Sepsis/drug therapy

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10.4269/ajtmh.22-0556Licence: CC BY

2023astmh1095Final published version, 1.18 MBLicence: CC BY

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Krapp, F., García, C., Hinostroza, N., Astocondor, L., Rondon, C. R., Ingelbeen, B., Alpaca-Salvador, H. A., Amaro, C., Aguado Ventura, C., Barco-Yaipén, E., Bocangel Fernandez, C., Briones, A., Burgos, A., Campana, R., Castillo, K., Castañeda-Sabogal, A., Coaquira, A., Concha-Velasco, F., Cuadros, E. C., ... Jacobs, J. (2023). Prevalence of antimicrobial resistance in gram-negative bacteria bloodstream infections in Peru and associated outcomes: VIRAPERU Study. American Journal of Tropical Medicine and Hygiene, 109(5), 1095-1106. https://doi.org/10.4269/ajtmh.22-0556

@article{351d9c4f92614511b1bdc3ae90fa48fa,

title = "Prevalence of antimicrobial resistance in gram-negative bacteria bloodstream infections in Peru and associated outcomes: VIRAPERU Study",

abstract = "Surveillance of antimicrobial resistance among gram-negative bacteria (GNB) is of critical importance, but data for Peru are not available. To fill this gap, a non-interventional hospital-based surveillance study was conducted in 15 hospitals across Peru from July 2017 to October 2019. Consecutive unique blood culture isolates of key GNB (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp.) recovered from hospitalized patients were collected for centralized antimicrobial susceptibility testing, along with linked epidemiological and clinical data. A total of 449 isolates were included in the analysis. Resistance to third-generation cephalosporins (3GCs) was present in 266 (59.2%) GNB isolates. Among E. coli (n = 199), 68.3% showed 3GC resistance (i.e., above the median ratio for low- and middle-income countries in 2020 for this sustainable development goal indicator). Carbapenem resistance was present in 74 (16.5%) GNB isolates, with wide variation among species (0% in E. coli, 11.0% in K. pneumoniae, 37.0% in P. aeruginosa, and 60.8% in Acinetobacter spp. isolates). Co-resistance to carbapenems and colistin was found in seven (1.6%) GNB isolates. Empiric treatment covered the causative GNB in 63.3% of 215 cases. The in-hospital case fatality ratio was 33.3% (92/276). Pseudomonas aeruginosa species and carbapenem resistance were associated with higher risk of in-hospital death. In conclusion, an important proportion of bloodstream infections in Peru are caused by highly resistant GNB and are associated with high in-hospital mortality.",

keywords = "Anti-Bacterial Agents/pharmacology, Carbapenems, Drug Resistance, Bacterial, Escherichia coli, Gram-Negative Bacteria, Gram-Negative Bacterial Infections/drug therapy, Hospital Mortality, Humans, Klebsiella pneumoniae, Microbial Sensitivity Tests, Peru/epidemiology, Prevalence, Pseudomonas aeruginosa, Sepsis/drug therapy",

author = "Fiorella Krapp and Coralith Garc{\'i}a and Noemi Hinostroza and Lizeth Astocondor and Rondon, {Claudia R} and Brecht Ingelbeen and Alpaca-Salvador, {Hugo A} and Catherine Amaro and {Aguado Ventura}, Carla and Evelyn Barco-Yaip{\'e}n and {Bocangel Fernandez}, Cesar and Alexander Briones and Antonio Burgos and Rene Campana and Kelly Castillo and Alex Casta{\~n}eda-Sabogal and Angelica Coaquira and F{\'a}tima Concha-Velasco and Cuadros, {Edwin Cuaresma} and Omayra Chincha and Diaz, {Juan Carlos} and {D{\'i}az Sipi{\'o}n}, Roberto and Victor Fernandez and Miguel Hueda-Zavaleta and Enrique L{\'o}pez and Mar{\'i}a Valera-Krumdieck and Rub{\'e}n V{\'a}squez and {Vidaurre Torres}, {Ana Mar{\'i}a} and Miguel Villegas-Chiroque and {Sarmiento Lopez}, Favio and {Sull{\'o}n Zavaleta}, {Pedro Alberto} and {Sierra Chavez}, Elizett and {Paricahua Peralta}, Eduardo and {Peralta C{\'o}rdova}, Teresa and Pino-Due{\~n}as, {Jimena Edith} and Jan Jacobs",

note = "FTX; (CC BY 4.0)",

year = "2023",

doi = "10.4269/ajtmh.22-0556",

language = "English",

volume = "109",

pages = "1095--1106",

journal = "American Journal of Tropical Medicine and Hygiene",

issn = "0002-9637",

publisher = "American Society for Tropical Medicine & Hygiene",

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Krapp, F, García, C, Hinostroza, N, Astocondor, L, Rondon, CR, Ingelbeen, B, Alpaca-Salvador, HA, Amaro, C, Aguado Ventura, C, Barco-Yaipén, E, Bocangel Fernandez, C, Briones, A, Burgos, A, Campana, R, Castillo, K, Castañeda-Sabogal, A, Coaquira, A, Concha-Velasco, F, Cuadros, EC, Chincha, O, Diaz, JC, Díaz Sipión, R, Fernandez, V, Hueda-Zavaleta, M, López, E, Valera-Krumdieck, M, Vásquez, R, Vidaurre Torres, AM, Villegas-Chiroque, M, Sarmiento Lopez, F, Sullón Zavaleta, PA, Sierra Chavez, E, Paricahua Peralta, E, Peralta Córdova, T, Pino-Dueñas, JE & Jacobs, J 2023, 'Prevalence of antimicrobial resistance in gram-negative bacteria bloodstream infections in Peru and associated outcomes: VIRAPERU Study', American Journal of Tropical Medicine and Hygiene, vol. 109, no. 5, pp. 1095-1106. https://doi.org/10.4269/ajtmh.22-0556

Prevalence of antimicrobial resistance in gram-negative bacteria bloodstream infections in Peru and associated outcomes: VIRAPERU Study. / Krapp, Fiorella; García, Coralith; Hinostroza, Noemi et al.
In: American Journal of Tropical Medicine and Hygiene, Vol. 109, No. 5, 2023, p. 1095-1106.

Research output: Contribution to journal › A1: Web of Science-article › peer-review

TY - JOUR

T1 - Prevalence of antimicrobial resistance in gram-negative bacteria bloodstream infections in Peru and associated outcomes: VIRAPERU Study

AU - Krapp, Fiorella

AU - García, Coralith

AU - Hinostroza, Noemi

AU - Astocondor, Lizeth

AU - Rondon, Claudia R

AU - Ingelbeen, Brecht

AU - Alpaca-Salvador, Hugo A

AU - Amaro, Catherine

AU - Aguado Ventura, Carla

AU - Barco-Yaipén, Evelyn

AU - Bocangel Fernandez, Cesar

AU - Briones, Alexander

AU - Burgos, Antonio

AU - Campana, Rene

AU - Castillo, Kelly

AU - Castañeda-Sabogal, Alex

AU - Coaquira, Angelica

AU - Concha-Velasco, Fátima

AU - Cuadros, Edwin Cuaresma

AU - Chincha, Omayra

AU - Diaz, Juan Carlos

AU - Díaz Sipión, Roberto

AU - Fernandez, Victor

AU - Hueda-Zavaleta, Miguel

AU - López, Enrique

AU - Valera-Krumdieck, María

AU - Vásquez, Rubén

AU - Vidaurre Torres, Ana María

AU - Villegas-Chiroque, Miguel

AU - Sarmiento Lopez, Favio

AU - Sullón Zavaleta, Pedro Alberto

AU - Sierra Chavez, Elizett

AU - Paricahua Peralta, Eduardo

AU - Peralta Córdova, Teresa

AU - Pino-Dueñas, Jimena Edith

AU - Jacobs, Jan

N1 - FTX; (CC BY 4.0)

PY - 2023

Y1 - 2023

N2 - Surveillance of antimicrobial resistance among gram-negative bacteria (GNB) is of critical importance, but data for Peru are not available. To fill this gap, a non-interventional hospital-based surveillance study was conducted in 15 hospitals across Peru from July 2017 to October 2019. Consecutive unique blood culture isolates of key GNB (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp.) recovered from hospitalized patients were collected for centralized antimicrobial susceptibility testing, along with linked epidemiological and clinical data. A total of 449 isolates were included in the analysis. Resistance to third-generation cephalosporins (3GCs) was present in 266 (59.2%) GNB isolates. Among E. coli (n = 199), 68.3% showed 3GC resistance (i.e., above the median ratio for low- and middle-income countries in 2020 for this sustainable development goal indicator). Carbapenem resistance was present in 74 (16.5%) GNB isolates, with wide variation among species (0% in E. coli, 11.0% in K. pneumoniae, 37.0% in P. aeruginosa, and 60.8% in Acinetobacter spp. isolates). Co-resistance to carbapenems and colistin was found in seven (1.6%) GNB isolates. Empiric treatment covered the causative GNB in 63.3% of 215 cases. The in-hospital case fatality ratio was 33.3% (92/276). Pseudomonas aeruginosa species and carbapenem resistance were associated with higher risk of in-hospital death. In conclusion, an important proportion of bloodstream infections in Peru are caused by highly resistant GNB and are associated with high in-hospital mortality.

AB - Surveillance of antimicrobial resistance among gram-negative bacteria (GNB) is of critical importance, but data for Peru are not available. To fill this gap, a non-interventional hospital-based surveillance study was conducted in 15 hospitals across Peru from July 2017 to October 2019. Consecutive unique blood culture isolates of key GNB (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp.) recovered from hospitalized patients were collected for centralized antimicrobial susceptibility testing, along with linked epidemiological and clinical data. A total of 449 isolates were included in the analysis. Resistance to third-generation cephalosporins (3GCs) was present in 266 (59.2%) GNB isolates. Among E. coli (n = 199), 68.3% showed 3GC resistance (i.e., above the median ratio for low- and middle-income countries in 2020 for this sustainable development goal indicator). Carbapenem resistance was present in 74 (16.5%) GNB isolates, with wide variation among species (0% in E. coli, 11.0% in K. pneumoniae, 37.0% in P. aeruginosa, and 60.8% in Acinetobacter spp. isolates). Co-resistance to carbapenems and colistin was found in seven (1.6%) GNB isolates. Empiric treatment covered the causative GNB in 63.3% of 215 cases. The in-hospital case fatality ratio was 33.3% (92/276). Pseudomonas aeruginosa species and carbapenem resistance were associated with higher risk of in-hospital death. In conclusion, an important proportion of bloodstream infections in Peru are caused by highly resistant GNB and are associated with high in-hospital mortality.

KW - Anti-Bacterial Agents/pharmacology

KW - Carbapenems

KW - Drug Resistance, Bacterial

KW - Escherichia coli

KW - Gram-Negative Bacteria

KW - Gram-Negative Bacterial Infections/drug therapy

KW - Hospital Mortality

KW - Humans

KW - Klebsiella pneumoniae

KW - Microbial Sensitivity Tests

KW - Peru/epidemiology

KW - Prevalence

KW - Pseudomonas aeruginosa

KW - Sepsis/drug therapy

U2 - 10.4269/ajtmh.22-0556

DO - 10.4269/ajtmh.22-0556

M3 - A1: Web of Science-article

C2 - 37722663

SN - 0002-9637

VL - 109

SP - 1095

EP - 1106

JO - American Journal of Tropical Medicine and Hygiene

JF - American Journal of Tropical Medicine and Hygiene

IS - 5

ER -

Prevalence of antimicrobial resistance in gram-negative bacteria bloodstream infections in Peru and associated outcomes: VIRAPERU Study

Abstract

Keywords

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