[Antibibiotic resistance by nosocomial infections' causal agents]

Rev Med Inst Mex Seguro Soc. 2016 Jul-Aug;54(4):462-71.
[Article in Spanish]


Background: The antibibiotic resistance by nosocomial infections (NI) causal agents constitutes a seriously global problematic that involves the Mexican Institute of Social Security's Regional General Hospital 1 in Chihuahua, Mexico; although with special features that required to be specified and evaluated, in order to concrete an effective therapy.

Methods: Observational, descriptive and prospective study; by means of active vigilance all along 2014 in order to detect the nosocomial infections, for epidemiologic study, culture and antibiogram to identify its causal agents and antibiotics resistance and sensitivity.

Results: Among 13527 hospital discharges, 1079 displayed NI (8 %), standed out: the related on vascular lines, of surgical site, pneumonia and urinal track; they added up two thirds of the total. We carried out culture and antibiogram about 300 of them (27.8 %); identifying 31 bacterian species, mainly seven of those (77.9 %): Escherichia coli, Staphylococcus aureus and epidermidis, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae and Enterobacter cloacae; showing multiresistance to 34 tested antibiotics, except in seven with low or without resistance at all: vancomycin, teicoplanin, linezolid, quinupristin-dalfopristin, piperacilin-tazobactam, amikacin and carbapenems.

Conclusions: When we contrasted those results with the recommendations in the clinical practice guides, it aroused several contradictions; so they must be taken with reserves and has to be tested in each hospital, by means of cultures and antibiograms in practically every case of nosocomial infection.

Introducción: la resistencia a antimicrobianos por agentes causales de infección nosocomial (IN) constituye un grave problemática global que involucra al HGR 1 del IMSS en Chihuahua, México; si bien con particularidades que requirieron especificarla y evaluarla, a fin de concretar una terapéutica eficaz. Métodos: estudio observacional, descriptivo y prospectivo; se llevó a cabo mediante vigilancia activa durante 2014 para la detección de infecciones nosocomiales, su estudio epidemiológico, cultivo y antibiograma para identificar al agente causal y su resistencia a los antibióticos. Resultados: de 13527 egresos hospitalarios, 1079 presentaron IN (8 por 100 egresos) y de ellas destacaron: de líneas vasculares, quirúrgicas, neumonía y de vías urinarias; sumando dos tercios del total. Se realizó cultivo y antibiograma en 300 de ellas (27.8 %); identificando 31 especies bacterianas, siendo siete las principales (77.9 %): Escherichia coli, Staphylococcus aureus y epidermidis, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae y Enterobacter cloacae; mostrando multirresistencia a 34 antibióticos probados, excepto en siete con baja o nula resistencia: vancomicina, teicoplanina, linezolid, quinupristina-dalfopristina, piperacilina–tazobactam, amikacina y carbapenémicos. Conclusiones: al contrastar tales resultados ante las recomendaciones de las guías de práctica clínica, surgieron contradicciones; por lo que deben tomarse con reserva y ser probadas en cada hospital, mediante cultivos y antibiogramas en prácticamente todos los casos de infección nosocomial.

Keywords: Bacterial infections; Cross infection; Microbial drug resistance.

Publication types

  • Observational Study

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Cross Infection / diagnosis
  • Cross Infection / drug therapy
  • Cross Infection / microbiology*
  • Drug Resistance, Multiple, Bacterial*
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology*
  • Gram-Positive Bacteria / drug effects*
  • Gram-Positive Bacteria / isolation & purification
  • Gram-Positive Bacterial Infections / diagnosis
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / microbiology*
  • Hospitals, General
  • Hospitals, Public
  • Humans
  • Mexico
  • Microbial Sensitivity Tests
  • Prospective Studies


  • Anti-Bacterial Agents