Geographic mapping of Enterobacteriaceae with extended-spectrum β-lactamase (ESBL) phenotype in Pereira, Colombia

• Published in: BMC infectious diseases Vol. 20; no. 1; pp. 1 - 540
• Main Authors: Arias Ramos, Deving, Hoyos Pulgarín, Julián Andrés, Moreno Gómez, Germán Alberto, Alzate, John Alexander, Olaya Gómez, Juan Camilo, Cortés Bonilla, Isabella, Vargas Mosquera, Camila
• Format: Journal Article
• Language: English
• Published: London BioMed Central 23.07.2020; BMC
• Subjects: Antibiotics; Antimicrobial agents; Antimicrobial drug resistance; Antimicrobial resistance; Automation; Bacteria; Data collection; Disease hot spots; Drug resistance; Ecological effects; Enterobacteriaceae; Extended spectrum β-lactamase (ESBL); Gene mapping; Geographic information systems; Geographic mapping; Geographical distribution; Geography; Gram-negative bacteria; Hospitals; Infections; Infectious diseases; Mapping; Medical laboratories; Nosocomial infections; Patients; Phenotypes; Poultry; Remote sensing; Rivers; Software; Studies; β Lactamase; Colombia
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-020-05267-1

Abstract Background Antimicrobial resistance is an ecological and multicausal problem. Infections caused by extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E) can be acquired and transmitted in the community. Data on community-associated ESBL-E infections/colonizations in Colombia are scarce. Georeferencing tools can be used to study the dynamics of antimicrobial resistance at the community level. Methods We conducted a study of geographic mapping using modern tools based on geographic information systems (GIS). Two study centers from the city of Pereira, Colombia were involved. The records of patients who had ESBL-producing Enterobacteriaceae were reviewed. Antimicrobial susceptibility testing and phenotypic detection of ESBL was done according to CLSI standards. Results A population of 415 patients with community-acquired infections/colonizations and 77 hospital discharges were obtained. Geographic distribution was established and heat maps were created. Several hotspots were evidenced in some geographical areas of the south-west and north-east of the city. Many of the affected areas were near tertiary hospitals, rivers, and poultry industry areas. Conclusions There are foci of antimicrobial resistance at the community level. This was demonstrated in the case of antimicrobial resistance caused by ESBL in a city in Colombia. Causality with tertiary hospitals in the city, some rivers and the poultry industry is proposed as an explanation of the evidenced phenomenon. Geographic mapping tools are useful for monitoring antimicrobial resistance in the community.