Prevalence of difficult-to-treat resistance in ESKAPE pathogens in a third level hospital in Mexico.

BACKGROUND

Antimicrobial resistance and difficult-to-treat resistance (DTR) in ESKAPE pathogens ( and species) is a threat to human health. The aim of this study was to determine the prevalence of antimicrobial resistance and DTR rates in ESKAPE pathogens over six years in a third-level hospital from Monterrey, Mexico.

METHODS

Antimicrobial susceptibility testing was determined by either disk diffusion or broth microdilution in strains from 2018 to 2023. Isolates were screened for carbapenemase genes. Multidrug resistance (MDR), extensively drug resistance (XDR), carbapenem resistance (CR), extended-spectrum cephalosporin-resistance (ESCR), fluoroquinolone resistance (FQR), and DTR were determined.

RESULTS

From 3,239 strains, 48.5% were from respiratory infections, resistance was 87.5% to meticillin in spp. and 39.8% in and 13.9% to vancomycin in spp. MDR, FQR and ESCR rates were between 54-90% in , 20-60% in Enterobacterales and 17-25% in . CR was 85.7% in 33.3% in and <5% in Enterobacterales. Most frequent CR genes were OXA-24/40-like in and NDM and OXA-48 in carbapenem-resistant Enterobacterales. DTR rates were 59.7% in (49.2% in 2018 vs 62.9% in 2023), 8.9% in and <3% in Enterobacterales. XDR in was 14.4%.

CONCLUSIONS

Antimicrobial resistance rates were high in Gram-negative pathogens. CR and DTR rates were higher in than and Enterobacterales. DTR surveillance in healthcare providers should be continuous updating local and regional DTR trends among Gram-negative bacteria.