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Memorias del Instituto de Investigaciones en Ciencias de la Salud

On-line version ISSN 1812-9528


PEREIRA, Alicia et al. Extended-spectrum-β-lactamases producing Enterobacteriaceae isolated from outpatient and hospitalized patients in a private laboratory in Asunción, Paraguay. Mem. Inst. Investig. Cienc. Salud [online]. 2016, vol.14, n.1, pp.17-24. ISSN 1812-9528.

Among resistance mechanisms of Enterobacteriaceae, the production of extended spectrum ß-lactamases (ESBL) plays an important role. These enzimes can confer resistencia to penicilins, first, second and third generation cephalosporins and aztreonam, and because of their plasmidic nature, they spread easily. We conducted a cross-sectional descriptive observational study. The objective was to determine the frequency of ESBL producing Enterobacteriaceae in outpatient and hospitalized patients at the San Roque laboratory from September to November 2012. Microbiological ESBL detection was performed by the double-disk synergy and combined disk tests. Among 481 clinical isolates of Enterobacteriaceae, 88.1% was from outpatients and 11.9% from hospitalized patients. Escherichia coli was predominant, followed by Klebsiella pneumoniae. ESBL production was confirmed by both methods in 47 Enterobacteriaceae, 9.8%. Among these, the most frequent producer of ESBL was K. pneumoniae 30.8% followed by E. coli, 6.6%. All ESBL-producing Enterobacteriacea in this study presented cefotaximase activity. The frequency obtained is lower than rates reported in neighboring countries, which could be explained by the fact that most of the isolates were from outpatients. Like other studies in Latin America, ESBL- producing K. pneumoniae was more frequent and the action of ESBLs was mainly on cefotaximase. While the number of ESBL found is not high, we should insist on taking steps towards reducing the frequency, considering the serious implications of the presence of this enzyme.

Keywords : Extended-spectrum ß-lactamase; ESBL; cefalosporins; Enterobacteriaceae; nosocomial infections; outpatient infections.

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