Introduction:

the actual of germs to antimicrobials is a serious current health problem. The mechanisms can be intrinsic or adaptive. The indiscriminate and inappropriate use of these drugs in humans and animals is accelerating the resistance process, being the main causes.

Objective:

to describe the antimicrobial resistance in the National Hospital in the year 2017.

Materials and Methods:

a description was made of 1544 isolates of microorganisms from clinical samples (blood, catheter, urine, samples of respiratory origin, purulent collections) of patients admitted to the Adult Intensive Care Unit (ICUU), Medical Clinic, Pediatric Intensive Care Unit (PICU), Neonatology and Pediatrics Wards of the National Hospital (Itauguá, Paraguay) from January to December 2017; the mechanisms by which resistance and multiresistance are established in them.

Results:

During the study period, 1544 isolates from hospitalized patients were obtained, with the following frequency: coagulase negative staphylococci (NEC) 17%, E. coli 14%, K. pneumoniae 13%, S. aureus 11%, P. aeruginosa 9%, Enterococcus spp 8%, Acinetobacter spp 7%, and other non fermenting gram-negative bacilli 4%, among the main ones. This frequency varies according to hospitalization ward and according to the type of sample. Thus, in blood culture samples from the Internal Medicine and Adult Intensive Care Unit (ICU), the main microorganism isolated was coagulase-negative staphylococci; while in urine samples, the first place belongs E. coli. Considering the samples of respiratory origin of the ICU service, the main isolated microorganism is Acinetobacter baumannii (30%). Similarly, in blood cultures of pediatric patients, ECN is found in first place (41%).

Methicillin resistance coagulase-negative Staphylococcus isolates in all services analyzed were extremely high (96% in Internal Medicine, 80% in ICU, 87% in Neonatology).

The resistance detected in Gram negative were equally worrisome. The production of Extended Spectrum Beta Lactamase (ESBL) were detected in 34% of the E. coli isolates and in 60% of K. pneumoniae from Medicine. Added to this is the production of carbapenemasas and resistance to colistin in several hospitalization services.

Conclusion:

the resistance of Gram positive and Gram negative microorganism to antimicrobials is quite high in the National Hospital, in the services that were included.

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