Los carbapenem son los antibióticos -lactámicos más potentes debido a su estabilidad frente a las -lactamasas de espectro extendido y -lactamasas AmpC. Sin embargo, la resistencia a los carbapenem mediada por carbapenemasas es un serio problema que se ha diseminado en todo el mundo. Objetivos. El objetivo de este estudio fue establecer la prevalencia de metalo-b-lactamasas y evaluar los perfiles de resistencia de los aislamientos clínicos de Pseudomonas aeruginosa y Acinetobacter baumannii resistentes a los carbapenem. Materiales y métodos. Se analizaron 96 microorganismosaislados de pacientes con infección hospitalariadel Hospital San Jerónimo de Montería (Colombia); paradeterminar la susceptibilidad antibiótica se emplearon los siguientes métodos: difusión de disco, el método Etest® MBL y MicroScan® ESBL. La detección de metalo- - lactamasas se midió por el sinergismo de imipenem en combinación con EDTA y la resistencia a los -lactámicos de amplio espectro y cefamicina .
Carbapenems are the most powerful b-lactamic antimicrobial agents due to their stability when confronted with extended-spectrum b-lactamases (ESBL) and AmpC- b -lactamases. However, carbape-nemase mediated resistance is a serious problem, disseminated worldwide.Objectives: The purpose of this study was to establish the prevalence of metallo-b -lactamases(MBL)-producing Pseudomonas aeruginosa y Acinetobacter baumannii and to evaluate the resistance profiles of clinical isolates of these bacteria.Materials and methods: Ninety six isolates obtained from patients with nosocomial infections at the Hospital San Jerónimo (HSJ) in Montería, Colombia, were studied. The following methods were carried out to determine antimicrobial susceptibility: disk-agar diffusion, the MBL E-test® method and the ESBL MicroScan® method. Detection of MBL was measured by the E-test with imipenem/imipenem plus EDTA and by resistance to broad spectrum b -lactamic antimicrobials and cefamycins.Results: 15 of 96 (15,6%) isolates showed resistance to carbape-nems. A total of 14/96 (14.5%) isolates, 6 of 51 of P. aeruginosa (11.7%) and 8 of 45 (17.7%) of A. baumannii, produced MBL. Bearing in mind the resistance profile the possible overexpression of the MexAB-OprM efflux pump was considered in 1 of 51 (2%) P. aeruginosa carbapenem-resistant isolates.Conclusion: The high prevalence of MBL producing isolates is possibly a consequence of the abuse of aggressive combinations of antimicrobial agents. Prevalence of MBL-producing bacteria could increase by horizontal dissemination of strains in this hospital, which suggests the prudent use of carbapenems to prevent selection of strains and to alert the clinicians from the impact that empirical administration of carbapenems might have.
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