High presence of enterobacterias with antimicrobial resistance genes in patients diagnosed with COVID-19 in public hospitals in Peru

Marcos-Carbajal P.; Yareta-Yareta J.; Liñan-Martínez C.; Fajardo-Loyola A.; Remon-Chinchay R.; Romero-Japay D.; Bazán-Huapaya A.; Márquez-Espinoza M.; Chambi-Quispe M.; Luque-Arapa Á.; Pino-Dueñas J.E.; Diaz-Rengifo P.E.; Arévalo-Ramirez H.; Santillán-Ruiz D.; Briones-Alejos A.; Salazar-Granara A. · Acta Medica Peruana (2025) · DOI: 10.35663/amp.2025.421.3408

Resumen

Objective: To characterize phenotypic and genotypic profiles, and to determine the prevalence of extended-spectrum betalactamases (ESBLs), AmpC, and carbapenemase resistance genes in gram-negative isolates obtained from COVID-19 patients in five health centers in Peru. Materials and methods: A descriptive and retrospective study was conducted, analyzing 78 bacterial isolates from COVID-19 patients collected during 2020. Bacterial identification and interpretation of antimicrobial susceptibility profiles were performed using the MicroScan® system. Detection of resistance genes blaCTX-M, blaTEM, blaSHV, blaAmpC, blaKPC, blaIMP, and blaNDM was conducted using polymerase chain reaction (PCR). Results: Amongst bacterial isolates analyzed, 49 (62.83%) were Enterobacteriaceae, and 29 (37.17%) were non-fermenting gram-negative bacteria (NFGNB). Escherichia coli was the most prevalent species, with 33 isolates (42.30%). Resistance to antibacterials was observed, including cefotaxime, ciprofloxacin, and aztreonam, while most bacteria remained susceptible to ertapenem, colistin, and tigecycline. PCR analysis revealed that the blaCTX-M gene was the most prevalent, detected in 25.64% of isolates (20/78) and distributed across the five hospitals studied. Conclusions: The findings indicate a high prevalence of bacterial resistance genes in the samples studied, with blaCTX-M and blaTEM being most prevalent in Enterobacteriaceae and blaIMP in non-fermenting bacteria. These findings underscore the need to strengthen AMR surveillance in the context of coinfection in COVID-19 patients.

Instituciones: Universidad de San Martín de Porres; Universidad Nacional Federico Villarreal; Universidad Nacional de San Martín; Universidad Peruana Unión