Antimicrobial susceptibility profile in urinary pathogens causing community-acquired infections in diabetic patients in Colombia

• Main Authors: Laura Cristina Nocua-Báez, Jorge Alberto Cortés, Aura Lucía Leal, Gerson Fitzgerald Arias, María Victoria Ovalle-Guerro, Sandra Yamile Saavedra-Rojas, Giancarlo Buitrago, Javier Antonio Escobar-Pérez, Betsy Castro-Cardozo
• Format: Article
• Language: English
• Published: Instituto Nacional de Salud 2017-09-01
• Series: Biomédica: revista del Instituto Nacional de Salud
• Subjects: Pyelonephritis; cistitis; diabetes mellitus; Enterobacteriaceae; betalactamases.
• Online Access: https://www.revistabiomedica.org/index.php/biomedica/article/view/3348
• ISSN: 0120-4157; 0120-4157

Introduction: Urinary tract infection is the most common pathology in diabetic patients, and an important determinant of morbidity and mortality among them. The increasing resistance of uropathogens acquired in the community to commonly used antibiotics is alarming. Objective: To identify the profile of antibiotic susceptibility of uropathogens responsible for communityacquired infections among diabetic patients in hospitals in Colombia. Materials and methods: We conducted a descriptive study in a subgroup of diabetic patients in the framework of a larger study in adults with urinary tract infection acquired in the community. Over one year, we collected Escherichia coli, Klebsiella spp. and Proteus mirabilis isolates from nine hospitals in Colombia. Their susceptibility profile was determined using microbiological and molecular methods to establish the presence of extended-spectrum AmpC betalactamases and KPC carbapenemases. Results: We collected 68 isolates (58 E. coli, nine Klebsiella spp. and one Proteus mirabilis). Four (6.9%) of the E. coli isolates expressed extended spectrum betalactamases, two (3.4%) of them belonged to the phylogenetic group B2 and to ST131 clone and expressed the TEM-1 and CTM-X-15 betalactamases. The AmpC phenotype was found in four (6.9%) of the E. coli isolates, three of which produced TEM-1 and CMY-2 betalactamases. One K. pneumoniae isolate expressed the KPC-3 carbapenemase. Conclusion: The presence of extended spectrum betalactamases and carbapenemases in uropathogens responsible for community-acquired infection was confirmed in diabetic patients.