Hector Daniel Salazar-Holguin
Department of Social Medicine and Epidemiology, Mexican Institute of Social Security (IMSS), MexicoFulltext PDF
Introduction: Nosocomial infections constitute a global sociobiological process from local cases, to be passed in all hospital institutions and by their similar etiology, and through the evolution by natural selection of their causal agents, in which their development of resistance to antimicrobials is vital. This perspective is necessary in its epidemiological surveillance in order to detect in a timely manner changes in pathogenic hospital microbiome and in its sensitivity and resistance to antimicrobials and to formulate more effective strategies for the control, treatment and abatement of its incidence. Methodology: With the objective of showing possible evolutionary changes of the causal agents of nosocomial infections, regarding its virulence, pathogenicity and antimicrobial resistance; in a hospital with 300 number of census beds and 10,000 annual patient discharges, a clinicalepidemiological, descriptive, longitudinal and comparative study was conducted regarding nosocomial infections, their causative agents and their resistance to antimicrobials during the years 2014 to 2020. Through active epidemiological vigilance, with the aim of identifying and confirming probable cases of nosocomial infection in a clinical, microbiological and epidemiological manner; main nosocomial infections and their causative agents were selected and tested again statin microbials with automatic microbiology equipment for cultures and antibiogram. Results: In this period, although the main nosocomial infections (pneumonia, of urinary tract, surgical site and bacteremia) and, likewise, their causal agents (Acinetobacter baumannii, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae) remained unchanged; all did so through changes between such infections that evidence inter bacterial competition, even between different strains of the same species and, in general, expanded the sites of infection, their incidence and the global resistance to antimicrobials, although with ups and downs and contradictions. Conclusion: The increase in morbidity and changes in the epidemiological profile of nosocomial infections show the development of virulence and pathogenicity of their causative agents, correlated with the development of antimicrobial resistance. And none of it could happen without adjustments to their genomes. All these evolutionary changes do not occur in a linear way, but with ups and downs and contradictions. This information has been useful to know the trend of pathogenic bacterial microbiome in the Hospital and to specify a rational use of antibiotics to combat it.
Nosocomial infections; Bacterial evolution; Antimicrobial resistance
Salazar-Holguin HD. Evolution of Antimicrobial Resistance of the Main Causative Agents of Nosocomial Infection. Am J Clin Microbiol Antimicrob. 2021; 4(2): 1055..