Epidemiological trends of Gram-negative nosocomial infections in a Latin American hospital with limited resources: a retrospective observational study (2020-2024).
DOI:
https://doi.org/10.61708/ygecgv95Keywords:
hospital-acquired infections, gram-negative bacteria, drug resistance, microbial, intensive care units, epidemiological surveillanceAbstract
Nosocomial infections continue to be a significant challenge in hospital settings, especially in critical care units, where the incidence is high and pathogens often present multidrug resistance. We analyzed the incidence of nosocomial infections by pathogen and hospital department in a hospital located in Guayaquil, Ecuador, from 2020 to 2024. Materials and methods: A retrospective, descriptive observational study was conducted at a tertiary hospital in southern Guayaquil, Ecuador (2020–2024). A total of 1,315 positive cultures for Gram-negative bacteria from five hospital units (adult ICU, intermediate care, pulmonology, neonatal ICU, and general surgery) were analyzed. Temporal trends and resistance mechanisms were evaluated using statistical tests (Chi-square and Cochran-Armitage). Results: Klebsiella pneumoniae (30.3%) and Acinetobacter baumannii (27.7%) predominated, with a significant association between bacterial species and hospital unit (χ² = 87.41; p<0.0001). Frequent mechanisms were identified, such as KPC (390 cases), OXA-24/51 (247 cases), VIM (87 cases), and KPC with colistin resistance (112 cases), although there were no clear linear trends over time (p>0.99). In 2024, Klebsiella pneumoniae accounted for 44.4% (95% CI: 38.8–50.1), Acinetobacter baumannii 32.5% (95% CI: 27.4–38.1), and Pseudomonas aeruginosa 12.5% (95% CI: 9.2–16.8) of cultures. The high prevalence of multidrug-resistant bacteria in critical care units emphasizes the urgent need to strengthen continuous epidemiological surveillance, implement strict infection control measures, and make therapeutic decisions based on up-to-date local data tailored to specific epidemiological patterns. Conclusion: The high prevalence of multidrug-resistant bacteria in critical care units emphasizes the urgent need to strengthen continuous epidemiological surveillance, implement strict infection control measures, and make therapeutic decisions based on up-to-date local data tailored to specific epidemiological patterns.
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