Detección de betalactamasas de espectro extendido en enterobacterales de la microbiota intestinal y su asociación con determinantes de salud en pacientes ambulatorios atendidos en laboratorio del Hospital Universitario del Río. Cuenca 2023

Abstract

Background: bacterial resistance is a global public health issue in both community and hospital settings, influenced by human, environmental, animal, and food chain factors. Objective: to determine the prevalence of extended-spectrum beta-lactamases (ESBL) in Enterobacterales from the intestinal microbiota and their association with health determinants in outpatients attended at the Hospital Universitario del Río laboratory in Cuenca, Ecuador. Methodology: a cross-sectional analytical study was conducted with 223 participants. Fecal samples were analyzed to identify ESBL-producing Enterobacterales (ESBL-PE), detecting the genes blaCTX-M-1, blaTEM and blaSHV through conventional PCR. The data obtained were statistically analyzed to explore associations between dependent and independent variables. Results: the frequency of ESBL-PE was 9.4%, with Escherichia coli being the only isolated bacterium. No statistically significant associations were found between ESBL presence and health determinants such as sex, origin, residence, potable water consumption, travel or antibacterial use history, recent hospitalization, or diagnosed diseases. The blaCTX-M-1 gene was present in 71% of the samples, blaTEM in 57%, and blaSHV in none. A total of 43% of isolates carried both blaCTX-M-1 and blaTEM, while 14% contained none of the studied genes. Conclusion: The study highlights an increase in beta-lactam resistance in E coli among the analyzed outpatient population, although no significant associations with health determinants were observed.