Evolución de la resistencia antibiótica de Pseudomonas aeruginosa en Latinoamérica. Una revisión de alcance
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Vive Rev. Salud
Abstract
Estudios de la región muestran que, en hospitales y clínicas de América Latina, el perfil de resistencia de Pseudomonas aeruginosa ha evolucionado notablemente. El objetivo: analizar la evolución de la resistencia antibiótica de Pseudomonas aeruginosa en Latinoamérica. Metodología: Enfoque cualitativo, bajo una revisión de la literatura, siguiendo la metodología PRISMA 2020. Se utilizaron las bases de datos PubMed y LILACS. La búsqueda se llevó a cabo en marzo 2025, priorizando publicaciones de los últimos cinco años, se consideraron estudios anteriores de los años 2007, 2008, 2013, 2014, 2016, 2017 y 2018. Los resultados muestran que, desde 2015 se registraron cambios importantes en la epidemiología: varios centros reportaron un aumento en la prevalencia de carbapenemasas de tipo bla KPC (con cifras de hasta 75% en algunos estudios), la emergencia de bla NDM y la aparición de variantes OXA, así como la detección de otros genes (bla IMP, bla SPM, bla PER) mediante métodos moleculares (PCR, WGS, RT-PCR). También, se confirman la variabilidad en la coproducción de mecanismos de resistencia y la presencia continua de sistemas de eflujo y alteraciones en la permeabilidad de la membrana, lo que refleja la diversidad microbiológica y molecular que caracteriza la evolución de la resistencia en P. aeruginosa a lo largo del tiempo en la región. En conclusión, resulta fundamental priorizar la estandarización de los protocolos de vigilancia y la integración de herramientas moleculares en la rutina diagnóstica y, promover la colaboración regional para el monitoreo de clones y mecanismos emergentes.
Studies from the region show that the resistance profile of Pseudomonas aeruginosa has evolved significantly in hospitals and clinics in Latin America. The objective: to analyze the evolution of antibiotic resistance against Pseudomonas aeruginosa in Latin America. Methodology: A qualitative approach, based on a literature review, followed the PRISMA 2020 methodology. The PubMed and LILACS databases were used. The search was carried out in March 2025, prioritizing publications from the last five years, previous studies from the years 2007, 2008, 2013, 2014, 2016, 2017 and 2018 were considered. The results show that, since 2015, important changes in epidemiology have been recorded: several centers reported an increase in the prevalence of bla KPC-type carbapenemases (with figures of up to 75% in some studies), the emergence of bla NDM and the appearance of OXA variants, as well as the detection of other genes (bla IMP, bla SPM, bla PER) by molecular methods (PCR, WGS, RT-PCR). Furthermore, variability in the co-production of resistance mechanisms and the continued presence of efflux systems and alterations in membrane permeability are confirmed, reflecting the microbiological and molecular diversity that characterizes the evolution of resistance in P. aeruginosa over time in the region. In conclusion, it is essential to prioritize the standardization of surveillance protocols and the integration of molecular tools into diagnostic routines, and to promote regional collaboration for the monitoring of emerging clones and mechanisms.
Studies from the region show that the resistance profile of Pseudomonas aeruginosa has evolved significantly in hospitals and clinics in Latin America. The objective: to analyze the evolution of antibiotic resistance against Pseudomonas aeruginosa in Latin America. Methodology: A qualitative approach, based on a literature review, followed the PRISMA 2020 methodology. The PubMed and LILACS databases were used. The search was carried out in March 2025, prioritizing publications from the last five years, previous studies from the years 2007, 2008, 2013, 2014, 2016, 2017 and 2018 were considered. The results show that, since 2015, important changes in epidemiology have been recorded: several centers reported an increase in the prevalence of bla KPC-type carbapenemases (with figures of up to 75% in some studies), the emergence of bla NDM and the appearance of OXA variants, as well as the detection of other genes (bla IMP, bla SPM, bla PER) by molecular methods (PCR, WGS, RT-PCR). Furthermore, variability in the co-production of resistance mechanisms and the continued presence of efflux systems and alterations in membrane permeability are confirmed, reflecting the microbiological and molecular diversity that characterizes the evolution of resistance in P. aeruginosa over time in the region. In conclusion, it is essential to prioritize the standardization of surveillance protocols and the integration of molecular tools into diagnostic routines, and to promote regional collaboration for the monitoring of emerging clones and mechanisms.
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Vol. 8, No. 23