Abstract:
Pseudomonas aeruginosa is one of the most prevalent opportunistic pathogens in health care-associated infections. Its high level of intrinsic resistance to antibiotics and great capacity for acquire new resistances, determines a major difficult to establish an opportune treatment. ESBLs GES-type have a diverse hydrolytic activity mediated by their 33 variants reported worldwide, 12 with carbapenemase activity. Moreover, 55 strains were provided from the National Institute for Public Health Research. Bacterial identification was performed by biochemical tests and automated system Vitek 2. The antimicrobial susceptibility was determined using disc diffusion method and minimum inhibitory concentration by automated system Vitek 2 against the antibiotics recommended by the CLSI (2017). The phenotypic detection of ESBL GES-type was identified by the double disk synergy test between ceftazidime and imipenem. On the other hand, the molecular analyses consisted in the amplification of the blaGES gene by endpoint PCR and Sanger type sequencing in Macrogen Korea. The majority of isolates came mainly from ICU with 21%, adult and male population with 99% and 65% respectively. The most frequent sample was secretion with 62%. Moreover, high resistance to extended spectrum cephalosporins and carbapenems with a phenotypic MDR/XDR pattern was found. The double disc synergy test between ceftazidime and imipenem identified 52/54 positive strains for the blaGES gene by PCR. Two variants of the blaGES gene were determined in 18 strains analyzed, 17 belonging to the variant blaGES-26 and 1 to the variant blaGES-5.The blaGES-5 and blaGES-26 are the first report of these variants in Ecuador. Thus place Pseudomonasaeruginosaas an emerging threat capable of generate outbreaks in different health centers of Quito.