High antimicrobial resistance in hospital uropathogens from Tapachula, Chiapas, Mexico
Resistance and age as factors associated with prolonged hospital stay
DOI:
https://doi.org/10.31644/RMI.V5N6.2025.A21Keywords:
Empirical Management, Epidemiological Surveillance, Extended-Spectrum Beta-Lactamases (ESBL), Pseudomonas aeruginosa, Urinary Tract Infection (UTI)Abstract
The objective of this study was to describe the antimicrobial resistance and susceptibility profiles of uropathogens isolated from hospitalized patients and to determine their association with age and length of hospital stay. An observational, descriptive, and retrospective study was conducted in a secondary-level hospital in Tapachula, Chiapas, Mexico, through the analysis of retrospective institutional data. Forty-eight records of positive urine cultures were examined. For the final resistance assessment, 36 isolates with complete bacterial identification and susceptibility profiles to 14 antibiotics were included, obtained from existing clinical records. Inferential statistics (correlation analyses) were used to establish associations. Escherichia coli was the predominant pathogen (55.6%). Aggregate resistance to cephalosporins (cefotaxime and cephalotin) and to the aminoglycoside amikacin exceeded 96% among all uropathogens analyzed. Additionally, patterns of extreme multidrug resistance were identified, with Pseudomonas aeruginosa exhibiting 100% resistance to all 14 antimicrobials tested. Statistical analysis revealed a significant association (p < 0.01) between antimicrobial resistance and longer hospital stay, as well as a positive correlation between infection and length of stay with patient age (p < 0.05). The high prevalence of antimicrobial resistance—particularly to cephalosporins and aminoglycosides—combined with factors such as age and prolonged hospitalization, underscores the urgent need to implement continuous microbiological surveillance programs and to critically update empirical therapeutic regimens for urinary tract infections (UTIs) in southern Mexico.
Downloads
References
Arpitha, Rakesh, Aishwarya, Gandhi V. (2022). A review on antibiotic resistance in bacteria.Int J Res Appl Sci Eng Technol. 10(10):536–42. http://dx.doi.org/10.22214/ijraset.2022.47034
Bhuiya, H., Kaushik, S., Logheeswaran, J., Karthika, P., Prathiviraj, R., Selvin, J., & Seghal Kiran, G. (2025). Emergence of recurrent urinary tract infection: Dissecting the mechanism of antimicrobial resistance, host-pathogen interaction, and hormonal imbalance. Microbial Pathogenesis, 206, 107698. https://doi.org/10.1016/j.micpath.2025.107698
Blanco VM, Maya JJ, Correa A, Perenguez M, Muñoz JS, Motoa G, et al. (2016). Prevalence and risk factors for extended-spectrum β-lactamase-producing Escherichia coli causing community-onset urinary tract infections in Colombia. Enferm Infecc Microbiol Clin. 2016;34(9):559–65. https://doi.org/10.1016/j.eimc.2015.11.017
Chan L, Li C, Li J, Lee WS, Lai CKC, et al (2025) Case Report on Cefiderocol-Non-Susceptible Escherichia Coli in the Absence of Carbapenemase Genes. Ann Case Report. 10: 2279. https://doi.org/10.29011/2574-7754.102279
CLSI. (2022). CLSI. Performance Standards for Antimicrobial Susceptibility Testing (32nd ed.). (CLSI document M100). Clinical and Laboratory Standards Institute https://clsi.org/about/news/clsi-publishes-m100-performance-standards-for-antimicrobial-susceptibility-testing-32nd-edition/
Council for International Organizations of Medical Sciences (CIOMS) & World Health Organization (OMS). (2016). International Ethical Guidelines for Health-related Research Involving Humans https://cioms.ch/wp-content/uploads/2017/12/CIOMS-EthicalGuideline_SP_INTERIOR-FINAL.pdf
Deac LM. (2020). Urinary tract infections (UTI) at elderly people. Clinical Case Reports 3(3). https://www.scientizepublishers.com/wp-content/uploads/2021/03/Urinary-Tract-Infections-UTI-At-Elderly-People.pdf
Gonzales-Rodriguez, A. O., Infante Varillas, S. F., Reyes-Farias, C. I., Ladines Fajardo, C. E., & Gonzales Escalante, E. (2022). Beta-lactamasas de espectro extendido y factores de virulencia en Escherichia coli uropatógenas en asilos de ancianos en Lima, Perú. Revista Peruana de Medicina Experimental y Salud Pública, 39(1), 98–103. https://doi.org/10.17843/rpmesp.2022.391.8580
Guajardo-Lara, E., González-Martínez, P., & Ayala-Gaytán, J. (2009). Resistencia antimicrobiana en la infección urinaria por Escherichia coli adquiridaen la comunidad. ¿Cuál antibiótico voy a usar?. Salud Pública De México, 51(2), 157-159. https://saludpublica.mx/index.php/spm/article/view/6897
Ibarra, E. D., López Portillo, A., Lugo García, J. A., & Hernández León, O. (2024). Resistencia bacteriana en urocultivos durante una década. Revista Mexicana de Urología, 84(2). https://doi.org/10.48193/s2nr5761
Lyudmila, M. V., Maksym, I. H., Nadiia, I. V., Yulia, I. A., Olexander, I. D., & Volodymyr, V. K. (2023). Peculiarities of antimicrobial resistance of uropathogens in patients with kidney and urinary tract diseases in the conditions of war in Ukraine. Wiadomości Lekarskie (Warsaw, Poland : 1991), 76(2), 269–275. https://doi.org/10.36740/WLek202302115
Nahab, H. M., Al-Oebady, A. H., & Abdul Munem, A. (2022). Bacteriological study of urinary tract infections among pregnant women in Al-Samawa, Iraq. Archives of Razi Institute, 77(1), 117–122. https://doi.org/10.22092/ARI.2021.356676.1889
Ortiz, I. L., Hernandez, E. C., & Merino, G. D. (2024). Incidencia de complicaciones de infecciones del tracto urinario en urgencias. Innovación y desarrollo tecnológico 16(4). https://iydt.wordpress.com/wp-content/uploads/2024/08/4_04_incidencia-de-complicaciones-de-infecciones_.pdf
PUCRA (2024). Resistencia antimicrobiana en México 2017 a 2023. Reporte de los hospitales de la Red PUCRA: Resistencia antimicrobiana y consumo de antibióticos. UNAM https://puiree.cic.unam.mx/divulgacion/docs/pucra2024.pdf
Rahme, D., Nakkash Chmaisse, H., & Salameh, P. (2025). Unraveling the Length of Hospital Stay for Patients with Urinary Tract Infections: Contributing Factors and Microbial Susceptibility. Antibiotics, 14(4), 421. https://doi.org/10.3390/antibiotics14040421
Raksha, G. S. (2022). Study of bacteriuria among pregnant women attending a tertiary care hospital in Panipat district, India. Era’s Journal of Medical Research, 9(2), 193–199. https://doi.org/10.24041/ejmr2022.30
Rincón N, Baena JF, Daza JA. (2025). Enfoque del paciente con infección urinaria. Perlas Clínicas, Universidad de Antioquia https://hdl.handle.net/10495/48096
Rodríguez-Mañas, L. (2020). Urinary tract infections in the elderly: A review of disease characteristics and current treatment options. Drugs in Context, 9, 1–8. https://doi.org/10.7573/dic.2020-4-13
Sisay, E. A., Mengistu, B. L., Taye, W. A., Fentie, A. M., & Yabeyu, A. B. (2022). Length of Hospital Stay and Its Predictors Among Neonatal Sepsis Patients: A Retrospective Follow-Up Study. International journal of general medicine, 15, 8133–8142 https://doi.org/10.2147/IJGM.S385829
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Mesoamerican Journal of Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
