Damnoble1818

e periods studied, which suggests that either the antimicrobial stewardship program may have prevented an increase in bacterial resistance since its implementation, or that it is too soon to see impact on bacterial resistance.

To describe the resistance profile and the genetic characteristics of Escherichia coli isolates that harbor the mobilizable colistin resistance gene mcr-1 in Argentina.

This was a retrospective study of 192 E. coli isolates positive for mcr-1 obtained from 69 hospitals of Buenos Aires City and 14 Argentinean provinces in 2012 - 2018. The antimicrobial susceptibility was performed by agar diffusion, broth macrodilution, and/or agar dilution. Standard polymerase chain reaction (PCR) was performed to detect resistance genes and incompatibility groups; specific PCR was applied to discriminate between blaCTX-M allelic groups and mcr-1.5 variant. The genetic relatedness among isolates was evaluated by XbaI-pulsed field gel electrophoresis and multilocus sequence typing in a subset of isolates.

All E. coli isolates showed minimal inhibitory concentrations to colistin ≥ 4μg/mL; nearly 50% were resistant to third-generation cephalosporins, with CTX-M-2 being the main extended-spectrum β-lactamase detected. Five E. coli were carbapenemase-producers (3 NDM, 2 KPC). The mcr-1.5 variant was detected in 13.5% of the isolates. No genetic relationship was observed among the mcr-1-positive E. coli clinical isolates, but a high proportion (164/192; 85.4%) of IncI2 plasmids was detected.

The presence of IncI2 plasmids among highly diverse E. coli clones suggests that the mcr-1 gene's wide distribution in Argentina may be driven by the horizontal transmission of IncI2 plasmids.

The presence of IncI2 plasmids among highly diverse E. RNA Synthesis inhibitor coli clones suggests that the mcr-1 gene's wide distribution in Argentina may be driven by the horizontal transmission of IncI2 plasmids.

Evaluate the level of adherence to guidelines on surgical prophylaxis in health facilities in Argentina and the determinants of non-adherence.

Cross-sectional multicenter study in 35 centers in Argentina. The level of adherence to guidelines and the forms of non-adherence were determined and these were compared based on the characteristics of the indicated antibiotic, anesthesiologist, surgery, and facility, as well as patient age. An adjusted logistic regression model was used.

A total of 1,083 surgical procedures were reviewed. Adherence to guidelines was 67%. The most frequent forms of non-adherence were incorrect antibiotic (28.9%), unnecessary prophylaxis (25.5%), and prolonged prophylaxis (24.4%). Adherence to guidelines was higher in persons under 18 years of age (84.9% compared to 65.5%, p < 0.001). According to the type of health coverage (social welfare, private insurance, public coverage, or community coverage), adherence was 33.3%, 64.4%, 78.8%, and 83.3%, respectively; p < 0.001. Accod use of antibiotics were the most frequent forms of non-adherence. Adherence was higher with younger patients, where programs exist to optimize the use of antimicrobial drugs, where there is private or public health coverage, with the pediatric population, for specific pathologies, in emergency surgery, and in certain specialties.

Adherence to guidelines was 67%. Incorrect, unnecessary, and prolonged use of antibiotics were the most frequent forms of non-adherence. Adherence was higher with younger patients, where programs exist to optimize the use of antimicrobial drugs, where there is private or public health coverage, with the pediatric population, for specific pathologies, in emergency surgery, and in certain specialties.

To characterize carbapenemase-producing

isolated from patients treated at a hospital in Cumaná, Sucre, Venezuela.

This was a retrospective study conducted at the general hospital in Cumaná where 58

strains were analyzed for resistance to antimicrobials, specifically carbapenems, in January - June 2015. Production of metallo-β-lactamases and serine carbapenemases was determined by the double-disc synergy test, using EDTA-sodium mercaptoacetic acid and 3-aminophenyl boronic acid discs, respectively. Multiplex-PCR was used to detect genes coding for carbapenemases. Molecular typing using ERIC-PCR determined the presence of clones.

Four strains of

resistant to carbapenems were identified. Phenotypic methods for detection of metallo-β-lactamases and serine carbapenemases were positive, and PCR demonstrated the co-presence of



and



genes in all four strains. ERIC-PCR identified two clones circulating in the hospital.

Infection control strategies are needed at the central hospital in Cumaná and its surrounding areas to prevent the spread of these pathogens, especially given the high levels of migration from Venezuela to other countries in South America.

Infection control strategies are needed at the central hospital in Cumaná and its surrounding areas to prevent the spread of these pathogens, especially given the high levels of migration from Venezuela to other countries in South America.

Measure social inequalities in antimicrobial resistance in

in Colombia.

Ecological study using a multi-panel of data, disaggregated at the subnational level, and using isolations of

as a proxy for antimicrobial resistance (AMR) between 2009 and 2018. A sociodemographic characterization, an analysis of the antimicrobial sensitivity of isolations of

, and a measurement of inequalities in AMR in

were conducted using the slope index of inequality, the relative inequality index, and the concentration index.

The findings indicate antimicrobial resistance to penicillin (50.7%) and tetracycline (67.3%) in isolations of

, and the existence of absolute and relative inequalities during the study period. Access barriers to health services, not having received information on the prevention of sexually transmitted infections, basic unmet needs, and illiteracy explained the inequalities in AMR in

.

Six recommendations emerged with a view to largely containing AMR in

i) increase awareness of safe sexual and reproductive health; ii) rethink how to deliver key messages with an equity approach; iii) improve information, prescription, and drug chain systems; iv) form coalitions to improve response and share objectives with the private sector; v) improve the availability and disaggregation of data; and vi) support research on inequalities in AMR.

Six recommendations emerged with a view to largely containing AMR in N. gonorrhoeae i) increase awareness of safe sexual and reproductive health; ii) rethink how to deliver key messages with an equity approach; iii) improve information, prescription, and drug chain systems; iv) form coalitions to improve response and share objectives with the private sector; v) improve the availability and disaggregation of data; and vi) support research on inequalities in AMR.