Multidrug-Resistant Microorganisms Colonizing Lower Extremity Wounds in Patients in a Tertiary Care Hospital, Lima, Peru

Rafael Mendo-Lopez Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Luis Jasso Hospital Cayetano Heredia, Lima, Peru;

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Ximena Guevara Hospital Cayetano Heredia, Lima, Peru;

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Aurora Lizeth Astocondor Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Saul Alejos Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Ana C. Bardossy Infectious Disease Division, Henry Ford Health System, Detroit, Michigan;

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Tyler Prentiss Infectious Disease Division, Henry Ford Health System, Detroit, Michigan;

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Marcus J. Zervos Infectious Disease Division, Henry Ford Health System, Detroit, Michigan;

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Jan Jacobs Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium;
Department of Microbiology and Immunology, University of Leuven, Leuven, Belgium

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Coralith García Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru;
Hospital Cayetano Heredia, Lima, Peru;

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Multidrug-resistant organism (MDRO) infections cause high morbidity and mortality, and high costs to patients and hospitals. The study aims were to determine the frequency of MDRO colonization and associated factors in patients with lower-extremity wounds with colonization. A cross-sectional study was designed during November 2015 to July 2016 in a tertiary care hospital in Lima, Peru. A wound swab was obtained for culture and susceptibility testing. MDRO colonization was defined if the culture grew with methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and/or extended spectrum beta-lactamase (ESBL) microorganisms. The frequency of MDRO wound colonization was 26.8% among the 97 patients enrolled. The most frequent MDRO obtained was ESBL-producing Escherichia coli, which was significantly more frequent in chronic wounds versus acute wounds (17.2% versus 0%, P < 0.05). Infection control measures should be implemented when patients with chronic lower-extremity wounds are admitted.

Author Notes

Address correspondence to Coralith García, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima, Peru. E-mail: coralith.garcia@upch.pe

Financial support: This study was sponsored by the Directorate General for Development Cooperation (DGCD) of the Belgian Government (framework agreement 3, project 95502) and Henry Ford Health System.

Authors’ addresses: Rafael Mendo-Lopez, Aurora Lizeth Astocondor, and Saul Alejos, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: rafael.mendo@upch.pe, lizeth1226@hotmail.com, and savaf@hotmail.com. Luis Jasso and Ximena Guevara, Department of Endocrinology, Hospital Nacional Cayetano Heredia, Lima, Peru, E-mails: ljasso18@yahoo.es and ximenaguevara@yahoo.com. Ana C. Bardossy and Marcus J. Zervos, Infectious Disease Division, Henry Ford Health System, Detroit, MI, E-mails: cbardos1@hfhs.org and mzervos1@hfhs.org. Tyler Prentiss, Global Health Initiative, Henry Ford Health Services, Detroit, MI, E-mail: tprenti1@hfhs.org. Jan Jacobs, Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium, E-mail: jjacobs@itg.be. Coralith García, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru, and Infectious Disease Division, Hospital Nacional Cayetano Heredia, Lima, Peru, E-mail: coralith.garcia@upch.pe.

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