Resumo

MARTIN, G  e  GRUPO VENEZOLANO DE VIGILANCIA DE LA RESISTENCIA BACTERIANA et al. Trends in pseudomonas aeruginosa resistance to ß-lactams and others antimicrobials agents in Venezuelan hospitals. nosocomial and community resistance. Rev. Soc. Ven. Microbiol. [online]. 2003, vol.23, n.1, pp.21-29. ISSN 1315-2556.

    In order to approach the infection produced by resistant bacteria, it is convenient to consider the hospital and the community as two separate ecosystems. This division reflect different population, selection pressure, reservoirs and others factors which are important in the development, persistence and transmission of resistant organism to antimicrobials. This hospital ecosystem has special relevance in the infection and resistance of gramnegative aerobic bacilli. Today they are the main responsible of nosocomial infection, with special reference to Pseudomonas aeruginosa. The problem of infection by resistant bacteria occur in the whole world; related to nosocomial as well as communitarian infection in developing countries, where the problem has important dimension. In this study we present the tendencies of resistance in P. aeruginosa, nosocomial and communitarian in Venezuelan medical centres, at the same time we make difference between publics and private hospitals. Since 1988, The Venezuelan Group of Bacterial Resistance to antimicrobials, with 29 health institution in the country; identify, analyses and publish data on bacterial resistance of isolates from patients with bacterial infection coming from hospitals and the community. It was used diffusion disk, according NCCLS. The software program WHONET (WORLD HEALTH ORGANIZATION NET) was used. Statistical analyses was made by evaluating the difference among percentages of resistance. We show important differences in the resistance of P. aeruginosa nosocomial and communitarian. We also established differences between the resistance arising in public hospitals and private hospitals. Since 1998, we show the tendency in decreasing of resistance; this tendency is more evident in private hospitals. New antimicrobials and new mechanism of action, and in the future the new technology will solve today’s problem. However, the most important tools we have today are prevention and antimicrobials, and we must make them suitable.

Palavras-chave : Resistencia bacteriana; ß-lactámicos; fluoroquinolonas; aminoglicósidos; Gram-negativos; Pseudomonas aeruginosa; nosocomial; programa de vigilancia de resistencia.