title: [Trends in antibiotic resistance in Medellín and municipalities of the Metropolitan Area between 2007 and 2012: Results of six years of surveillance].
abstract: BACKGROUND
  Bacterial resistance is a global phenomenon, but it presents geographic and temporal variations; this is the importance of local surveillance programs.
  
  
  OBJECTIVE
  To determine trends in antibiotic resistance in hospitals between 2007 and 2012 in Medellín and its Metropolitan Area.
  
  
  METHODS
  Percentages of antibiotic resistance between 2007 and 2012 in 22 institutions were obtained using WHONET 5.6 program. For interpretation of susceptibility results, CLSI standards of 2009 and 2012 were used. Using the Epi-Info 6.04 program a trends analysis of antibiotic resistance was done using the chi-square for linear trend with a confidence level of 95%, a value of p=0.05 was considered significant.
  
  
  RESULTS
  In six years of surveillance of antibiotic resistance we found a decrease of oxacillin resistance in Staphylococcus aureus (p=0.0006) and an increase of vancomycin resistance in Enterococcus faecium (p=0.0000). In Escherichia coli and Serratia marcescens an increase of resistance to ceftazidime was found, in contrast to a decrease in Klebsiella pneumoniae (p=0.0000) and Enterobacter cloacae (p=0.058). K. pneumoniae , S. marcescens and E. cloacae showed an increase of carbapenem resistance in contrast to a reduction of carbapenem resistance in Pseudomonas aeruginosa and Acinetobacter baumannii .
  
  
  CONCLUSIONS
  The resistance surveillance identified important findings as the emergence of E. faecium resistant to vancomycin and carbapenem-resistant Enterobacteriaceae . It is essential to determine the antibiotic use in the region to establish their influence on the resistance profiles, as well as ensuring the quality of information and microbiological procedures in the microbiology laboratories.
authors.affiliation: Laboratorio Médico de Referencia S.A.S, Clínica El Rosario, Medellín, Colombia.
authors.forename: Natalia Andrea
authors.initials: NA
authors.lastname: Maldonado
authors.affiliation: Departamento de Laboratorio, Hospital Pablo Tobón Uribe, Medellín, Colombia.
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Múnera
authors.affiliation: Sección de Microbiología, Laboratorio Clínico Hematológico S.A, Medellín, Colombia.
authors.forename: Jaime Alberto
authors.initials: JA
authors.lastname: López
authors.affiliation: Control de Infecciones, IPS Universitaria, Medellín, Colombia.
authors.forename: Patricia
authors.initials: P
authors.lastname: Sierra
authors.affiliation: Laboratorio Médico de Referencia S.A.S, Clínica El Rosario, Medellín, Colombia.
authors.forename: Carlos
authors.initials: C
authors.lastname: Robledo
authors.affiliation: Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas.
authors.forename: Jaime
authors.initials: J
authors.lastname: Robledo
mesh_terms: D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D002947:Cities; D003105:Colombia; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D004352:Drug Resistance, Microbial; D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance; D011786:Quality Control; D012189:Retrospective Studies; D013045:Species Specificity; D013211:Staphylococcus aureus / Q000187:drug effects; D014504:Urban Health / Q000639:trends*