Situación actual de la resistencia a los betalactámicos, una revisión sistemática de la literatura

Abstract

Introduction: β-lactams are widely prescribed antibiotics due to their efficacy, safety, and availability. They have been used for decades to treat various bacterial infections. However, misuse and overuse have contributed to developing bacterial resistance, particularly in organisms such as Staphylococcus aureus, Enterobacteriaceae, and Pseudomonas aeruginosa.

Objective: This systematic review aims to compile updated information on β-lactams and the main mechanisms of resistance.

Methodology: A systematic review of scientific literature was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The review included articles published between 2018 and 2023. The literature search was performed in Medline, PubMed, SciELO, and Google Scholar, using appropriate MeSH (Medical Subject Headings) terms (AND/Y). Twenty studies were selected, focusing on the main resistance mechanisms to β-lactams.

Results: Among Pseudomonas aeruginosa and Enterobacteriaceae, the primary resistance mechanism to β-lactams is the production of β-lactamase enzymes. In Staphylococcus aureus, the alteration in PBPs (penicillin-binding proteins) predominates.

Conclusion: The indiscriminate use of β-lactams has led to the evolution of bacterial resistance, with the production of β-lactamase enzymes being a significant concern in Pseudomonas aeruginosa and Enterobacteriaceae. Similarly, the alteration in PBPs in Staphylococcus aureus contributes to resistance. These mechanisms render β-lactams ineffective and require more potent antibiotics, increasing patient risks. Comprehensive strategies, including responsible antibiotic use and implementing surveillance and control programs for bacterial resistance, are essential to address this issue.