Assessment of Antibiotic Resistance and Establishment of a Molecular Research Laboratory in Santo Domingo, Ecuador

Location: Santo Domingo, Ecuador

Alumni: Alexandria Bow

Faculty: Shaun Lee

As antibiotic resistance (ABR) becomes an increasing global threat, the need for widespread monitoring and surveillance of antibiotic resistance becomes more critical. In countries that lack adequate reporting of resistance data, issues that limit the proper detection and analysis of ABR include shortage of capacity in the health systems, prioritization of other health issues, and the absence of a plan to collect and report such data (WHO, 2014). In many of these countries, accurate data on ABR bacterial pathogens are unavailable, ultimately hindering physicians from making well-informed decisions when prescribing antibiotics. In Ecuador, an upper-middle income country in highly ABR-burdened Latin America, a recent assessment of the clinical laboratory in Santo Domingo’s Hesburgh Hospital confirmed the presence of necessary equipment for collecting and testing bacterial isolates for resistance on a microbiological level via antibiogram analysis. However, the hospital lacks the necessary equipment to test for antibiotic resistance using molecular methods, such as polymerase chain reactions (PCR), which are considered to be a faster and more accurate method to test for resistance (Fluit, Visser, & Schmitz, 2001). Currently, there is no method in place for the cataloguing and subsequent molecular analysis of resistant bacterial isolates, suggesting that the hospital needs the appropriate equipment and knowledge to improve their resistance testing methods. It was our aim to evaluate the capacities of Hesburgh Hospital with regard to current testing methods for antibiotic resistance and make recommendations to begin a molecular research core at the hospital. These efforts encompassed assessment and acquisition of equipment needed to increase molecular capacity, and administration of protocols for cataloguing and storage of bacterial isolates, as well as a PCR detection method of β-lactamase genes. In addition, antibiotic resistance data that was determined via antibiogram analysis was compiled and assessed. The results of this study were reported to the hospital so that molecular research could begin on site and the physicians could prescribe antibiotic treatment that is more likely to be effective towards targeted bacteria and not exacerbate the ABR burden in Ecuador.

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