# Profile of Priority Antimicrobial-Resistant Pathogens and the Behavior of Multidrug-Resistant Tuberculosis in the Santiago de Cali District, Colombia

## TL;DR

This study examines antimicrobial resistance patterns and MDR-TB trends in Santiago de Cali, Colombia, highlighting high resistance rates and risk factors for hospitalization and mortality.

## Contribution

The study provides a detailed profile of priority antimicrobial-resistant pathogens and MDR-TB behavior in a specific Colombian district.

## Key findings

- High carbapenem resistance was observed in A. baumannii and K. pneumoniae.
- MDR-TB showed a resistance burden of 96%, with projections of increasing resistance.
- HIV-positive and homeless patients with drug-resistant TB had higher hospitalization and mortality risks.

## Abstract

Background: Antimicrobial resistance is a threat that increases morbidity and mortality. This cross-sectional study aimed to describe the profile of priority antimicrobial-resistant pathogens and to analyze the behavior of multidrug-resistant tuberculosis (MDR-TB) in the Santiago de Cali District, Colombia. Methods: researchers compiled information from data provided by healthcare institutions, the National Public Health Surveillance System, and laboratory-based surveillance using the World Health Organization’s WHONET v.5.6 software. Univariate statistical analysis described trends in pathogen resistance, and multivariate analysis analyzed the behavior of MDR-TB. Results: Among Gram-negative bacteria, high levels of carbapenem resistance were observed in A. baumannii (84% aztreonam resistance) and in K. pneumoniae (63%). P. aeruginosa exhibited elevated multidrug resistance, consistent with extensive antimicrobial selective pressure. MDR-TB exhibited a high burden of resistance, reaching 96%, with projections indicating a potential increase driven by monoresistance and resistance to rifampicin. Patients with drug-resistant tuberculosis who were HIV-positive or experiencing homelessness had a significantly higher likelihood of hospitalization (OR 5.59; 95% CI 3.09–10.11 and OR 2.94; 95% CI 1.48–5.81, respectively) and mortality (OR 3.34; 95% CI 1.72–6.49 and OR 2.59; 95% CI 1.16–5.79, respectively). Conclusions: The expansion of resistance mechanisms suggests sustained selective pressure, underscoring the need for strategies to optimize antibiotics.