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Background  Hospital-acquired infections caused by multiresistant gram-negative bacteria are difficult to treat and cause high rates of morbidity and mortality. The analysis of antimicrobial resistance trends of gram-negative pathogens isolated from hospital-acquired infections is important for the development of antimicrobial stewardship programs. The information obtained from antimicrobial resistant programs from two hospitals from Mexico will be helpful in the selection of empiric therapy for hospital-acquired gram-negative infections.    Findings  Two thousand one hundred thirty two gram-negative bacteria collected between January 2005 and December 2010 from hospital-acquired infections occurring in two teaching hospitals in Mexico were evaluated.  Escherichia coli  was the most frequently isolated gram-negative bacteria, with >50% of strains resistant to ciprofloxacin and levofloxacin.  Klebsiella  spp. showed resistance rates similar to  Escherichia coli  for ceftazidime (33.1% vs 33.2%), but exhibited lower rates for levofloxacin (18.2% vs 56%). Of the samples collected for the third most common gram-negative bacteria,  Pseudomonas aeruginosa , >12.8% were resistant to the carbapenems, imipenem and meropenem. The highest overall resistance was found in  Acinetobacter  spp.  Enterobacter  spp. showed high susceptibility to carbapenems.    Conclusions   E. coli  was the most common nosocomial gram-negative bacilli isolated in this study and was found to have the second-highest resistance to fluoroquinolones (>57.9%, after  Acinetobacter  spp. 81.2%). This finding represents a disturbing development in a common nosocomial and community pathogen.

Resistance trends in gram-negative bacteria: surveillance results from two Mexican hospitals, 2005–2010