Tendencias epidemiológicas de Escherichia coli productora de BLEE en infecciones urinarias en América Latina: revisión sistemática de la evidencia reciente (2019–2026).

Urinary tract infections caused by extended-spectrum beta-lactamase-producing Escherichia coli represent a growing challenge for antimicrobial treatment and surveillance in Latin America. This systematic review analyzed regional epidemiological trends through 29 studies published between 2019 and 2026 from ten countries, with critical appraisal using Joanna Briggs Institute tools. Frequencies with interpretable denominators ranged from 6.0% to 73.6%, precluding a pooled regional estimate because of population, clinical, and methodological differences. Circulation was documented in hospital and community settings, with predominance of blaCTX-M genes, presence of high-risk lineages such as ST131, and co-resistance to fluoroquinolones and trimethoprim-sulfamethoxazole. Ten studies had low risk of bias and 19 had moderate risk. The evidence confirms heterogeneous expansion and supports harmonized multicenter surveillance linking clinical data, antimicrobial consumption, and molecular characterization to improve comparability and guide context-specific responses across the region in countries with limited current evidence.