Antimicrobial consumption and resistance in a tertiary care hospital in Brazil: a 7-year time series.

Abstract

Introduction: Antimicrobial resistance (AMR) is a major public health challenge globally. This study aimed to analyze the antibacterial consumption (ATBc), and the incidence of multidrug-resistant organisms (MDRO), focusing on pathogens Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. (ESKAPE group), in a Brazilian tertiary care hospital.

Methodology: The ATBc was measured by defined daily doses (DDD) calculated per 1000 patient days. The incidence of MDRO was collected from the hospital infection control committee specialized reports. Changes in ATBc and MDRO incidence over time were explained by the compound annual growth rate (CAGR) represented by the average yearly change as a proportion (%) of consumption in the starting year. This was a time series study using data collected retrospectively from January 2015 to December 2021.

Results: There was an increase in consumption of daptomycin and linezolid during the study period (39.4% and 27.7%, respectively), followed by polymyxins (9.8%). The MDRO of the ESKAPE group with the highest variation in the period were Staphylococcus spp (29.2%), Enterococcus spp (27.8%), and Acinetobacter spp (18.4%). Other MDROs, outside the ESKAPE group, such as Providencia sp (51.2%) and Clostridioides dificille (37.7%) had significant variation.

Conclusions: The coronavirus disease 2019 (COVID-19) pandemic may have reinforced the deterioration of the scenario of accelerating AMR increase. This warrants investigations of further surveillance data to assess the impact of the pandemic on AMR epidemiological trends.