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To the Editor-Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacts on economic, social, and healthcare systems. Uncertainties regarding coronavirus disease (COVID-19) promote concerns in choosing the best therapeutic strategy. Several drugs with antiviral effects were prescribed to treat COVID-19, but scientific evidence is not conclusive regarding benefit. Unnecessary antimicrobial use may cause an increase in multidrug-resistant organisms. 1,2 It is necessary to consider actions to prevent consequences that SARS-CoV-2 may have on antimicrobial use. 1,2 Antibiotic stewardship is a strategy to promote the optimal use of antibiotics. SARS-CoV-2 probably changes the antibiotic consumption profile, and it is necessary to measure this difference. Thus, our goal was to evaluate the impact of the pandemic on antimicrobial usage patterns comparing cohorts of SARS-CoV-2-positive and SARS-CoV-2-negative patients admitted in specific hospital locations.

Multidrug-resistant organisms (MDROs) are emerging and disseminating around the globe. The guidelines for the management of MDROs support the use of various interventions to reduce the burden of MDROs. We conducted a study to assess the impact of the creation of a unit for cohorting of patients with infection due to MDROs.Hospital de Clínicas de Porto Alegre, a 795-bed university, public hospital, is located in the city of Porto Alegre in southern Brazil. In a quasi-experimental study, we assessed the impact of the creation of an MDRO unit for patient cohorting on the overall hospital incidence of infection due to MDROs.The 34 beds of the unit were located in 16 rooms for adult MDRO-infected patients and 2 additional rooms for respiratory isolation. Patients were transferred to the unit when they were identified as infected or colonized with MDROs. The unit staff was trained for MDRO-infected patient care; unit staff, patients, and families attended weekly meetings for education about MDROs with a multidisciplinary team (doctors, nurses, pharmacists, and social assistants).

Objective To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials.