Total antibiotic use in a state-wide area and resistance patterns in Brazilian hospitals: an ecologic study

Boszczowski, Ícaro; Neto, Francisco Chiaravalloti; Blangiardo, Marta; Baquero, Oswaldo Santos; Madalosso, Geraldine; Assis, Denise Brandão de; Olitta, Thais; Levin, Anna S.

doi:10.1016/j.bjid.2020.08.012

Cited by 1 publication

(2 citation statements)

References 17 publications

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“…Most of the articles report bacteria with resistance to antibiotics based on conventional methods (as disk diffusion method, Double disc synergy test, dilution methods, Epsilometer test), especially in countries of Africa (2,11,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), Asia and Latin America (1, 6, 61-66). Phenotypic detection of antibiotic resistance by Disk Diffusion Method was reported in 60.5% of the total studies, followed by the Vitek 2 system (18.4%).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Bacteria that cause hospital-acquired infections are chracterised by a genetic structure composed of a high genotypic diversity, but a predominance of several clones can be found. Whole genome analysis (WGS)-based analysis on MDR and ESBL-positive E. coli evidenced high genetic diversity in hospitals in Benin (22) and Bangladesh (35). However, a study conducted in Mozambique using ERIC-PCR analysis revealed that despite evidence of high genetic diversity among E. coli isolates, there was a predominance of few clones adapted to the hospital environment, what would they probably be HiRCs (17).…”

Section: Genetic Diversity Of Antibiotic Resistant Isolatesmentioning

confidence: 99%

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Bacterial Resistance in Hospital-Acquired Infections Acquired in the Intensive Care Unit: A Systematic Review

Loaiza

Ruiz

Patiño

et al. 2023

Acta Med. (Hradec Kralove, Czech Repub.)

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Purpose: In this review we present the status of the prevalence of bacteria resistant to antibiotics and the main antibiotic resistance genes that are reported in infections acquired in intensive care units (ICU) around the world. Methods: A systematic review based on the PRISMA guide was carried out, from the Science Direct, Redalyc, Scopus, Hinari, Scielo, Dialnet, PLOS, ProQuest, Taylor, Lilacs and PubMed/Medline databases. Inclusion criteria of this review were original research study published in a scientific journal in a 10-year time span from 1 January 2017 and 30 April 2022. Results: A total of 1686 studies were identified, but only 114 studies were considered eligible for inclusion. Klebsiella pneumoniae and Escherichia coli resistant to carbapenems and producers of extended-spectrum β-lactamases (ESBL) are the most frequently isolated pathogens in ICUs in Asia, Africa and Latin America. The blaOXA and blaCTX were antibiotic resistance genes (ARG) most commonly reported in different geographic regions (in 30 and 28 studies, respectively). Moreover, multidrug-resistant (MDR) strains were reported in higher frequency in hospital-acquired infections. Reports of MDR strains vary between continents, with the majority of publications being in Asia and between countries, with Egypt and Iran being highlighted. There is a predominance of few bacterial clones with MDR phenotype, for example, clonal complex 5 Methicillin-Resistant Staphylococcus aureus (CC5-MRSA) circulates frequently in hospitals in the United States, clone ST23-K. pneumoniae is reported in India and Iran, and clone ST260 carbapenemase-producing P. aeruginosa in the United States and Estonia. Conclusion: Our systematic review reveals that ESBL- and carbapenemase-producing K. pneumoniae and E. coli are the most problematic bacteria that are reported, mainly in tertiary hospitals in Asia, Africa, and Latin America. We have also found propagation of dominant clones with a high degree of MDR, becoming a problem due to its high capacity to cause morbidity, mortality and additional hospital costs.

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