Antimicrobial resistance in Brazil: an integrated research agenda

Corrêa, Juliana Silva; Zago, Luiz Felipe; Silva-Brandão, Roberto Rubem da; Oliveira, Sandi Michele de; Fracolli, Lislaine Aparecida; Padoveze, Maria Clara; Córdoba, Gloria

doi:10.1590/1980-220x-reeusp-2021-0589

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…It examines aspects of antibiotic use at the community level among users; prescription practices among antibiotic prescribers, dispensers and other healthcare professionals (HP) in Primary Care; and the development of AMR policy in Brazil among policymakers, researchers and other stakeholders. 16 The perspectives of the three groups of participants are integrated to provide a holistic view of the social dimensions for tackling AMR in the country. In this article, we focus on the perspectives of 19 users of the SUS, as they are generally underrepresented in biomedical or governance research.…”

Section: Methodsmentioning

confidence: 99%

“…This study is part of a broader, qualitative project using the One Health approach to explore the perspectives of those involved in the demand and supply of antibiotics ( N = 76). It examines aspects of antibiotic use at the community level among users; prescription practices among antibiotic prescribers, dispensers and other healthcare professionals (HP) in Primary Care; and the development of AMR policy in Brazil among policymakers, researchers and other stakeholders 16 . The perspectives of the three groups of participants are integrated to provide a holistic view of the social dimensions for tackling AMR in the country.…”

Section: Methodsmentioning

confidence: 99%

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Experiences of antibiotic use among Brazilian healthcare users: An exploratory study

Zago

Corrêa

Silva-Brandão

et al. 2022

Health Expectations

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Introduction This article analyzes experiences of antibiotic use and bacterial infections among Primary Health Care users of the Brazilian Unified Health System (SUS) and the possible implications for antimicrobial resistance (AMR). The aim is to map aspects that shape users' lay knowledge regarding antibiotics use and AMR. Methods This is an exploratory study, which consists primarily of individual in‐depth interviews with 19 respondents. Recurrent interview topics were coded and analysed according to thematic content analysis. Results Our findings show users' lived experiences constitute three dimensions related to users' previous antibiotic use: (1) lay knowledge about medicines; (2) previous bacterial infections and (3) communication during the consultation. Lay knowledge encompasses the users' understanding of how antibiotics work in comparison to other drugs and experimentations they make with medication. Users' narratives about bacterial infections are divided into situations of urinary tract infections and antibiotic treatments for other conditions. Communication during the consultation is mainly characterized by a lack of shared knowledge and trust in the doctor–patient relationship. Discussion Users bring together knowledge learned from their own experiences to create the rationale, which shapes how they understand antibiotic use, bacterial infections and medical advice. These experiences are interwoven with information received from healthcare professionals (HPs) on these topics, creating a scenario that goes beyond professional information about antibiotic use. Users have knowledge about medication, antibiotics use and bacterial infection but do not have room to share it with HP, allowing lived experiences to take precedence over professional information. Conclusion Users ascribe symbolic meanings to antibiotics creating a lay knowledge frame, even if this knowledge is not scientifically correct. The personal experiences of bacterial infections and their treatment are also an important source of knowledge about antibiotic use and AMR among users. Users demand from their HPs both trust and willingness to listen to their health narratives and experiences. By considering lay knowledge as part of the assessment of a user's health condition, rather than dismissing it as erroneous and therefore unworthy of attention, HPs may enhance the compliance of users. Patient or Public Contribution Patients or community members did not participate in the design stage of the study. Primary Care patients were invited to participate as respondents of in‐depth interviews, which were carried out by the first author at a Primary Care Unit (PCU) in the suburb of Campo Limpo, Southern region of São Paulo, Brazil. Patients were interviewed after reading and signing a Free and Informed Consent Form, holding with them a copy of the Form. Among the fin...

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Experiences of antibiotic use among Brazilian healthcare users: An exploratory study

Zago

Corrêa

Silva-Brandão

et al. 2022

Health Expectations

Self Cite

View full text Add to dashboard Cite

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“…Em diversos países, o histórico das políticas sobre a resistência antimicrobiana é bem documentado ( 8 - 10 ). No Brasil, entretanto, apesar das medidas que vêm sendo propostas pelo governo, sobretudo após a formalização de uma agenda nacional a partir do PAN-BR ( 11 , 12 ), os estudos são escassos ( 13 ) e não existem pesquisas que sistematizem o histórico das políticas nacionais sobre o tema. Dessa forma, o objetivo do presente estudo foi mapear as políticas públicas relacionadas à prevenção e ao controle da resistência aos antimicrobianos na perspectiva da saúde humana no Brasil e sistematizar a evolução histórica dessas políticas.…”

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Evolução das políticas brasileiras de saúde humana para prevenção e controle da resistência aos antimicrobianos: revisão de escopo

Aguiar,

Carvalho,

Domingues

et al. 2023

Revista Panamericana De Salud Pública

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Objetivo. Mapear políticas relacionadas à prevenção e ao controle da resistência aos antimicrobianos na perspectiva da saúde humana no Brasil e sistematizar a evolução histórica dessas políticas. Método. Desenvolveu-se uma revisão de escopo conforme as diretrizes do Instituto Joana Briggs e PRISMA. A busca na literatura foi realizada em dezembro de 2020 nas bases de dados LILACS, PubMed e EMBASE. Utilizaram-se os termos “antimicrobial resistance” AND “Brazil” e sinônimos. Uma pesquisa documental com os mesmos termos foi conduzida nos sites eletrônicos do governo brasileiro até dezembro de 2021. Foram incluídos estudos de todos os desenhos, sem restrição de idioma ou data. Excluíram-se documentos clínicos, revisões e estudos epidemiológicos que não referenciavam políticas de gestão da resistência aos antimicrobianos no Brasil. Para coleta e análise de dados, estabeleceram-se categorias baseadas em documentos da Organização Mundial da Saúde. Resultados. Desde antes da criação do Sistema Único de Saúde, o Brasil possuía políticas relacionadas à resistência aos antimicrobianos, como o Programa Nacional de Imunização e programas de controle de infecção hospitalar. No final das décadas de 1990 e 2000, estabeleceram-se as primeiras políticas específicas sobre resistência aos antimicrobianos (redes e programas de vigilância) e estratégias de educação. Destaca-se o Plano de Ação Nacional de Prevenção e Controle da Resistência aos Antimicrobianos no Âmbito da Saúde Única (PAN-BR), de 2018. Conclusões. Apesar do longo histórico de políticas relacionadas à resistência aos antimicrobianos no Brasil, foram identificadas lacunas, sobretudo no monitoramento da utilização de antimicrobianos e na vigilância da resistência aos antimicrobianos. O PAN-BR, primeiro documento de governo elaborado na perspectiva One Health, é um marco nas políticas brasileiras.

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A 7-Year Brazilian National Perspective on Plasmid-Mediated Carbapenem Resistance in Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii Complex and the Impact of the Coronavirus Disease 2019 Pandemic on Their Occurrence

Kiffer,

Rezende,

Costa-Nobre

et al. 2023

Clinical Infectious Diseases

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Background Carbapenemase production is a global public health threat. Antimicrobial resistance (AMR) data analysis is critical to public health policy. Here we analyzed carbapenemase detection trends using the AMR Brazilian Surveillance Network. Methods Carbapenemase detection data from Brazilian hospitals included in the public laboratory information system dataset were evaluated. The detection rate (DR) was defined as carbapenemase detected by gene tested per isolate per year. The temporal trends were estimated using the Prais–Winsten regression model. The impact of COVID-19 on carbapenemase genes in Brazil was determined for the period 2015–2022. Detection pre- (October 2017 to March 2020) and post-pandemic onset (April 2020 to September 2022) was compared using the χ2 test. Analyses were performed with Stata 17.0 (StataCorp, College Station, TX). Results 83 282 blaKPC and 86 038 blaNDM were tested for all microorganisms. Enterobacterales DR for blaKPC and blaNDM was 68.6% (41 301/60 205) and 14.4% (8377/58 172), respectively. P. aeruginosa DR for blaNDM was 2.5% (313/12 528). An annual percent increase for blaNDM of 41.1% was observed, and a decrease for blaKPC of −4.0% in Enterobacterales, and an annual increase for blaNDM of 71.6% and for blaKPC of 22.2% in P. aeruginosa. From 2020 to 2022, overall increases of 65.2% for Enterobacterales, 77.7% for ABC, and 61.3% for P. aeruginosa were observed in the total isolates. Conclusions This study shows the strengths of the AMR Brazilian Surveillance Network with robust data related to carbapenemases in Brazil and the impact of COVID-19 with a change in carbapenemase profiles with blaNDM rising over the years.

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Antimicrobial resistance in Brazil: an integrated research agenda

Cited by 5 publications

References 6 publications

Experiences of antibiotic use among Brazilian healthcare users: An exploratory study

Experiences of antibiotic use among Brazilian healthcare users: An exploratory study

Evolução das políticas brasileiras de saúde humana para prevenção e controle da resistência aos antimicrobianos: revisão de escopo

A 7-Year Brazilian National Perspective on Plasmid-Mediated Carbapenem Resistance in Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii Complex and the Impact of the Coronavirus Disease 2019 Pandemic on Their Occurrence

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