Consumo de antimicrobianos e o impacto na resistência bacteriana em um hospital público do estado do Pará, Brasil, de 2012 a 2016

Diego Moreno Fernandes Furtado; Vinicius Sousa da Silveira; Irna Carla do Rosário Souza Carneiro; Danielle Moreno Fernandes Furtado; Monica Pereira Kilishek

doi:10.5123/S2176-6223201900041

Authors

Diego Moreno Fernandes Furtado Universidade do Estado do Pará, Belém, Pará, Brasil http://orcid.org/0000-0003-2243-1373
Vinicius Sousa da Silveira Universidade do Estado do Pará, Belém, Pará, Brasil http://orcid.org/0000-0001-9061-031X
Irna Carla do Rosário Souza Carneiro Universidade Federal do Pará, Faculdade de Medicina, Instituto de Ciências da Saúde, Belém, Pará, Brasil http://orcid.org/0000-0001-5851-1477
Danielle Moreno Fernandes Furtado Universidade do Estado do Pará, Belém, Pará, Brasil http://orcid.org/0000-0001-6682-2996
Monica Pereira Kilishek Centro Universitário do Estado do Pará, Belém, Pará, Brasil http://orcid.org/0000-0002-0680-622X

DOI:

https://doi.org/10.5123/S2176-6223201900041

Keywords:

Drug Utilization, Multiple Antibacterial Drug Resistance, Anti-Infective Agents

Abstract

OBJECTIVE:

To evaluate the profile of antibiotic consumption and its impact on bacterial resistance in a university hospital in Pará State, Northern Brazil, from 2012 to 2016.

MATERIALS AND METHODS:

A total of 279 blood cultures from adult patients, both sexes, admitted to wards and Intensive Care Unit (ICU), were selected for further analysis of clinical specimen culture results.

RESULTS:

Primary bloodstream infections accounted for 60.2% of the total. Gram-negative bacilli (GNB) were the most frequent microorganisms (51.3%), of which the fermenters were resistant to ceftazidime (83.0%) and cefepime (76.1%). Staphylococcus aureus resistance to clindamycin and oxacillin reached 57.4% and 48.9%, respectively. There was a statistically significant reduction in overall consumption of piperacillin + tazobactam and vancomycin. In ICU, there was reduction in ceftriaxone, oxacillin, piperacillin + tazobactam and vancomycin consumption and increase in amikacin and meropenem consumption (all statistically significant). Fermentative GNB and S. aureus showed a positive and nonlinear correlation between the increase of resistance rates and cefepime and oxacillin consumption, respectively.

CONCLUSION:

Antimicrobial consumption and its impact on bacterial resistance varied over the study period, highlighting the positive and nonlinear correlation between increased cefepime and oxacillin consumption and the recrudescence of fermenting BGN strains and resistant S. aureus strains, respectively.