Antimicrobial resistance (AMR) has a major impact on healthcare, being associated with worse clinical outcomes and higher hospital costs. Policies focused on the identification and control of AMR, such as appropriate antimicrobial use, are essential to mitigate this public health problem. This study aimed to describe the resistance profiles of Klebsiella pneumoniae (KP), Pseudomonas aeruginosa (PA), and Acinetobacter spp. (AS) and to evaluate the association between antimicrobial consumption and AMR in isolates from patients with catheter-associated urinary tract infection (CA-UTI) and laboratory-confirmed central line-associated bloodstream infection (CLABSI) in adult intensive care units (ICUs) in Brazil from 2019 to 2023. Secondary data were extracted from the ANVISA Patient Safety Bulletin (2019–2023). Resistance and antimicrobial consumption data (expressed in defined daily doses DDD per 1,000 patient-days) were included for carbapenems, third- and fourth-generation cephalosporins, polymyxins B/E, ceftazidime-avibactam (CAZ-AVI), and ceftolozane-tazobactam (C/T). Associations between consumption and resistance were evaluated using simple linear regression. A p-value <0.05 was considered statistically significant. In CLABSI cases, KP showed 61.5% resistance to carbapenems, 70.9% to cephalosporins, 20.8% to polymyxins, and 37.1% to CAZ-AVI, with a significant association between carbapenem consumption and resistance (β = 0.055; p = 0.02). PA exhibited 37.4% resistance to carbapenems, 21.9% to C/T, and 18.4% to polymyxins, with a significant association between carbapenem consumption and resistance (β = 0.051; p = 0.01). AS showed 84.2% resistance to carbapenems and 7.8% to polymyxins, also with a significant association between carbapenem consumption and resistance (β = 0.051; p = 0.02). In CA-UTI, KP demonstrated 52.3% resistance to carbapenems, 70.2% to cephalosporins, 17.7% to polymyxins, and 34.3% to CAZ-AVI, with a significant association between cephalosporin consumption and resistance (β = 0.057; p = 0.02). PA showed 43.2% resistance to carbapenems and 7.6% to polymyxins, with a significant association between carbapenem consumption and resistance (β = 0.058; p = 0.03). AS presented 83.5% resistance to carbapenems and 8% to polymyxins. Higher consumption of certain antimicrobials was associated with increased AMR rates in K. pneumoniae , P. aeruginosa , and Acinetobacter spp. in both CLABSI and CA-UTI cases.
Boschiero et al. (Sun,) studied this question.
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