Antimicrobial resistance in Brazil: comparison of results from two multicenter studies

To evaluate whether our previous study of the antimicrobial resistance patterns in three centers in Brazil represented the pattern in the country as a whole, the results were compared to new data on 855 isolates from 20 clinical laboratories and 36 hospitals located in different regions of Brazil. Both multicenter studies showed high rates of antimicrobial resistance among Gram-negative bacilli isolated in Brazilian hospitals with the most important problems being: 1) E.coli and K.pneumoniae that produce ESBL; 2) Enterobacter spp. which likely express chromosomally mediated (AmpC) stably derepressed cephalosporinases producing resistance to third-generation cephalosporins and broad spectrum penicillins; 3) carbapenem resistance among Acinetobacter spp. and P.aeruginosa; and 4) fluoroquinolone and aminoglycoside resistance among many Gram-negative species. Our results emphasize the importance of regional antimicrobial resistance surveillance programs in guiding empirical therapy and for focusing intervention controls of antimicrobial resistance. Although the SENTRY Program has only three participating centers in Brazil, its results were validated by a larger Brazilian multicenter study.