Mariana Guedes Ribeiro
Laboratório Central de Saúde Pública do Rio de Janeiro (LACEN-RJ), Rio de Janeiro, Brazil
Tiago Nascimento Carvalho
Departamento de Patologia Clínica, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
ABSTRACT
With a population of 192 million, Brazil is the largest country in Latin America and has continental dimensions. Several physical and economic variances distinguish it. With a population of 20 million, São Paulo, located in the country's southeast, is the biggest metropolis and home to important medical institutions. Brazilian hospitals face a severe issue with bacterial resistance, which is difficult to cure even in its medical centres of excellence. The nation has no central microbiology reference laboratory, and the dearth of official publications makes it difficult to compile national statistics on bacterial resistance. It appears that resistance has more significance in the southern and southeastern states. The trend of local hospitals consolidating and moving off-site microbiology laboratory services has grown recently. This has resulted in a lengthier turnaround time for the findings of antibiotic susceptibility tests and culture tests. Despite the fact that most hospitals have antimicrobial stewardship groups, the delay in reporting microbiological findings may affect the prescription of certain antibiotics, which may lead to a high level of selective pressure due to the widespread use of broad-spectrum antibiotics. In Brazilian intensive care units (ICUs), the use of last-resort medications, including colistin, is quite commonplace because many isolates have developed resistance to practically all currently available medications. There is proof that one of the main factors influencing resistance selection is the total amount of antibiotics used. Ironically, subpar antimicrobials, poor adherence, and insufficient doses may contribute as much to resistance development as excessive usage. Antibiotic resistance may have its roots in Brazil, where the availability of medicines over the counter encourages self-medication. Antimicrobial resistance is becoming more common, which is a worldwide problem. Compared to Europe and the US, Brazil and Latin America generally have higher levels of bacterial resistance among most of their key pathogens, especially among no fermentative gram-negative bacilli and Enterobacteriaceae that produce extended-spectrum β-lactamase (ESBL), but also among some gram-positive organisms (like Staphylococcus aureus).
Keywords: Pathogens (P), Brazil laboratory Identification (BLI), Clinical (CC), Correlation (CC).
