Fiocruz warns of an increase in antibiotic-resistant bacteria

The Hospital Infection Research Laboratory at the Oswaldo Cruz Institute (IOC/Fiocruz) has already received in 2021 more than triple the number of samples of antibiotic-resistant bacteria compared to what was analyzed in 2019, the last year before the covid-19 pandemic. The survey was released today (19) by the institute, whose researchers warn of the risk of further spread of antibiotic resistance due to the increased use of these drugs during health emergencies.

Samples of “superbacteria” are sent to the IOC laboratory by other public health laboratories in different states, as the back office of the Analytical Subnetwork for Microbial Resistance in Health Services (Subnetwork RM) functions there. instituted by the National Health Surveillance Agency (Anvisa) and by the Ministry of Health (MS). As a back-up unit, the laboratory works in the in-depth analysis of antibiotic-resistant bacteria, which are detected in cases of hospital infection.

The IOC informs that, in 2019, just over a thousand samples of antibiotic-resistant bacteria arrived at the laboratory. In 2020, that number reached almost 2,000, and, from January to October of this year, it has already reached 3,700. The institute points out that, while the official figures from Anvisa on resistant bacteria for 2020 and 2021 are not yet available, the increase observed in reference centers can be considered a warning.

In a text released by the IOC/FIocruz, the head of the Hospital Infection Research Laboratory, Ana Paula Assef, explains that there was an increase in the volume of patients hospitalized in serious condition and for long periods during the pandemic, which increases the risk of infections hospitals.

“In part, the increase in antibiotic prescriptions in hospitals during the pandemic can be explained by the greater number of critically ill patients hospitalized, who end up developing secondary infections and needing these drugs. However, excessive use needs to be controlled to avoid boosting the bacterial resistance,” warns the head of the laboratory.

The researcher said that research in Brazil and abroad suggests that there may have been an exaggerated prescription of antibiotics for those admitted to covid-19. The IOC cites a global study published in January that points to more than 70% of patients with covid-19 being treated with antibiotics during hospitalization, when bacterial coinfections are estimated to be in only 8% of cases.

Another concern highlighted by the head of the laboratory is the increase in resistance to polymyxin, a drug considered the last therapeutic option for infections that do not respond to other antibiotics. This growth occurred in three groups of bacteria frequent among cases of hospital infections: A. baumanii (from 2.5% in 2019 to 5.6% in 2021), Pseudomonas aeruginosa (from 14% to 51%) , and enterobacteria (from 42% to 58%).

In August, Anvisa published a technical note with guidelines to reduce the spread of resistant bacteria during the covid-19 pandemic, noting that antibiotics are not indicated in the routine treatment of covid-19, as the disease is caused by viruses and these drugs only work against bacteria. Antibiotics are recommended only for cases with suspected bacterial infection associated with viral infection, the agency recommends.

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