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Comparison of antimicrobial resistance rates in an ICU in Rio de Janeiro, Brazil and the United States

Introduction

Antimicrobial resistance has been the major problem for treating patients in the ICU. Most international guidelines are based on antimicrobial resistance rates observed in the USA. For an empirical antimicrobial decision strategy it is important to know the differences between local and imported data.

Objective

To compare local ICU antimicrobial resistance rates (RJ-ICU) with USA-ICU antimicrobial resistance rates (USA-ICU).

Methods

A prospective analysis of antimicrobial resistance rates in a seven-bed medical–surgical ICU in Rio de Janeiro, Brazil and comparison with ICARE (CDC-USA) rates. All isolates were responsible for hospital-acquired infections. The National Committee for Clinical Laboratory Standards were used for the minimum inhibitory concentration, or zone diameter testing standards reporting susceptible, intermediate, or resistant organisms.

Results

The rates of antimicrobial resistance were: methicillin-resistant S. aureus, 50% RJ-ICU vs 68% USA-ICU (P = 0.165); quinolone-resistant P. aeruginosa, 80% RJ-ICU vs 52% USA-ICU (P < 0.0001); imipenem-resistant P. aeruginosa, 49% RJ-ICU vs 38% USA-ICU; ceftazidime-resistant P. aeruginosa, 32% RJ-ICU vs 24% USA-ICU (P = 0.15); third cephalosporin-resistant Enterobacter spp., 60% RJ-ICU vs 47% USA-ICU (P = 0.412); and third cephalosporin-resistant K. pneumoniae, 30% RJ-ICU vs 21% EUA-ICU (P = 0.329).

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Figure 1

Conclusion

Quinolone-resistant P. aeruginosa was significantly higher in the RJ-ICU than in the USA-ICU. We speculate that this difference could be related to different antimicrobial use or patient severity.

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Santos, M., Gutierrez, F., Costa, J. et al. Comparison of antimicrobial resistance rates in an ICU in Rio de Janeiro, Brazil and the United States. Crit Care 9 (Suppl 2), P72 (2005). https://doi.org/10.1186/cc3616

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  • DOI: https://doi.org/10.1186/cc3616

Keywords

  • Minimum Inhibitory Concentration
  • Emergency Medicine
  • Inhibitory Concentration
  • Testing Standard
  • Laboratory Standard