{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T08:58:05Z","timestamp":1793609885816,"version":"4.5.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Diseases Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"name":"(CDC;","award":["CDC-RFA-CK21-2104"],"award-info":[{"award-number":["CDC-RFA-CK21-2104"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Carbapenemase production is a global public health threat. Antimicrobial resistance (AMR) data analysis is critical to public health policy. Here we analyzed carbapenemase detection trends using the AMR Brazilian Surveillance Network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Carbapenemase detection data from Brazilian hospitals included in the public laboratory information system dataset were evaluated. The detection rate (DR) was defined as carbapenemase detected by gene tested per isolate per year. The temporal trends were estimated using the Prais\u2013Winsten regression model. The impact of COVID-19 on carbapenemase genes in Brazil was determined for the period 2015\u20132022. Detection pre- (October 2017 to March 2020) and post-pandemic onset (April 2020 to September 2022) was compared using the \u03c72 test. Analyses were performed with Stata 17.0 (StataCorp, College Station, TX).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>83 282 blaKPC and 86 038 blaNDM were tested for all microorganisms. Enterobacterales DR for blaKPC and blaNDM was 68.6% (41 301\/60 205) and 14.4% (8377\/58 172), respectively. P. aeruginosa DR for blaNDM was 2.5% (313\/12 528). An annual percent increase for blaNDM of 41.1% was observed, and a decrease for blaKPC of \u22124.0% in Enterobacterales, and an annual increase for blaNDM of 71.6% and for blaKPC of 22.2% in P. aeruginosa. From 2020 to 2022, overall increases of 65.2% for Enterobacterales, 77.7% for ABC, and 61.3% for P. aeruginosa were observed in the total isolates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study shows the strengths of the AMR Brazilian Surveillance Network with robust data related to carbapenemases in Brazil and the impact of COVID-19 with a change in carbapenemase profiles with blaNDM rising over the years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciad260","type":"journal-article","created":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T19:59:24Z","timestamp":1684958364000},"page":"S29-S37","source":"Crossref","is-referenced-by-count":58,"title":["A 7-Year Brazilian National Perspective on Plasmid-Mediated Carbapenem Resistance in Enterobacterales,\n                    <i>Pseudomonas aeruginosa<\/i>\n                    , and\n                    <i>Acinetobacter baumannii<\/i>\n                    Complex and the Impact of the Coronavirus Disease 2019 Pandemic on Their Occurrence"],"prefix":"10.1093","volume":"77","author":[{"given":"Carlos R V","family":"Kiffer","sequence":"first","affiliation":[{"name":"Escola Paulista de Medicina (EPM), Universidade Federal de S\u00e3o Paulo\u2014UNIFESP , S\u00e3o Paulo , Brazil"},{"name":"Infectious Diseases Discipline, Laborat\u00f3rio Especial de Microbiologia Cl\u00ednica\u2014LEMC\/ALERTA, EPM, UNIFESP , S\u00e3o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thais F T","family":"Rezende","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina (EPM), Universidade Federal de S\u00e3o Paulo\u2014UNIFESP , S\u00e3o Paulo , Brazil"},{"name":"Infectious Diseases Discipline, Laborat\u00f3rio Especial de Microbiologia Cl\u00ednica\u2014LEMC\/ALERTA, EPM, UNIFESP , S\u00e3o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Testoni","family":"Costa-Nobre","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina (EPM), Universidade Federal de S\u00e3o Paulo\u2014UNIFESP , S\u00e3o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana S\u00edlvia Scavacini","family":"Marinonio","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina (EPM), Universidade Federal de S\u00e3o Paulo\u2014UNIFESP , S\u00e3o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Hidemitsu","family":"Shiguenaga","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina (EPM), Universidade Federal de S\u00e3o Paulo\u2014UNIFESP , S\u00e3o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora Nicole Oliveira","family":"Kulek","sequence":"additional","affiliation":[{"name":"Laboratorio Central do Paran\u00e1 - LACENPR, Secretaria de Estado da Sa\u00fade , Curitiba, Parana , Brazil"},{"name":"Escola de Medicina e Ciencias da Vida - EMCV, Pontif\u00edcia Universidade Cat\u00f3lica do Paran\u00e1\u2014PUCPR , Curitiba, Parana , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavinia Nery Villa Stangler","family":"Arend","sequence":"additional","affiliation":[{"name":"Laboratorio Central do Paran\u00e1 - LACENPR, Secretaria de Estado da Sa\u00fade , Curitiba, Parana , Brazil"},{"name":"Escola de Medicina e Ciencias da Vida - EMCV, Pontif\u00edcia Universidade Cat\u00f3lica do Paran\u00e1\u2014PUCPR , Curitiba, Parana , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivson Cassiano de Oliveira","family":"Santos","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz (IOC)\u2014Funda\u00e7\u00e3o Instituto Oswaldo Cruz (FIOCRUZ) , Rio de Janeiro , Brazil"},{"name":"Laborat\u00f3rio de Pesquisa em Infec\u00e7\u00e3o Hospitalar\u2014LAPIH, Instituto Oswaldo Cruz , Rio de Janeiro , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Ribeiro","family":"Sued-Karam","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz (IOC)\u2014Funda\u00e7\u00e3o Instituto Oswaldo Cruz (FIOCRUZ) , Rio de Janeiro , Brazil"},{"name":"Laborat\u00f3rio de Pesquisa em Infec\u00e7\u00e3o Hospitalar\u2014LAPIH, Instituto Oswaldo Cruz , Rio de Janeiro , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio Marcos","family":"Rocha-de-Souza","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz (IOC)\u2014Funda\u00e7\u00e3o Instituto Oswaldo Cruz (FIOCRUZ) , Rio de Janeiro , Brazil"},{"name":"Laborat\u00f3rio de Pesquisa em Infec\u00e7\u00e3o Hospitalar\u2014LAPIH, Instituto Oswaldo Cruz , Rio de Janeiro , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia","family":"Kraft","sequence":"additional","affiliation":[{"name":"Coordena\u00e7\u00e3o Geral de Laborat\u00f3rios de Sa\u00fade Publica, Departamento de Articula\u00e7\u00e3o Estrat\u00e9gica de Vigil\u00e2ncia em Sa\u00fade e Ambiente, Secretaria de Vigil\u00e2ncia em Sa\u00fade e Ambiente, Minist\u00e9rio da Sa\u00fade , Brasilia, Distrito Federal , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Abreu","sequence":"additional","affiliation":[{"name":"N\u00facleo de Epidemiologia e Vigil\u00e2ncia em Sa\u00fade, Instituto Oswaldo Cruz\u2014FIOCRUZ , Brasilia, Distrito Federal , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata Tigulini de Souza","family":"Peral","sequence":"additional","affiliation":[{"name":"Coordena\u00e7\u00e3o Geral de Laborat\u00f3rios de Sa\u00fade Publica, Departamento de Articula\u00e7\u00e3o Estrat\u00e9gica de Vigil\u00e2ncia em Sa\u00fade e Ambiente, Secretaria de Vigil\u00e2ncia em Sa\u00fade e Ambiente, Minist\u00e9rio da Sa\u00fade , Brasilia, Distrito Federal , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula D\u2019Alincourt","family":"Carvalho-Assef","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz (IOC)\u2014Funda\u00e7\u00e3o Instituto Oswaldo Cruz (FIOCRUZ) , Rio de Janeiro , Brazil"},{"name":"Laborat\u00f3rio de Pesquisa em Infec\u00e7\u00e3o Hospitalar\u2014LAPIH, Instituto Oswaldo Cruz , Rio de Janeiro , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2896-3186","authenticated-orcid":false,"given":"Marcelo","family":"Pillonetto","sequence":"additional","affiliation":[{"name":"Laboratorio Central do Paran\u00e1 - LACENPR, Secretaria de Estado da Sa\u00fade , Curitiba, Parana , Brazil"},{"name":"Escola de Medicina e Ciencias da Vida - EMCV, Pontif\u00edcia Universidade Cat\u00f3lica do Paran\u00e1\u2014PUCPR , Curitiba, Parana , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,5]]},"reference":[{"key":"2023070517370067300_ciad260-B1","first-page":"15","article-title":"Carbapenem resistance: overview of the problem and future perspectives","volume":"3","author":"Meletis","year":"2016","journal-title":"Ther Adv Infect Dis"},{"key":"2023070517370067300_ciad260-B2","author":"Pan American Health Organization","year":"2021"},{"key":"2023070517370067300_ciad260-B3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3201\/eid2811.220415","article-title":"Increased detection of carbapenemase-producing Enterobacterales bacteria in Latin America and the Caribbean during the COVID-19 pandemic","volume":"28","author":"Thomas","year":"2022","journal-title":"Emerg Infect Dis"},{"key":"2023070517370067300_ciad260-B4","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1017\/ice.2021.362","article-title":"The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: a summary of data reported to the National Healthcare Safety Network","volume":"43","author":"Weiner-Lastinger","year":"2022","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2023070517370067300_ciad260-B5","first-page":"2459","article-title":"Bacterial and fungal coinfection in individuals with coronavirus: a rapid review to support COVID-19 antimicrobial prescribing","volume":"71","author":"Rawson","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2023070517370067300_ciad260-B6","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.jiph.2021.02.011","article-title":"Antimicrobial resistance threats in the emerging COVID-19 pandemic: where do we stand?","volume":"14","author":"Ghosh","year":"2021","journal-title":"J Infect Public Health"},{"key":"2023070517370067300_ciad260-B7","doi-asserted-by":"crossref","DOI":"10.1016\/j.scitotenv.2021.150873","article-title":"COVID-19 and antimicrobial resistance: a cross-study","volume":"807","author":"Rizvi","year":"2022","journal-title":"Sci Total Environ"},{"key":"2023070517370067300_ciad260-B8","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S2213-2600(20)30079-5","article-title":"Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study","volume":"8","author":"Yang","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2023070517370067300_ciad260-B9","doi-asserted-by":"crossref","first-page":"e99","DOI":"10.1016\/S1473-3099(17)30485-1","article-title":"Surveillance for control of antimicrobial resistance","volume":"18","author":"Tacconelli","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2023070517370067300_ciad260-B10","first-page":"1","volume-title":"Trend estimators and serial correlation","author":"Prais","year":"1954"},{"key":"2023070517370067300_ciad260-B11","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.bjm.2016.10.002","article-title":"Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on \u03b2-lactams and polymyxins","volume":"47","author":"Sampaio","year":"2016","journal-title":"Braz J Microbiol"},{"key":"2023070517370067300_ciad260-B12","author":"John Hopkins University\u2013Coronavirus Resource Center"},{"key":"2023070517370067300_ciad260-B13","author":"Instituto Brasileiro de Geografia e Estat\u00edstica"},{"key":"2023070517370067300_ciad260-B14","author":"Worldometer"},{"key":"2023070517370067300_ciad260-B15","doi-asserted-by":"crossref","first-page":"i35","DOI":"10.1093\/jac\/dkac215","article-title":"Country data on AMR in Brazil in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicine and clinical outcome","volume":"77","author":"Torumkuney","year":"2022","journal-title":"J Antimicrob Chemother"},{"key":"2023070517370067300_ciad260-B16","author":"Brasil. 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