{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T01:12:29Z","timestamp":1778980349051,"version":"3.51.4"},"reference-count":0,"publisher":"Journal of Infection in Developing Countries","issue":"04","license":[{"start":{"date-parts":[[2023,4,30]],"date-time":"2023-04-30T00:00:00Z","timestamp":1682812800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Infect Dev Ctries"],"abstract":"<jats:p>Introduction: Geographical analyses of antibiotic use identify regions with the highest consumption and help design policies for strategic patient groups.\nMethodology: We conducted a cross-sectional study based on official data available in July 2022 from Brazilian Health Surveillance Agency (Anvisa). Antibiotics are reported as a defined daily dose (DDD) per 1,000 patient-days, and central line-associated bloodstream infection (CLABSI) is defined according to Anvisa criteria. We also considered multi-drug resistant (MDR) as the critical pathogens the World Health Organization listed. We measured antimicrobial use and CLABSI trends per ICU bed using the compound annual growth rate (CAGR). Results: we evaluated the regional variation in CLABSI by multidrug-resistant pathogens and the antimicrobial use in 1,836 hospital intensive care units (ICUs). In 2020, the leader in use in intensive care units (ICUs) in the North was piperacillin\/tazobactam (DDD = 929.7) in the Northeast. Midwest and South were meropenem (DDD = 809.4 and DDD = 688.1, respectively), and Southeast was ceftriaxone (DDD = 751.1). The North has reduced polymyxin use (91.1%), and ciprofloxacin increased (439%) in the South. There was an increase in CLABSI by carbapenem-resistant Pseudomonas aeruginosa in the North region (CAGR = 120.5%). Otherwise, CLABSI by vancomycin-resistant Enterococcus faecium (VRE) increased in all regions except the North (CAGR = -62.2%), while that carbapenem-resistant Acinetobacter baumannii increased in the Midwest (CAGR = 27.3%).\nConclusions: we found heterogeneity in antimicrobial use patterns and CLABSI etiology among Brazilian ICUs. Although Gram-negative bacilli were the primary responsible agent, we observed a notable increase trend of CLABSI by VRE.<\/jats:p>","DOI":"10.3855\/jidc.17686","type":"journal-article","created":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T19:10:42Z","timestamp":1683659442000},"page":"485-493","source":"Crossref","is-referenced-by-count":4,"title":["Geographical variation in antimicrobial use and multiresistant pathogens in Brazilian intensive care units: a nationwide study"],"prefix":"10.3855","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6037-8206","authenticated-orcid":false,"given":"Alice","family":"Ramos Oliveira Silva","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constanza","family":"Xavier Borges Barbosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raianne","family":"Soares Rebelo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Fernandez-Llimos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0101-790X","authenticated-orcid":false,"given":"Elisangela","family":"Costa Lima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2222","published-online":{"date-parts":[[2023,4,30]]},"container-title":["The Journal of Infection in Developing Countries"],"original-title":[],"link":[{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/download\/17686\/3057","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/download\/17686\/3057","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T19:10:43Z","timestamp":1683659443000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/view\/17686"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,30]]},"references-count":0,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2023,4,30]]}},"URL":"https:\/\/doi.org\/10.3855\/jidc.17686","relation":{},"ISSN":["1972-2680"],"issn-type":[{"value":"1972-2680","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,30]]}}}