<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2176-6223</journal-id>
<journal-title><![CDATA[Revista Pan-Amazônica de Saúde]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Pan-Amaz Saude]]></abbrev-journal-title>
<issn>2176-6223</issn>
<publisher>
<publisher-name><![CDATA[Instituto Evandro Chagas. Secretaria de Vigilância em Saúde e Ambiente. Ministério da Saúde]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2176-62232019000100012</article-id>
<article-id pub-id-type="doi">10.5123/s2176-6223201900041</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Consumo de antimicrobianos e o impacto na resistência bacteriana em um hospital público do estado do Pará, Brasil, de 2012 a 2016]]></article-title>
<article-title xml:lang="en"><![CDATA[Antimicrobial consumption and its impact on bacterial resistance in a public hospital in Pará State, Brazil, from 2012 to 2016]]></article-title>
<article-title xml:lang="es"><![CDATA[Consumo de antimicrobianos y el impacto en la resistencia bacteriana en un hospital público del estado de Pará, Brasil, de 2012 a 2016]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Furtado]]></surname>
<given-names><![CDATA[Diego Moreno Fernandes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silveira]]></surname>
<given-names><![CDATA[Vinicius Sousa da]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carneiro]]></surname>
<given-names><![CDATA[Irna Carla do Rosário Souza]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Furtado]]></surname>
<given-names><![CDATA[Danielle Moreno Fernandes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Kilishek]]></surname>
<given-names><![CDATA[Monica Pereira]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidade do Estado do Pará  ]]></institution>
<addr-line><![CDATA[Belém Pará]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidade Federal do Pará Faculdade de Medicina Instituto de Ciências da Saúde]]></institution>
<addr-line><![CDATA[Belém Pará]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro Universitário do Estado do Pará  ]]></institution>
<addr-line><![CDATA[Belém Pará]]></addr-line>
<country>Brazil</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2019</year>
</pub-date>
<volume>10</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_arttext&amp;pid=S2176-62232019000100012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_abstract&amp;pid=S2176-62232019000100012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_pdf&amp;pid=S2176-62232019000100012&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO  OBJETIVO:  Avaliar o perfil de consumo de antimicrobianos e o seu impacto na resistência bacteriana em um hospital universitário do estado do Pará, Região Norte do Brasil, entre 2012 e 2016.  MATERIAIS E MÉTODOS:  Foram selecionadas 279 hemoculturas de pacientes adultos, de ambos os sexos, internados em enfermarias e no Centro de Terapia Intensiva (CTI), para posterior análise dos resultados de culturas de espécimes clínicos.  RESULTADOS:  As infecções primárias de corrente sanguínea representaram 60,2% do total. Os bacilos Gram-negativos (BGN) foram os microrganismos mais frequentes (51,3%), dos quais os fermentadores mostraram-se resistentes a ceftazidima (83,0%) e a cefepima (76,1%). A resistência do Staphylococcus aureus a clindamicina e a oxacilina atingiu 57,4% e 48,9%, respectivamente. Houve redução, estatisticamente significativa, do consumo global de piperacilina + tazobactam e de vancomicina. No CTI, observou-se a redução do consumo de ceftriaxona, oxacilina, piperacilina + tazobactam e vancomicina e o aumento do consumo de amicacina e meropeném (todos estatisticamente significativos). Os BGN fermentadores e o S. aureus apresentaram correlação positiva e não linear entre o aumento do percentual de resistência e o consumo de cefepima e oxacilina, respectivamente.  CONCLUSÃO:  O consumo de antimicrobianos e o impacto na resistência bacteriana variaram durante o período analisado, destacando-se a correlação positiva e não linear entre o aumento do consumo de cefepima e oxacilina e o recrudescimento das cepas de BGN fermentadores e S. aureus resistentes, respectivamente.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  OBJECTIVE:  To evaluate the profile of antibiotic consumption and its impact on bacterial resistance in a university hospital in Pará State, Northern Brazil, from 2012 to 2016.  MATERIALS AND METHODS:  A total of 279 blood cultures from adult patients, both sexes, admitted to wards and Intensive Care Unit (ICU), were selected for further analysis of clinical specimen culture results.  RESULTS:  Primary bloodstream infections accounted for 60.2% of the total. Gram-negative bacilli (GNB) were the most frequent microorganisms (51.3%), of which the fermenters were resistant to ceftazidime (83.0%) and cefepime (76.1%). Staphylococcus aureus resistance to clindamycin and oxacillin reached 57.4% and 48.9%, respectively. There was a statistically significant reduction in overall consumption of piperacillin + tazobactam and vancomycin. In ICU, there was reduction in ceftriaxone, oxacillin, piperacillin + tazobactam and vancomycin consumption and increase in amikacin and meropenem consumption (all statistically significant). Fermentative GNB and S. aureus showed a positive and nonlinear correlation between the increase of resistance rates and cefepime and oxacillin consumption, respectively.  CONCLUSION:  Antimicrobial consumption and its impact on bacterial resistance varied over the study period, highlighting the positive and nonlinear correlation between increased cefepime and oxacillin consumption and the recrudescence of fermenting BGN strains and resistant S. aureus strains, respectively.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  OBJETIVO: Evaluar el perfil de consumo de antimicrobianos y su impacto en la resistencia bacteriana en un hospital universitario del estado de Pará, Región Norte de Brasil, entre 2012 y 2016.  MATERIALES Y MÉTODOS: Fueron seleccionados 279 hemocultivos de pacientes adultos, de ambos sexos, internados en enfermerías y en el Centro de Terapia Intensiva (CTI), para posterior análisis de los resultados de cultivos de especímenes clínicos.  RESULTADOS: Las infecciones primarias de corriente sanguínea representaron el 60,2% del total. Los bacilos Gram negativos (BGN) fueron los microorganismos más frecuentes (51,3%), de los cuales los fermentadores se mostraron resistentes a la ceftazidima (83,0%) y a la cefepima (76,1%). La resistencia del Staphylococcus aureus a la clindamicina y a la oxacilina alcanzó 57,4% y 48,9%, respectivamente. Hubo reducción, estadísticamente significativa, del consumo global de piperacilina + tazobactam y de vancomicina. En el CTI, se observó la reducción del consumo de ceftriaxona, oxacilina, piperacilina + tazobactam y vancomicina y el aumento del consumo de amikacina ye meropenem (todos estadísticamente significativos). Los BGN fermentadores y el S. aureus presentaron correlación positiva y no linear entre el aumento del porcentual de resistencia y el consumo de cefepima y oxacilina, respectivamente.  CONCLUSIÓN: El consumo de antimicrobianos y el impacto en la resistencia bacteriana variaron durante el período analizado, destacándose la correlación positiva y no linear entre el aumento del consumo de cefepima y oxacilina y el recrudecimiento de las cepas de BGN fermentadores ye S. aureus resistentes, respectivamente.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Uso de Medicamentos]]></kwd>
<kwd lng="pt"><![CDATA[Farmacorresistência Bacteriana Múltipla]]></kwd>
<kwd lng="pt"><![CDATA[Anti-infecciosos]]></kwd>
<kwd lng="en"><![CDATA[Drug Utilization]]></kwd>
<kwd lng="en"><![CDATA[Multiple Antibacterial Drug Resistance]]></kwd>
<kwd lng="en"><![CDATA[Anti-Infective Agents]]></kwd>
<kwd lng="es"><![CDATA[Utilización de Medicamentos]]></kwd>
<kwd lng="es"><![CDATA[Farmacorresistencia Bacteriana Múltiple]]></kwd>
<kwd lng="es"><![CDATA[Antiinfecciosos]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mota]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Vilar]]></surname>
<given-names><![CDATA[FC]]></given-names>
</name>
<name>
<surname><![CDATA[Dias]]></surname>
<given-names><![CDATA[LBA]]></given-names>
</name>
<name>
<surname><![CDATA[Nunes]]></surname>
<given-names><![CDATA[TF]]></given-names>
</name>
<name>
<surname><![CDATA[Moriguti]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Uso racional de antimicrobianos]]></article-title>
<source><![CDATA[Medicina]]></source>
<year>2010</year>
<volume>43</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>164-72</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Onzi]]></surname>
<given-names><![CDATA[PS]]></given-names>
</name>
<name>
<surname><![CDATA[Hoffman]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Camargo]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Avaliação do consumo de antimicrobianos injetáveis de um hospital privado no ano de 2009]]></article-title>
<source><![CDATA[R Bras Farm Hosp Serv Saude]]></source>
<year>2011</year>
<volume>2</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>20-5</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<collab>World Health Organization. Collaborating Centre for Drug Statistics Methodology</collab>
<source><![CDATA[Guidelines for ATC classification and DDD assignment]]></source>
<year>2013</year>
<edition>16th ed</edition>
<publisher-loc><![CDATA[Oslo ]]></publisher-loc>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alós]]></surname>
<given-names><![CDATA[JI]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Resistencia bacteriana a los antibióticos: una crisis global]]></article-title>
<source><![CDATA[Enferm Infecc Microbiol Clin]]></source>
<year>2015</year>
<volume>33</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>692-9</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Magiorakos]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Srinivasan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Carey]]></surname>
<given-names><![CDATA[RB]]></given-names>
</name>
<name>
<surname><![CDATA[Carmeli]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Falagas]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Giske]]></surname>
<given-names><![CDATA[CG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance]]></article-title>
<source><![CDATA[Clin Microbiol Infect]]></source>
<year>2012</year>
<volume>18</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>268-81</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barlam]]></surname>
<given-names><![CDATA[TF]]></given-names>
</name>
<name>
<surname><![CDATA[Cosgrove]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Abbo]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Macdougall]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Schuetz]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Septimus]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2016</year>
<volume>62</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>e51-77</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[ATC/DDD index]]></source>
<year>2017</year>
<publisher-loc><![CDATA[Oslo ]]></publisher-loc>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tavares]]></surname>
<given-names><![CDATA[NUL]]></given-names>
</name>
<name>
<surname><![CDATA[Bertoldi]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
<name>
<surname><![CDATA[Muccillo-Baisch]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prescrição de antimicrobianos em unidades de saúde da família no Sul do Brasil]]></article-title>
<source><![CDATA[Cad Saude Publica]]></source>
<year>2008</year>
<volume>24</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1791-800</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Costa]]></surname>
<given-names><![CDATA[FM]]></given-names>
</name>
<name>
<surname><![CDATA[Soares]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Batista]]></surname>
<given-names><![CDATA[LB]]></given-names>
</name>
<name>
<surname><![CDATA[Carneiro]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[JAD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Infecção hospitalar: distribuição topográfica e microbiológica em um hospital público de ensino]]></article-title>
<source><![CDATA[J Health Sci Inst]]></source>
<year>2014</year>
<volume>32</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>265-70</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="">
<collab>Agência Nacional de Vigilância Sanitária (BR)</collab>
<source><![CDATA[Critérios diagnósticos de infecções relacionadas à assistência à saúde. Brasília: Agência Nacional de Vigilância Sanitária]]></source>
<year>2013</year>
<volume>v. 2</volume>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="book">
<collab>Agência Nacional de Vigilância Sanitária (BR)</collab>
<source><![CDATA[]]></source>
<year>2017</year>
<publisher-loc><![CDATA[Brasília ]]></publisher-loc>
<publisher-name><![CDATA[Agência Nacional de Vigilância Sanitária]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Santana]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
<name>
<surname><![CDATA[Lima Jr]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Lobo]]></surname>
<given-names><![CDATA[IMF]]></given-names>
</name>
<name>
<surname><![CDATA[Araújo]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Infecção de corrente sanguínea em um hospital terciário]]></article-title>
<source><![CDATA[Rev Soc Bras Clin Med]]></source>
<year>2016</year>
<volume>14</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>22-6</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lima]]></surname>
<given-names><![CDATA[MFP]]></given-names>
</name>
<name>
<surname><![CDATA[Borges]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Parente]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Victória Jr]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[Oliveira]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Staphylococcus aureus e as infecções hospitalares - revisão de literatura]]></article-title>
<source><![CDATA[Rev Uninga Rev]]></source>
<year>2015</year>
<volume>21</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>32-9</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dallacorte]]></surname>
<given-names><![CDATA[TS]]></given-names>
</name>
<name>
<surname><![CDATA[Indras]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Teixeira]]></surname>
<given-names><![CDATA[JJV]]></given-names>
</name>
<name>
<surname><![CDATA[Peder]]></surname>
<given-names><![CDATA[LD]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalência e perfil de sensibilidade antimicrobiana de bactérias isoladas de hemoculturas realizadas em hospitais particulares]]></article-title>
<source><![CDATA[Rev Inst Adolfo Lutz]]></source>
<year>2016</year>
<volume>75</volume>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hidalgo]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
</person-group>
<source><![CDATA[Análise do perfil de consumo de antimicrobianos e correlação com resistência bacteriana de alguns agentes isolados em hemoculturas de um hospital de ensino de São Paulo]]></source>
<year>2008</year>
<publisher-loc><![CDATA[São Paulo, SP ]]></publisher-loc>
<publisher-name><![CDATA[Universidade Federal de São Paulo, Escola Paulista de Medicina]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
