New research from CAMO-Net Brazil has examined the link between healthcare workers and antimicrobial resistance (AMR). The research, published in the European Journal of Clinical Microbiology & Infectious Diseases, explores the prevalence of multidrug-resistant organisms (MDRO) among health workers in primary care settings in São Caetano do Sul, Brazil. Led by Dr Vítor Falcão de Oliveira, the study looked at how many healthcare workers were carrying drug-resistant bacteria, known as colonisation rates, and what factors might increase this risk.
Our National Hub in Brazil is based at the Faculdade de Medicina of the University of São Paulo. Led by Professor Anna Levin and Professor Silvia Costa, the team in Brazil focus on antibiotic prescribing decision support in the community, antibiotic prescribing interventions in a heterogeneous urban population in primary care, and surveillance of wastewater and asymptomatic carriers for measuring impact. The city of São Caetano do Sul, a part of the greater São Paulo, has 165,000 inhabitants. It is participating actively in the study, involving its entire primary care system.
Study Overview
The latest research from CAMO-Net Brazil focused on 265 health workers across 12 primary care units in São Caetano do Sul, with self-collected swabs. Samples from local water sources were also tested to see how they compared with the bacteria found in the healthcare workers. The team found that approximately 8.7% of the workers were colonised by MDRO, with Stenotrophomonas maltophilia (3.4%), methicillin-resistant Staphylococcus aureus (3%), and extended-spectrum beta-lactamase (ESBL) producers being the most common.
Significantly, the study associated narrow-spectrum oral antimicrobials, such as amoxicillin and macrolides, with a higher risk of MDRO colonisation, an unexpected finding given that broad-spectrum antibiotics are typically linked to such resistance.
Implications for Healthcare Practice
The study’s findings highlight the potential risks of using narrow-spectrum antibiotics in primary care settings. Dr Vítor Falcão de Oliveira said, “Our findings shed light on a concerning trend in primary care. While narrow-spectrum antibiotics are often preferred for their targeted action, our study indicates they may still play a significant role in fostering multidrug resistance. This calls for an urgent reassessment of current prescribing guidelines to ensure the safety of both healthcare workers and the communities they serve.”
Professor Anna Levin emphasised the importance of reviewing antibiotic prescribing practices: “Our study reveals that even common antibiotics, thought to be safer, can contribute to the rise of multidrug resistance. We must rethink our approach to antibiotic use, particularly in primary care, to prevent further spread.”
This research highlights the ongoing need for robust infection control strategies and careful use of antibiotics to curb the spread of AMR among healthcare professionals and patients alike.
