title: Trends of 9,416 multidrug-resistant Gram-negative bacteria.
abstract: OBJECTIVE
  a resistance of hospital-acquired bacteria to multiple antibiotics is a major concern worldwide. The objective of this study was to investigate multidrugresistant (MDR) bacteria, clinical specimens, origin of specimen and trends, and correlate these with bacterial sensitivity and consumption of antimicrobials.
  
  
  METHODS
  9,416 bacteria of nosocomial origin were evaluated in a tertiary hospital, from 1999 to 2008. MDR was defined for Gram-negative bacteria (GNB) as resistance to two or more classes/groups of antibiotics.
  
  
  RESULTS
  GNB MDR increased by 3.7 times over the study period (p<0.001). Acinetobacter baumannii was the most prevalent (36.2%). Over the study period, there were significant 4.8-fold and 14.6-fold increases for A. baumannii and K. pneumoniae (p<0.001), respectively. Sixty-seven percent of isolates of MDR GNB were isolated in intensive care units. The resistance of A. baumannii to carbapenems increased from 7.4 to 57.5% during the study period and concomitant with an increased consumption.
  
  
  CONCLUSIONS
  that decade showed prevalence of GNB and a gradual increase in MDR GNB. There was an increase in carbapenem resistance of 50.1% during the study.
authors.affiliation: Department of General Nursery, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
authors.forename: Viviane Decicera Colombo
authors.initials: VD
authors.lastname: Oliveira
authors.affiliation: Department of Infectious, Parasitary and Dermatology Diseases, Famerp, São José do Rio Preto, SP, Brazil.
authors.forename: Fernando Góngora
authors.initials: FG
authors.lastname: Rubio
authors.affiliation: Department of Infectious, Parasitary and Dermatology Diseases, Famerp, São José do Rio Preto, SP, Brazil.
authors.forename: Margarete Teresa Gottardo
authors.initials: MT
authors.lastname: Almeida
authors.affiliation: Department of Infectious, Parasitary and Dermatology Diseases, Famerp, São José do Rio Preto, SP, Brazil.
authors.forename: Mara Corrêa Lelles
authors.initials: MC
authors.lastname: Nogueira
authors.affiliation: Special Clinical Microbiology Laboratory, Infectious Diseases Division, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Antonio Carlos Campos
authors.initials: AC
authors.lastname: Pignatari
mesh_terms: D040981:Acinetobacter baumannii / Q000302:isolation & purification; D015780:Carbapenems / Q000494:pharmacology; D003428:Cross Infection / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006784:Hospitals, Teaching; D006801:Humans; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014552:Urinary Tract Infections / Q000382:microbiology
chemical_list: D015780:Carbapenems