The year 2020 will be remembered for the SARS-CoV-2 coronavirus pandemic, responsible for more than 10 million cases and more than 500 000 deaths in the first half of the year alone, and receiving unprecedented political and social attention. This global public health crisis should draw attention to other silent epidemics, such as antimicrobial resistance (AMR), responsible for 700 000 annual deaths worldwide, 230 000 of them from multi-drug-resistant tuberculosis.2 In the Region of the Americas, multidrug-resistant microorganisms are the leading cause of health care-associated infections. Surveillance data from the Latin American Network for Antimicrobial Resistance Surveillance (RELAVRA) show an increasing trend in the resistance of hospital pathogens such as Klebsiella pneumoniae, whose non-susceptibility to carbapenem antibiotics has been increasing significantly in Latin America since 2014, reaching an average of 21%.3 There are significant consequences for health systems in terms of mortality, disability, and economic costs. For example, Staphylococcus aureus causes a wide range of infections and is one of the most commonly isolated microorganisms in health care-associated infections; in Latin America, more than 25% of S. aureus isolates are resistant to methicillin. The result is 45.2% excess mortality attributable to methicillin resistance, compared to susceptible strains, and increased antibiotic treatment costs (6.7 times greater) and hospitalization (almost 3 times greater).
Barbosa et al