HOSPITAL BACTERIAL RESISTANCE: MAIN MULTIDRUG-RESISTANT PATHOGENS AND CONTROL STRATEGIES

Abstract

Microbial resistance represents one of the main challenges of contemporary public health, especially in the hospital setting, where the frequent use of antimicrobials and patient vulnerability favor the spread of multidrug-resistant microorganisms. This phenomenon occurs when bacteria develop mechanisms capable of reducing or neutralizing the effectiveness of antibiotics used in the treatment of infections, making previously treatable diseases increasingly difficult to control. In this context, pathogens from the ESKAPE group, such as Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus, stand out due to their high capacity for adaptation and resistance to multiple classes of antimicrobials. Given this healthcare scenario, the present study aimed to analyze, through a review of the scientific literature, the main multidrug-resistant pathogens associated with healthcare-associated infections, as well as the most effective strategies for controlling and preventing microbial resistance in this context. To this end, an integrative literature review was conducted using the SciELO, PubMed/MEDLINE, Virtual Health Library, and CAPES Periodicals Portal databases, employing descriptors related to microbial resistance, hospital infections, multidrug-resistant bacteria, antimicrobials, and infection control. Studies published between 2022 and 2025, in Portuguese and English, were included. After applying eligibility criteria and screening according to PRISMA protocol recommendations, 15 scientific articles were selected. The results showed that bacteria from the ESKAPE group are the main agents associated with multidrug-resistant infections in healthcare settings. Furthermore, the indiscriminate use of antibiotics and failures in infection control measures significantly contribute to the spread of these microorganisms. It is concluded that strategies such as continuous microbiological surveillance, antimicrobial stewardship programs, and training of healthcare professionals are essential to reduce microbial resistance and strengthen patient safety in hospital settings.