**6. Conclusions**

The problem of multidrug resistance is serious. The loss of efficacy of antibiotics, within our current technified medicine, would limit procedures such as transplants, complex surgeries, the management of cancer patients, and so on. It is the responsibility of EVERYBODY to make an efficient use of antibiotics. We must remember that a large part of the use of these molecules is done at the industrial level, out of sanitary management.

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The striking finding of the NORTH-SOUTH and WEST-EAST gradient of MRB isolates frequency can have several explanations: different policies of antibiotic use, environmental conditions (heat) that favors the persistence of certain germs in the hospital environment, variable culture of security within the hospital centers, and so on.

The RZ project, despite the difficulties in its development, shows efficacy in reducing MRB infections acquired in the ICU. It has been achieved up to 40% of the days in ICU without the use of antibiotics. The number of germs discovered at the time of admission is greater than during the stay in ICU. The MRBs that caused colonization acquired in ICU increased, while the infections acquired by BMR decreased. A great proportion of MRSA and ESBL among isolated microorganisms has been documented on admission, and germs producers of carbapenemases, *P. aeruginosa* and *A. baumannii* are more frequent during their stay in the ICU. There are important differences between autonomous communities; there may even be differences between different units of critics of the same hospital. The active search for MRB in patients at the time of admission has doubled its detection. The application of the recommended measures in RZ has achieved to reduce acquired MRB infections acquired up to 45%.
