title: Prevalence of antimicrobial resistance among respiratory tract isolates in Latin America: results from SENTRY antimicrobial surveillance program (1997-98).
abstract: One thousand seventy-three bacterial isolates were collected from patients with community acquired respiratory tract infections (CARTI) in 11 Latin American centers (7 countries) during 1997 and 1998. They were tested against numerous antimicrobial agents by the reference broth microdilution method as part of the ongoing multinational SENTRY Antimicrobial Surveillance Program. Among Streptococcus pneumoniae (553 isolates), approximately 61% were susceptible to penicillin. There was a great variation of the penicillin susceptibility rates among participating countries. The highest susceptibility rates were found in Argentina (76.7%) and Brazil (71.9%), while the lowest rate of penicillin susceptibility was detected in Mexico (33.3%). High level resistance to penicillin and resistance to cefotaxime were observed in nearly 10% of the isolates. The newer quinolones, levofloxacin (MIC(90) 2 microg/mL) and gatifloxacin (MIC90 0.5 microg/mL), were active against 100% of the isolates tested. Among the other non-beta-lactams drugs tested, the rank order of susceptibility against the pneumococci was: chloramphenicol (93.9%)>clindamycin (93.2%)> azithromycin (89.1%) > clarithromycin (88.7%)>tetracycline (78.5%)> trimethoprim/sulfamethoxazole (55.7%). The percentage of Haemophilus influenzae (361 isolates) isolates resistant to amoxicillin was 12. 7% (beta-lactamase positive). Among Moraxella catarrhalis (159 isolates) isolates, only 8.2% were susceptible. Clavulanic acid restored the activity of amoxicillin against both species. Trimethoprim/sulfamethoxazole was active against only 59.5% of H. influenzae, while susceptibility to this compound among M. catarrhalis was 96.1%. All other compounds tested were active against>95% of H. influenzae and M. catarrhalis isolates. These species were susceptible to levofloxacin (MIC90 < or = 0.5 microg/mL for both) and gatifloxacin (MIC90 < or = 0.03 microg/mL for both) with very low MICs. Our results indicate that penicillin resistance rates are particularly high among pneumococci in some countries. The newer fluoroquinolones show an excellent potency and spectrum against pathogens causing community acquired respiratory infections in Latin America.
authors.affiliation: Federal University of São Paulo, Medical School of Medecine, São Paulo, São Paulo, Brazil. heliosader@uol.com.br
authors.forename: H S
authors.initials: HS
authors.lastname: Sader
authors.forename: A C
authors.initials: AC
authors.lastname: Gales
authors.forename: T D
authors.initials: TD
authors.lastname: Granacher
authors.forename: M A
authors.initials: MA
authors.lastname: Pfaller
authors.forename: R N
authors.initials: RN
authors.lastname: Jones
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001424:Bacterial Infections / Q000382:microbiology*; D017714:Community-Acquired Infections / Q000382:microbiology; D004352:Drug Resistance, Microbial; D006193:Haemophilus influenzae / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007843:Latin America; D008826:Microbial Sensitivity Tests / Q000379:methods; D001936:Moraxella catarrhalis / Q000187:drug effects* / Q000302:isolation & purification; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000382:microbiology*; D018571:Sentinel Surveillance; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents