Resistance trends of Acinetobacter spp. in Latin America and characterization of international dissemination of multi-drug resistant strains: five-year report of the SENTRY Antimicrobial Surveillance Program.
OBJECTIVE
To analyze the antimicrobial susceptibility of Acinetobacter spp. isolates collected from Latin American medical centers as part of the SENTRY Antimicrobial Surveillance Program and also to evaluate the dissemination of multi-drug resistant Acinetobacter spp. strains in the region.


METHODS
A total of 826 isolates of Acinetobacter spp. from multiple infection sites were collected from January 1997 to December 2001 in ten medical centers and susceptibility tested to >25 selected agents by broth microdilution. Multi-drug resistant Acinetobacter spp. isolates were molecular typed.


RESULTS
Resistance rates to carbapenems varied significantly among countries. A continued annual increase occurred in the Argentinean medical centers. In contrast, carbapenem resistance was rare in Chilean centers, and decreased significantly in the Brazilian institutions. Acinetobacter spp. isolates recovered from lower respiratory tract and bloodstream infections were associated with lower antimicrobial susceptibility rates. Resistance rates to imipenem were higher among isolates collected from intensive care units (13.5%) than among isolates from other units. A major ribogroup pattern (521-1) was detected among eight Acinetobacter spp. strains isolated from three distinct Latin American countries.


CONCLUSIONS
This study found that antimicrobial resistance is still a major issue among Acinetobacter spp. isolates collected from some Latin American countries. The dissemination of a major bacterial cluster in different regions reinforces the importance of longitudinal surveillance programs, such as SENTRY, as valuable tools for monitoring antimicrobial susceptibility rates and guiding local interventions.
Laboratório Especial de Microbiologia Clínica, Disciplina de Doenças Infecciosas e Parasitárias, Universidade Federal de São Paulo-SP, CEP 04025-010, Brazil.
Maria Cristina Bronharo
MC
Tognim
Soraya Sgambatti
SS
Andrade
Suzane
S
Silbert
Ana Cristina
AC
Gales
Ronald N
RN
Jones
Hélio S
HS
Sader
D000150:Acinetobacter / Q000187:drug effects* / Q000235:genetics; D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007843:Latin America; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance; D021521:Ribotyping
D000900:Anti-Bacterial Agents; D015780:Carbapenems