title: [Characterization of invasive isolates of S. pneumoniae, H. influenzae, and N. meningitidis in Latin America and the Caribbean: SIREVA II, 2000-2005].
abstract: OBJECTIVE
  To analyze the phenotypical characteristics and the susceptibility to antibiotics of the circulating strains of Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis circulating in Latin America and the Caribbean from 2000-2005. Potential coverage by conjugate vaccines was evaluated.
  
  
  METHODS
  Conventional methods were used to study the distribution of the serotypes or serogroups of 17 303 strains of S. pneumoniae, 2 782 strains of H. influenzae, and 6 955 strains of N. meningitidis isolated from cases of pneumonia, meningitis, sepsis, bacteriemias, and other invasive processes. The antimicrobial susceptibilities of the study strains were evaluated. The isolates came from 453 sentinel surveillance sites in 19 countries in Latin America and four in the Caribbean, as part of the SIREVA II (Network Surveillance System for the Bacterial Agents Responsible for Pneumonia and Meningitis) project.
  
  
  RESULTS
  S. pneumoniae serotype 14 was the most frequently isolated (21.1%), especially in children under 6 years of age (29.1%). The potential coverages by hepta-, nona-, deca-, and trideca-valent antipneumonia conjugate vaccines were 59.0%, 73.4%, 76.5%, and 85.9%, respectively. Of the isolates, 63.3% were sensitive to penicillin. H. influenzae serotype b was present in 72.2% of the isolations from children under 2 years of age, whereas 8.6% produced serotypes a, c, d, e, and f, and 19.2% could not be serotyped. The rate of H. influenzae beta-lactamase-producing strains isolated from children under 2 years of age was 16.3%. The most frequent N. meningitidis serogroups were B (69.0%) and C (25.7%); 65.8% and 99.2% of the strains were susceptible to penicillin and rifampicin, respectively.
  
  
  CONCLUSIONS
  These results highlight the importance of comprehensive epidemiological surveillance of S. pneumoniae, H. influenzae and N. meningitidis in Latin America and the Caribbean. The great heterogeneity found in the distribution of S. pneumoniae serotypes among the countries studied could reduce immunization coverage. Conducting a specific analysis of each country to adjust the introduction of new conjugate vaccines and determine the best immunization plan is recommended.
authors.affiliation: Area de Tecnología y Prestación de Servicios de Salud, Unidad de Medicamentos Esenciales, Vacunas y Tecnologías en Salud, Organización Panamericana de la Salud, Quito, Ecuador. jgabasto@ecu.ops-oms.org
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Gabastou
authors.forename: Clara Inés
authors.initials: CI
authors.lastname: Agudelo
authors.forename: Maria Cristina de Cunto
authors.initials: MC
authors.lastname: Brandileone
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Castañeda
authors.forename: Ana Paula Silva
authors.initials: AP
authors.lastname: de Lemos
authors.forename: José Luis
authors.initials: JL
authors.lastname: Di Fabio