title: [Resistance to non-beta-lactam antibiotics in the clinical isolates of Streptococcus pneumoniae of children in Latin America. SIREVA II, 2000-2005].
abstract: OBJECTIVE
  To examine the development of resistance to erythromycin, chloramphenicol, trimethoprim-sulfamethoxazole (TMP-SMZ), and vancomycin of the invasive isolates of Streptococcus pneumoniae obtained from children in 10 Latin American/Caribbean countries during six years of surveillance.
  
  
  METHODS
  Analysis of 8 993 isolates of S. pneumoniae recovered in 2000-2005 from children with invasive infections, who were less than 6 years of age, and from Argentina, Brazil, Chile, Colombia, Cuba, Dominican Republic, Mexico, Paraguay, Uruguay, or Venezuela. Antibiotic susceptibility was determined through the methods established and standardized by the SIREVA project. Multidrug resistance was defined as: resistance to three or more antibiotics of the same class; to the non-beta-lactams analyzed by this study; or, to the beta-lactams evaluated by a previous study, in which 37.8% of these isolates showed decreased susceptibility to penicillin.
  
  
  RESULTS
  Some degree of resistance was found to TMP-SMZ and erythromycin (56.4% and 15.4% of the isolates studied, respectively), with 4.6% highly resistant to chloramphenicol. All isolates were susceptible to vancomycin. The highest prevalence of TMP-SMZ resistance was observed in the pneumonia isolates; and that of erythromycin, in cases of sepsis (61.6% and 25.5%, respectively; P < 0.01). The highest prevalence of TMP-SMZ resistance was found in Brazil (71.9%), and that of erythromycin, in Mexico (38.2%) and Venezuela (32.9%). The 14, 6B, 19F, and 23F serotypes were most often associated with resistance to the antibiotics in the study.
  
  
  CONCLUSIONS
  High and increasing rates of isolates resistant to TMP-SMZ and erythromycin were observed, as well as a decreasing percentage of isolates resistant to chloramphenicol. These trends highlight differences among the countries studied.
authors.affiliation: Instituto Nacional de Salud, Bogotá, Colombia. cia1949@gmail.com
authors.forename: Clara Inés
authors.initials: CI
authors.lastname: Agudelo
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Castañeda
authors.forename: Alejandra
authors.initials: A
authors.lastname: Corso
authors.forename: Mabel
authors.initials: M
authors.lastname: Regueira
authors.forename: Maria Cristina de Cunto
authors.initials: MC
authors.lastname: Brandileone
authors.forename: Angela Pires
authors.initials: AP
authors.lastname: Brandão
authors.forename: Aurora
authors.initials: A
authors.lastname: Maldonado
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Hormazabal
authors.forename: Isis
authors.initials: I
authors.lastname: Tamargo
authors.forename: Gabriela
authors.initials: G
authors.lastname: Echániz-Aviles
authors.forename: Araceli
authors.initials: A
authors.lastname: Soto
authors.forename: Mónica Guadalupe
authors.initials: MG
authors.lastname: Viveros
authors.forename: Irma
authors.initials: I
authors.lastname: Hernández
authors.forename: Gustavo
authors.initials: G
authors.lastname: Chamorro
authors.forename: Natalie
authors.initials: N
authors.lastname: Weiler
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Sánchez
authors.forename: Jesús M
authors.initials: JM
authors.lastname: Feris
authors.forename: Teresa
authors.initials: T
authors.lastname: Camou
authors.forename: Gabriela
authors.initials: G
authors.lastname: García
authors.forename: Enza
authors.initials: E
authors.lastname: Spadola
authors.forename: Daisy
authors.initials: D
authors.lastname: Payares
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Gabastou
authors.forename: José Luis
authors.initials: JL
authors.lastname: Di Fabio
mesh_terms: D024881:Drug Resistance, Bacterial; D006801:Humans; D007843:Latin America; D008826:Microbial Sensitivity Tests; D013296:Streptococcus pneumoniae / Q000187:drug effects*