[Resistance to non-beta-lactam antibiotics in the clinical isolates of Streptococcus pneumoniae of children in Latin America. SIREVA II, 2000-2005].
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.
Agudelo
Clara Inés
CI
Instituto Nacional de Salud, Bogotá, Colombia. cia1949@gmail.com
Castañeda
Elizabeth
E
Corso
Alejandra
A
Regueira
Mabel
M
Brandileone
Maria Cristina de Cunto
MC
Brandão
Angela Pires
AP
Maldonado
Aurora
A
Hormazabal
Juan Carlos
JC
Tamargo
Isis
I
Echániz-Aviles
Gabriela
G
Soto
Araceli
A
Viveros
Mónica Guadalupe
MG
Hernández
Irma
I
Chamorro
Gustavo
G
Weiler
Natalie
N
Sánchez
Jacqueline
J
Feris
Jesús M
JM
Camou
Teresa
T
García
Gabriela
G
Spadola
Enza
E
Payares
Daisy
D
Gabastou
Jean-Marc
JM
Di Fabio
José Luis
JL
D024881:Drug Resistance, Bacterial; D006801:Humans; D007843:Latin America; D008826:Microbial Sensitivity Tests; D013296:Streptococcus pneumoniae / Q000187:drug effects*