title: [Capability of national reference laboratories in Latin America to detect emerging resistance mechanisms].
abstract: OBJECTIVE
  To evaluate the capability of 17 national reference laboratories participating in the Latin American Quality Control Program in Bacteriology and Antibiotic Resistance (LA-EQAS) to detect emerging resistance mechanisms- namely: resistance of enterobacteria to carbapenems due to the presence of Klebsiella pneumoniae carbapenemase (KPC) and metallo-beta-lactamase (MBL) type IMP, and intermediate resistance of Staphylococcus aureus isolates to vancomycin (vancomycin-intermediate resistant S. aureus-VISA).
  
  
  METHODS
  The following three isolates were sent to the 17 participating LA-EQAS laboratories: KPC -producing Klebsiella pneumoniae PAHO-161, IMP-producing Enterobacter cloacae PAHO-166, and S. aureus PAHO-165 with intermediate resistance to vancomycin. Performance of each of the following operations was evaluated: interpretation of sensitivity tests, detection of the resistance mechanism, and assessment of either inhibition halo size (disk diffusion method) or minimum inhibitory concentration (MIC).
  
  
  RESULTS
  Concordance in the detection of resistance mechanisms was 76.4%, 73.3%, and 66.7% for the K. pneumoniae PAHO-161, E. cloacae PAHO-166, and S. aureus PAHO-165 strains, respectively. Concordance between the inhibition areas observed by the participating laboratories and the ranges established by the coordinating laboratory was acceptable for all three isolates, at 90.8%, 92.8%, and 88.9%, respectively.
  
  
  CONCLUSIONS
  Overall concordance in on the detection of KPC, MBL, and VISA resistance mechanisms was 72.1%. We consider the national reference laboratories in Latin America capable of recognizing these emerging resistance mechanisms and expect that maximum levels of concordance will be reached in the future.
authors.affiliation: Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán", Instituto Nacional de Enfermedades Infecciosas, Departamento de Bacteriología, Servicio Antimicrobianos, Buenos Aires, Argentina. acorso@anlis.gov.ar
authors.forename: Alejandra
authors.initials: A
authors.lastname: Corso
authors.forename: Leonor
authors.initials: L
authors.lastname: Guerriero
authors.forename: Fernando
authors.initials: F
authors.lastname: Pasterán
authors.forename: Paola
authors.initials: P
authors.lastname: Ceriana
authors.forename: Raquel
authors.initials: R
authors.lastname: Callejo
authors.forename: Mónica
authors.initials: M
authors.lastname: Prieto
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Tuduri
authors.forename: Horacio
authors.initials: H
authors.lastname: Lopardo
authors.forename: Carlos
authors.initials: C
authors.lastname: Vay
authors.forename: Jorgelina
authors.initials: J
authors.lastname: Smayevsky
authors.forename: Marta
authors.initials: M
authors.lastname: Tokumoto
authors.forename: Jorge Matheu
authors.initials: JM
authors.lastname: Alvarez
authors.forename: Pilar Ramón
authors.initials: PR
authors.lastname: Pardo
authors.forename: Marcelo
authors.initials: M
authors.lastname: Galas
mesh_terms: D001426:Bacterial Proteins / Q000032:analysis*; D004352:Drug Resistance, Microbial / Q000235:genetics / Q000502:physiology*; D024901:Drug Resistance, Multiple, Bacterial; D016972:Enterobacter cloacae / Q000201:enzymology; D007711:Klebsiella pneumoniae / Q000201:enzymology; D007753:Laboratories / Q000592:standards* / Q000706:statistics & numerical data; D059021:Laboratory Proficiency Testing; D007843:Latin America; D008826:Microbial Sensitivity Tests / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D010175:Pan American Health Organization; D010641:Phenotype; D011786:Quality Control; D019984:Quality Indicators, Health Care; D012015:Reference Standards; D015203:Reproducibility of Results; D013211:Staphylococcus aureus / Q000201:enzymology; D020713:Vancomycin Resistance; D001618:beta-Lactamases / Q000032:analysis*
chemical_list: D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase