title: Susceptibility rates in Latin American nations: report from a regional resistance surveillance program (2011).
abstract: OBJECTIVE
  To establish a resistance (R) surveillance program monitoring antimicrobial susceptibility patterns in Latin America (LATAM; Argentina [ARG], Brazil [BRA], Chile, Colombia [CBA], Costa Rica, Ecuador [ECU], Guatemala [GUA], Mexico [MEX], Panama [PAN], Peru, and Venezuela [VEN]).
  
  
  METHODS
  In 2011, 4979 organisms were collected from 11 nations (20 laboratories) for susceptibility testing in a central laboratory design. Antimicrobials were tested by CLSI methods and results interpreted by CLSI and EUCAST breakpoints. Most common Gram-positive (Staphylococcus aureus [SA, 921], other staphylococci [CoNS; 299], enterococci [218], Streptococcus pneumoniae [SPN; 182], β-haemolytic streptococci [115]) and Gram-negative (E. coli [EC; 644], Klebsiella spp. [KSP; 517], Enterobacters [272], Pseudomonas aeruginosa [PSA; 586], Acinetobacters [ACB; 494]) pathogens were analyzed against linezolid (LZD), vancomycin (VAN), tigecycline (TIG), colistin (COL), cefoperazone/sulbactam (C/S), and amikacin (AMK).
  
  
  RESULTS
  MRSA rates varied from 29% (CBA, BRA) to 79% (Peru); but LZD (MIC90, 2mg/L), TIG (MIC90, 0.12mg/L) and VAN (MIC90, 1mg/L) covered all strains. Enterococci showed a 14% VRE rate, highest in BRA and MEX; all inhibited by TIG and daptomycin, but not LZD (three non-susceptible with G2576T mutations or cfr). Penicillin-R among SPN and viridans streptococci was 51.6 and 41.1%, respectively. LZD overall R against Gram-positives was 0.3%. High ESBL rates were observed in EC (54-71%) and KSP (≥50%) from GUA, MEX and Peru, and six nations, respectively. Carbapenem-R in KSP was 9%, highest rates associated with KPC in BRA, CBA, ECU, PAN and VEN; also a NDM-1 in KSP from CBA. AMK, TIG, C/S and carbapenems were the broadest-spectrum agents tested against Enterobacteriaceae. Only COL inhibited >90% of PSA; COL and TIG (≤2mg/L) covered ≥85% of ACB.
  
  
  CONCLUSIONS
  LATAM nations demonstrated variable levels of antimicrobial R especially among Enterobacteriaceae (β-lactamase-mediated), PSA and ACB. MRSA (48%), VRE (14%) and multidrug-R SPN were also regional therapeutic challenges.
authors.affiliation: JMI Laboratories, North Liberty, Iowa, USA. Electronic address: ronald-jones@jmilabs.com.
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Jones
authors.forename: Manuel
authors.initials: M
authors.lastname: Guzman-Blanco
authors.forename: Ana C
authors.initials: AC
authors.lastname: Gales
authors.forename: Belisario
authors.initials: B
authors.lastname: Gallegos
authors.forename: Aura Lucia Leal
authors.initials: AL
authors.lastname: Castro
authors.forename: Marines Dalla Valle
authors.initials: MD
authors.lastname: Martino
authors.forename: Silvio
authors.initials: S
authors.lastname: Vega
authors.forename: Jeannete
authors.initials: J
authors.lastname: Zurita
authors.forename: Mario
authors.initials: M
authors.lastname: Cepparulo
authors.forename: Mariana
authors.initials: M
authors.lastname: Castanheira
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects*; D006094:Gram-Positive Bacteria / Q000145:classification / Q000187:drug effects*; D006801:Humans; D007843:Latin America; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance
chemical_list: D000900:Anti-Bacterial Agents
keywords: ESBL; Latin America; Resistance; Surveillance; β-Lactamases