One-day point prevalence of healthcare-associated infections and antimicrobial use in four countries in Latin America.

BACKGROUND AND AIMS: Experience in the region shows that in some countries there is very good surveillance of Healthcare-associated infections (HAIs) in health services, but there is no national data consistently in all countries. Therefore, we set to estimate the total burden of HAIs and antimicrobial use in acute care hospitals in Brazil, Venezuela, Mexico, and Colombia using the one-day point prevalence methodology. METHODS: The survey was conducted between June and July 2016. In each ward or unit, HAIs and antimicrobial use data were collected on a single day by a trained team of researchers. Also, for each patient, we collected data on risk factors for infections. RESULTS: One out of ten individuals surveyed had at least one healthcare-associated infection (HAI). Pneumonia and surgical site infections were the most relevant among the surveyed countries. Most of the surveyed participants, regardless of their HAI status, received antibiotics except the individuals managed in Brazil. Carbapenems and third-generation Cephalosporins were among the most frequently used antibiotics. CONCLUSION: Our results add to WHO's recent efforts to understand HAIs prevalence and antibiotic consumption in low and middle-income countries, of which we studied three that were not included in their last report.

Comparative in vitro activity of tigecycline against bacteria recovered from clinical specimens in Latin America.

The present study was performed to evaluate the in vitro activity of tigecycline in comparison to other agents against isolates recovered from patients hospitalized in latin American. Organisms were collected in 47 clinical laboratories from 4 countries of latin America between November 2005 and October 2006 and were tested by using disk diffusion method as described by the CLSI. A total of 7966 isolates were assessed. Tigecycline proved highly active against staphylococci and enterococci (>99% susceptibility). Imipenem was the most active agent against Escherichia coli (100% susceptibility), followed by tigecycline, 98.6% susceptibility. Resistance to cefotaxime in this species was 15.3%. Global tigecycline susceptibility of Klebsiella species was 90.2%, but the susceptibility rate was significantly slower in Venezuela (82%) than in Argentina, Colombia and Chile (93%) (p<0.01). Global cefotaxime resistance to Klebsiella spp. was 32.2% and carbapenem resistance was detected in all countries. By adopting a susceptible breakpoint >or =16mm, 91.3% of the Acinetobacter isolates proved susceptible to tigecycline. Results from the present study suggest that tigecycline may be a suitable option in latin America, a region where multidrug resistance seems to be a dramatic, increasing problem and new antimicrobial choices are urgently needed.

Efecto de Inhibidores de ß-lactamasas sobre la evolución de la resistencia a ß-láctamicos en bacilos gram-negativos / Effect of ß-lactamases inhibitors on the evolution of resistance to ß-lactams in gram-negatives bacilli

Los ß-lactámicos, primeros antibióticos introducidos para uso en clínica, siguen siendo los más usados. también es frecuente el desarrollo de resistencia a ellos, la cual fue identificada inmediatamente después de la introducción de la penicilina. El mecanismo de resistencia más frecuente en bacilos gram-negativos a los ß-lactámicos es la producción de ß-lactamasas, y su forma de transmisión a travéz de plásmidos y cromosomas. Los bacilos gram-negativos aeróbicos son los principales responsables de infección nosocomial. Hemos publicado los valores de resistencia de éstos ante ß-lactámicos, haciendo un diagnóstico de la situación a nivel nacional. Además de seguir su evolución durante la década 1988-1998, estudiamos los cambios producidos sobre la evolución de la resistencia, en presencia de inhibidores de ß-lactamasas. Desde 1988, el Grupo Venezolano de Vigilancia de la Resistencia Bacteriana, cuyos miembros pertenecen a 29 instituciones de salud de siete estados, está a cargo de analizar y publicar resultados de resistencia bacteriana a antimicrobianos de bacterias asiladas de pacientes con infecciones hospitalarias y de la comunidad. Se usó el método de difusión de disco, de acuerdo a las normas de la NCCLS. Se siguió el programa software WHONET (World Health Organization Net). Las diferencias de sensibilidad entre el ß-lactámico más el inhibidor de ß-lactámico más el inhibidor de ß-lactamasas son: 1. Piperacilina versus piperacilina/tazobactam: entre el 10 y el 30 por ciento para la mayoría de los gérmenes estudiados, exepto para E. Coli (45 por ciento) y Serratia sp. (60 por ciento)

Bacterial resistance to antimicrobial agents in Latin America. The giant is awakening.

Resistant bacteria are emerging in Latin America as a real threat to the favorable outcome of infections in community- and hospital-acquired infections. Despite present extensive surveillance, healthcare workers who most need the information may be unaware of this growing problem. Outbreaks of meningococci with diminished susceptibility to penicillin have been reported in the region; a constant increase of resistance to penicillin in pneumococci and poor activity of commonly used oral antibiotics for the treatment of community-acquired urinary tract infections have made the treatment of these infections more difficult. Reports from tertiary hospitals are similar to many other areas of the world, with increasing frequency of Klebsiella pneumoniae-carrying extended-spectrum beta-lactamase, multiresistant strains of Pseudomonas aeruginosa and Acinetobacter baumanni in ICU settings, and reports of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. A surveillance network readily accessible to those who prescribe antibiotics in Latin America is highly desirable.

[Usefulness of the PCR technique (polymerase chain reaction) in the follow-up of patients infected with hepatitis C virus. Preliminary communication]. / Utilidad de la Técnica de PCR (reacción en cadena de la polimerasa) en el seguimiento de pacientes infectados con el virus de la hepatitis C. Comunicación preliminar.

UNLABELLED: In the study we show the usefulness of PCR (polymerase chain reaction) to follow patients with chronic hepatitis, infected with hepatitis C virus (HCV) of Centro Médico de Caracas. The study included 14 patients: 12 anti-HCV positive, 1 with chronic autoimmune hepatitis and 1 classified as non B-non C hepatitis. The patients were divided in 3 groups: Group 1 (5 pretreatment patients, anti-HCV+), 4 with increase in ALT and PCR positive, 1 with normal ALT and PCR negative. Group 2 (7 treated with recombinant interferon alpha 2b), 4 without normalization of ALT and PCR positive, 3 with normalization of ALT and PCR negative. Group 3 (control) 2 patients anti-HCV negative and PCR negative. Two posttreatment patients could be genotyped: one patient was infected with 1a and showed an early relapse with treatment and the other was infected with genotype 1b, which is reported to be more refractory to antiviral treatment. CONCLUSIONS: the results show a 100% correlation between biochemical markers of HCV infected patients and the presence of viral RNA detected by PCR. the usefulness of determination of genotype to assess any prognostic value of this parameter in Venezuela is discussed.