Publications by authors named "Manuel Guzman-Blanco"

28 Publications

  • Page 1 of 1

Staphylococcus aureus bloodstream infections in Latin America: results of a multinational prospective cohort study.

J Antimicrob Chemother 2018 Jan;73(1):212-222

Hospital Cayetano Heredia, Lima, Peru, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.

Background: Substantial heterogeneity in the epidemiology and management of Staphylococcus aureus bacteraemia (SAB) occurs in Latin America. We conducted a prospective cohort study in 24 hospitals from nine Latin American countries.

Objectives: To assess the clinical impact of SAB in Latin America.

Patients And Methods: We evaluated differences in the 30 day attributable mortality among patients with SAB due to MRSA compared with MSSA involving 84 days of follow-up. Adjusted relative risks were calculated using a generalized linear model.

Results: A total of 1030 patients were included. MRSA accounted for 44.7% of cases with a heterogeneous geographical distribution. MRSA infection was associated with higher 30 day attributable mortality [25% (78 of 312) versus 13.2% (48 of 363), adjusted RR: 1.94, 95% CI: 1.38-2.73, P < 0.001] compared with MSSA in the multivariable analysis based on investigators' assessment, but not in a per-protocol analysis [13% (35 of 270) versus 8.1% (28 of 347), adjusted RR: 1.10, 95% CI: 0.75-1.60, P = 0.616] or in a sensitivity analysis using 30 day all-cause mortality [36% (132 of 367) versus 27.8% (123 of 442), adjusted RR: 1.09, 95% CI: 0.96-1.23, P = 0.179]. MRSA infection was not associated with increased length of hospital stay. Only 49% of MSSA bloodstream infections (BSI) received treatment with β-lactams, but appropriate definitive treatment was not associated with lower mortality (adjusted RR: 0.93, 95% CI: 0.70-1.23, P = 0.602).

Conclusions: MRSA-BSIs in Latin America are not associated with higher 30 day mortality or longer length of stay compared with MSSA. Management of MSSA-BSIs was not optimal, but appropriate definitive therapy did not appear to influence mortality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/jac/dkx350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890709PMC
January 2018

A Prospective Cohort Multicenter Study of Molecular Epidemiology and Phylogenomics of Staphylococcus aureus Bacteremia in Nine Latin American Countries.

Antimicrob Agents Chemother 2017 10 22;61(10). Epub 2017 Sep 22.

Hospital Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.

is an important pathogen causing a spectrum of diseases ranging from mild skin and soft tissue infections to life-threatening conditions. Bloodstream infections are particularly important, and the treatment approach is complicated by the presence of methicillin-resistant (MRSA) isolates. The emergence of new genetic lineages of MRSA has occurred in Latin America (LA) with the rise and dissemination of the community-associated USA300 Latin American variant (USA300-LV). Here, we prospectively characterized bloodstream MRSA recovered from selected hospitals in 9 Latin American countries. All isolates were typed by pulsed-field gel electrophoresis (PFGE) and subjected to antibiotic susceptibility testing. Whole-genome sequencing was performed on 96 MRSA representatives. MRSA represented 45% of all (1,185 ) isolates. The majority of MRSA isolates belonged to clonal cluster (CC) 5. In Colombia and Ecuador, most isolates (≥72%) belonged to the USA300-LV lineage (CC8). Phylogenetic reconstructions indicated that MRSA isolates from participating hospitals belonged to three major clades. Clade A grouped isolates with sequence type 5 (ST5), ST105, and ST1011 (mostly staphylococcal chromosomal cassette [SCC] I and II). Clade B included ST8, ST88, ST97, and ST72 strains (SCC IV, subtypes a, b, and c/E), and clade C grouped mostly Argentinian MRSA belonging to ST30. In summary, CC5 MRSA was prevalent in bloodstream infections in LA with the exception of Colombia and Ecuador, where USA300-LV is now the dominant lineage. Clonal replacement appears to be a common phenomenon, and continuous surveillance is crucial to identify changes in the molecular epidemiology of MRSA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1128/AAC.00816-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610503PMC
October 2017

Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA).

Authors:
Massimo Sartelli Dieter G Weber Etienne Ruppé Matteo Bassetti Brian J Wright Luca Ansaloni Fausto Catena Federico Coccolini Fikri M Abu-Zidan Raul Coimbra Ernest E Moore Frederick A Moore Ronald V Maier Jan J De Waele Andrew W Kirkpatrick Ewen A Griffiths Christian Eckmann Adrian J Brink John E Mazuski Addison K May Rob G Sawyer Dominik Mertz Philippe Montravers Anand Kumar Jason A Roberts Jean-Louis Vincent Richard R Watkins Warren Lowman Brad Spellberg Iain J Abbott Abdulrashid Kayode Adesunkanmi Sara Al-Dahir Majdi N Al-Hasan Ferdinando Agresta Asma A Althani Shamshul Ansari Rashid Ansumana Goran Augustin Miklosh Bala Zsolt J Balogh Oussama Baraket Aneel Bhangu Marcelo A Beltrán Michael Bernhard Walter L Biffl Marja A Boermeester Stephen M Brecher Jill R Cherry-Bukowiec Otmar R Buyne Miguel A Cainzos Kelly A Cairns Adrian Camacho-Ortiz Sujith J Chandy Asri Che Jusoh Alain Chichom-Mefire Caroline Colijn Francesco Corcione Yunfeng Cui Daniel Curcio Samir Delibegovic Zaza Demetrashvili Belinda De Simone Sameer Dhingra José J Diaz Isidoro Di Carlo Angel Dillip Salomone Di Saverio Michael P Doyle Gereltuya Dorj Agron Dogjani Hervé Dupont Soumitra R Eachempati Mushira Abdulaziz Enani Valery N Egiev Mutasim M Elmangory Paula Ferrada Joseph R Fitchett Gustavo P Fraga Nathalie Guessennd Helen Giamarellou Wagih Ghnnam George Gkiokas Staphanie R Goldberg Carlos Augusto Gomes Harumi Gomi Manuel Guzmán-Blanco Mainul Haque Sonja Hansen Andreas Hecker Wolfgang R Heizmann Torsten Herzog Adrien Montcho Hodonou Suk-Kyung Hong Reinhold Kafka-Ritsch Lewis J Kaplan Garima Kapoor Aleksandar Karamarkovic Martin G Kees Jakub Kenig Ronald Kiguba Peter K Kim Yoram Kluger Vladimir Khokha Kaoru Koike Kenneth Y Y Kok Victory Kong Matthew C Knox Kenji Inaba Arda Isik Katia Iskandar Rao R Ivatury Maurizio Labbate Francesco M Labricciosa Pierre-François Laterre Rifat Latifi Jae Gil Lee Young Ran Lee Marc Leone Ari Leppaniemi Yousheng Li Stephen Y Liang Tonny Loho Marc Maegele Sydney Malama Hany E Marei Ignacio Martin-Loeches Sanjay Marwah Amos Massele Michael McFarlane Renato Bessa Melo Ionut Negoi David P Nicolau Carl Erik Nord Richard Ofori-Asenso AbdelKarim H Omari Carlos A Ordonez Mouaqit Ouadii Gerson Alves Pereira Júnior Diego Piazza Guntars Pupelis Timothy Miles Rawson Miran Rems Sandro Rizoli Claudio Rocha Boris Sakakushev Miguel Sanchez-Garcia Norio Sato Helmut A Segovia Lohse Gabriele Sganga Boonying Siribumrungwong Vishal G Shelat Kjetil Soreide Rodolfo Soto Peep Talving Jonathan V Tilsed Jean-Francois Timsit Gabriel Trueba Ngo Tat Trung Jan Ulrych Harry van Goor Andras Vereczkei Ravinder S Vohra Imtiaz Wani Waldemar Uhl Yonghong Xiao Kuo-Ching Yuan Sanoop K Zachariah Jean-Ralph Zahar Tanya L Zakrison Antonio Corcione Rita M Melotti Claudio Viscoli Perluigi Viale

World J Emerg Surg 2016 15;11:33. Epub 2016 Jul 15.

Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant' Orsola Hospital, University of Bologna, Bologna, Italy.

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13017-016-0089-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946132PMC
May 2018

Characterization and Clinical Impact of Bloodstream Infection Caused by Carbapenemase-Producing Enterobacteriaceae in Seven Latin American Countries.

PLoS One 2016 22;11(4):e0154092. Epub 2016 Apr 22.

Centro Médico de Caracas, Caracas, Venezuela.

Introduction: Infections caused by carbapenem-resistant Enterobacteriaceae are a public health problem associated with higher mortality rates, longer hospitalization and increased healthcare costs. We carried out a study to describe the characteristics of patients with carbapenemase-producing Enterobacteriaceae (CPE) and non-CPE bloodstream infection (BSI) from Latin American hospitals and to determine the clinical impact in terms of mortality and antibiotic therapy.

Methods: Between July 2013 and November 2014, we conducted a multicenter observational study in 11 hospitals from 7 Latin American countries (Argentina, Colombia, Ecuador, Guatemala, Mexico, Peru, Venezuela). Patients with BSI caused by Enterobacteriaceae were included and classified either as CPE or non-CPE based on detection of blaKPC, blaVIM, blaIMP, blaNDM and blaOXA-48 by polymerase chain reaction. Enrolled subjects were followed until discharge or death. Demographic, microbiological and clinical characteristics were collected from medical records. Both descriptive and inferential statistics were used to analyze the information.

Results: A total of 255 patients with Enterobacteriaceae BSI were included; CPE were identified in 53 of them. In vitro non-susceptibility to all screened antibiotics was higher in the patients with CPE BSI, remaining colistin, tigecycline and amikacin as the most active drugs. Combination therapy was significantly more frequent in the CPE BSI group (p < 0.001). The most common regimen was carbapenem + colistin or polymyxin B. The overall mortality was 37% (94/255). Overall and attributable mortality were significantly higher in patients with CPE BSI (p < 0.001); however, we found that patients with CPE BSI who received combination therapy and those who received monotherapy had similar mortality. After multivariate adjustment, CPE BSI (adjusted odds ratio [aOR] 4; 95% confidence interval [CI] 1.7-9.5; p = 0.002) and critical illness (aOR 6.5; 95% CI 3.1-13.7; p < 0.001) were independently associated with in-hospital mortality.

Conclusions: This study provides valuable data on the clinical characteristics and mortality risk factors in patients with CPE BSI. We determined that CPE infection is an independent mortality predictor and thus Latin American hospitals should perform campaigns on prevention and control of CPE BSI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0154092PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4841576PMC
March 2017

Gram-negative infections in adult intensive care units of latin america and the Caribbean.

Crit Care Res Pract 2014 27;2014:480463. Epub 2014 Nov 27.

Private Hospital Medical Center of Caracas and Vargas Hospital of Caracas, Caracas, Venezuela.

This review summarizes recent epidemiology of Gram-negative infections in selected countries from Latin American and Caribbean adult intensive care units (ICUs). A systematic search of the biomedical literature (PubMed) was performed to identify articles published over the last decade. Where appropriate, data also were collected from the reference list of published articles, health departments of specific countries, and registries. Independent cohort data from all countries (Argentina, Brazil, Chile, Colombia, Cuba, Mexico, Trinidad and Tobago, and Venezuela) signified a high rate of ICU infections (prevalence: Argentina, 24%; Brazil, 57%). Gram-negative pathogens, predominantly Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli, accounted for >50% of ICU infections, which were often complicated by the presence of multidrug-resistant strains and clonal outbreaks. Empirical use of antimicrobial agents was identified as a strong risk factor for resistance development and excessive mortality. Infection control strategies utilizing hygiene measures and antimicrobial stewardship programs reduced the rate of device-associated infections. To mitigate the poor health outcomes associated with infections by multidrug-resistant Gram-negative bacteria, urgent focus must be placed on infection control strategies and local surveillance programs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2014/480463DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265515PMC
December 2014

Carbapenem resistance in Pseudomonas aeruginosa and Acinetobacter baumannii in the nosocomial setting in Latin America.

Crit Rev Microbiol 2016 27;42(2):276-92. Epub 2014 Aug 27.

d Hospital Privado Centro Médico de Caracas and Hospital Vargas de Caracas , Caracas , Venezuela.

Increasing prevalence of carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii strains in the nosocomial setting in Latin America represents an emerging challenge to public health, as the range of therapeutic agents active against these pathogens becomes increasingly constrained. We review published reports from 2002 to 2013, compiling data from throughout the region on prevalence, mechanisms of resistance and molecular epidemiology of carbapenem-resistant strains of P. aeruginosa and A. baumannii. We find rates of carbapenem resistance up to 66% for P. aeruginosa and as high as 90% for A. baumannii isolates across the different countries of Latin America, with the resistance rate of A. baumannii isolates greater than 50% in many countries. An outbreak of the SPM-1 carbapenemase is a chief cause of resistance in P. aeruginosa strains in Brazil. Elsewhere in Latin America, members of the VIM family are the most important carbapenemases among P. aeruginosa strains. Carbapenem resistance in A. baumannii in Latin America is predominantly due to the oxacillinases OXA-23, OXA-58 and (in Brazil) OXA-143. Susceptibility of P. aeruginosa and A. baumannii to colistin remains high, however, development of resistance has already been detected in some countries. Better epidemiological data are needed to design effective infection control interventions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/1040841X.2014.940494DOI Listing
December 2016

Surveillance of Candida spp bloodstream infections: epidemiological trends and risk factors of death in two Mexican tertiary care hospitals.

PLoS One 2014 15;9(5):e97325. Epub 2014 May 15.

Department of Medicine, Salvador Zubiran National Institute of Medical Sciences and Nutrition, Mexico City, Mexico.

Introduction: Larger populations at risk, broader use of antibiotics and longer hospital stays have impacted on the incidence of Candida sp. bloodstream infections (CBSI).

Objective: To determine clinical and epidemiologic characteristics of patients with CBSI in two tertiary care reference medical institutions in Mexico City.

Design: Prospective and observational laboratory-based surveillance study conducted from 07/2008 to 06/2010.

Methods: All patients with CBSI were included. Identification and antifungal susceptibility were performed using CLSI M27-A3 standard procedures. Frequencies, Mann-Whitney U test or T test were used as needed. Risk factors were determined with multivariable analysis and binary logistic regression analysis.

Results: CBSI represented 3.8% of nosocomial bloodstream infections. Cumulative incidence was 2.8 per 1000 discharges (incidence rate: 0.38 per 1000 patient-days). C. albicans was the predominant species (46%), followed by C. tropicalis (26%). C. glabrata was isolated from patients with diabetes (50%), and elderly patients. Sixty-four patients (86%) received antifungals. Amphotericin-B deoxycholate (AmBD) was the most commonly used agent (66%). Overall mortality rate reached 46%, and risk factors for death were APACHE II score ≥ 16 (OR = 6.94, CI95% = 2.34-20.58, p<0.0001), and liver disease (OR = 186.11, CI95% = 7.61-4550.20, p = 0.001). Full susceptibility to fluconazole, AmBD and echinocandins among C. albicans, C. tropicalis, and C. parapsilosis was observed.

Conclusions: The cumulative incidence rate in these centers was higher than other reports from tertiary care hospitals from Latin America. Knowledge of local epidemiologic patterns permits the design of more specific strategies for prevention and preemptive therapy of CBSI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0097325PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4022628PMC
January 2015

Disseminated histoplasmic multifocal choroiditis in AIDS.

Ophthalmic Surg Lasers Imaging Retina 2014 Mar-Apr;45(2):179-80. Epub 2014 Feb 7.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3928/23258160-20140131-02DOI Listing
September 2014

Extended spectrum β-lactamase producers among nosocomial Enterobacteriaceae in Latin America.

Braz J Infect Dis 2014 Jul-Aug;18(4):421-33. Epub 2014 Jan 3.

Universidad Peruana Cayetano Heredia, Lima, Peru.

To review the epidemiology of nosocomial extended spectrum β-lactamase-producing Enterobacteriaceae in Latin America, a systematic search of the biomedical literature (PubMed) was performed for articles published since 2005. Rates of nosocomial infections caused by extended spectrum β-lactamase-producing Enterobacteriaceae in Latin America have increased since 2005. Up to 32% of Escherichia coli and up to 58% of Klebsiella pneumoniae isolates are extended spectrum β-lactamase-positive, rates that are higher than in other world regions. From a region-wide perspective, 11-25% of E. coli isolates and 45-53% of K. pneumoniae isolates were nonsusceptible to third-generation cephalosporins. At the country level, there was a wide range in Enterobacteriaceae resistance rates to third-generation cephalosporins, with especially high rates of resistance to E. coli in Guatemala, Honduras, and Mexico, and high resistance rates to Klebsiella spp. in Argentina, Brazil, Chile, Guatemala, Honduras, and Paraguay. Susceptibility of extended spectrum β-lactamase-producing Enterobacteriaceae to cefepime, fluoroquinolones, ampicillin/sulbactam, aminoglycosides, and piperacillin/tazobactam has also been compromised, leaving the carbapenems, tigecycline, and colistin as the only antibiotics with >90% susceptibility rates. There is a steady increase in the prevalence and types of extended spectrum β-lactamases produced by Enterobacteriaceae isolates in Latin American hospitals (particularly CTX-Ms), suggesting endemic conditions overlaid by clonal outbreaks. Appropriate treatment decisions and infection control strategies informed by surveillance of regional and local susceptibilities and mechanisms of resistance are required to mitigate this major public health concern.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bjid.2013.10.005DOI Listing
October 2014

Susceptibility rates in Latin American nations: report from a regional resistance surveillance program (2011).

Braz J Infect Dis 2013 Nov-Dec;17(6):672-81. Epub 2013 Oct 10.

JMI Laboratories, North Liberty, Iowa, USA. Electronic address:

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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bjid.2013.07.002DOI Listing
June 2014

Current status of carbapenemases in Latin America.

Expert Rev Anti Infect Ther 2013 Jul;11(7):657-67

CIDEIM International Center for Medical Research and Training, Cali, Colombia.

Enterobacteriaceae and non fermenting Gram-negative bacilli have become a threat to public health, in part due to their resistance to multiple antibiotic classes, which ultimately have led to an increase in morbidity and mortality. β-lactams are currently the mainstay for combating infections caused by these microorganisms, and β-lactamases are the major mechanism of resistance to this class of antibiotics. Within the β-lactamases, carbapenemases pose one of the gravest threats, as they compromise one of our most potent lines of defense, the carbapenems. Carbapenemases are being continuously identified worldwide; and in Latin America, numerous members of these enzymes have been reported. In this region, the high incidence of reports implies that carbapenemases have become a menace and that they are an issue that must be carefully studied and analyzed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1586/14787210.2013.811924DOI Listing
July 2013

[Recommendations for the management of candidemia in neonates in Latin America. Grupo Proyecto Épico].

Rev Iberoam Micol 2013 Jul-Sep;30(3 Suppl 1):158-70. Epub 2013 Jun 11.

Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile; Latin America Invasive Mycosis Network. Electronic address:

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in neonates in Latin America', was written to provide guidance to healthcare professionals on the management of neonates who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in neonates in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, central venous catheter management, and management of complications. This manuscript is the fourth of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in adults in Latin America', and 'Recommendations for the management of candidemia in children in Latin America'.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.riam.2013.06.002DOI Listing
August 2014

[Recommendations for the management of candidemia in children in Latin America. Grupo Proyecto Épico].

Rev Iberoam Micol 2013 Jul-Sep;30(3 Suppl 1):171-8. Epub 2013 Jun 11.

Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile; Latin America Invasive Mycosis Network. Electronic address:

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in children in Latin America', was written to provide guidance to healthcare professionals on the management of children who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in children in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in children with candidemia. This manuscript is the third of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in adults in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.riam.2013.05.011DOI Listing
August 2014

Recommendations for the management of candidemia in children in Latin America. Latin America Invasive Mycosis Network.

Rev Iberoam Micol 2013 Jul-Sep;30(3):171-8. Epub 2013 Jun 10.

Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile; Latin America Invasive Mycosis Network. Electronic address:

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in children in Latin America', was written to provide guidance to healthcare professionals on the management of children who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in children in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in children with candidemia. This manuscript is the third of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in adults in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.riam.2013.05.010DOI Listing
December 2016

[Recommendations for the management of candidemia in adults in Latin America. Grupo Proyecto Épico].

Rev Iberoam Micol 2013 Jul-Sep;30(3 Suppl 1):179-88. Epub 2013 Jun 10.

Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Latin America Invasive Mycosis Network. Electronic address:

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in adults in Latin America', was written to provide guidance to healthcare professionals on the management of adults who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in adults in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in patients with candidemia. This manuscript is the second of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.riam.2013.06.001DOI Listing
August 2014

Recommendations for the diagnosis of candidemia in Latin America. Latin America Invasive Mycosis Network.

Rev Iberoam Micol 2013 Jul-Sep;30(3):150-7. Epub 2013 Jun 10.

Federal University of São Paulo, São Paulo, Brazil; Latin America Invasive Mycosis Network. Electronic address:

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the diagnosis of candidemia in Latin America', was written to provide guidance to healthcare professionals on the diagnosis of candidemia, as well as on the usefulness and application of susceptibility testing in patients who have a confirmed diagnosis of candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the diagnosis of candidemia in Latin America' includes diagnostic methods used to detect candidemia, Candida species identification, and susceptibility testing. The availability of methods, their costs and treatment settings are considered. This manuscript is the first of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the management of candidemia in adults in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.riam.2013.05.008DOI Listing
December 2016

[Recommendations for the diagnosis of candidemia in Latin America. Grupo Proyecto Épico].

Rev Iberoam Micol 2013 Jul-Sep;30(3 Suppl 1):150-7. Epub 2013 Jun 10.

Federal University of São Paulo, São Paulo, Brasil; Latin America Invasive Mycosis Network. Electronic address:

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the diagnosis of candidemia in Latin America', was written to provide guidance to healthcare professionals on the diagnosis of candidemia, as well as on the usefulness and application of susceptibility testing in patients who have a confirmed diagnosis of candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the diagnosis of candidemia in Latin America' includes diagnostic methods used to detect candidemia, Candida species identification, and susceptibility testing. The availability of methods, their costs and treatment settings are considered. This manuscript is the first of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the management of candidemia in adults in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.riam.2013.05.009DOI Listing
August 2014

Recommendations for the management of candidemia in adults in Latin America. Latin America Invasive Mycosis Network.

Rev Iberoam Micol 2013 Jul-Sep;30(3):179-88. Epub 2013 Jun 10.

Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Latin America Invasive Mycosis Network. Electronic address:

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in adults in Latin America', was written to provide guidance to healthcare professionals on the management of adults who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in adults in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in patients with candidemia. This manuscript is the second of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.riam.2013.05.007DOI Listing
December 2016

Recommendations for the management of candidemia in neonates in Latin America. Latin America Invasive Mycosis Network.

Rev Iberoam Micol 2013 Jul-Sep;30(3):158-70. Epub 2013 Jun 10.

Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile; Latin America Invasive Mycosis Network. Electronic address:

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in neonates in Latin America', was written to provide guidance to healthcare professionals on the management of neonates who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in neonates in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, central venous catheter management, and management of complications. This manuscript is the fourth of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in adults in Latin America', and 'Recommendations for the management of candidemia in children in Latin America'.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.riam.2013.05.012DOI Listing
December 2016

Epidemiology of candidemia in Latin America: a laboratory-based survey.

PLoS One 2013 19;8(3):e59373. Epub 2013 Mar 19.

University Hospital, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

Background: The epidemiology of candidemia varies depending on the geographic region. Little is known about the epidemiology of candidemia in Latin America.

Methods: We conducted a 24-month laboratory-based survey of candidemia in 20 centers of seven Latin American countries. Incidence rates were calculated and the epidemiology of candidemia was characterized.

Results: Among 672 episodes of candidemia, 297 (44.2%) occurred in children (23.7% younger than 1 year), 36.2% in adults between 19 and 60 years old and 19.6% in elderly patients. The overall incidence was 1.18 cases per 1,000 admissions, and varied across countries, with the highest incidence in Colombia and the lowest in Chile. Candida albicans (37.6%), C. parapsilosis (26.5%) and C. tropicalis (17.6%) were the leading agents, with great variability in species distribution in the different countries. Most isolates were highly susceptible to fluconazole, voriconazole, amphotericin B and anidulafungin. Fluconazole was the most frequent agent used as primary treatment (65.8%), and the overall 30-day survival was 59.3%.

Conclusions: This first large epidemiologic study of candidemia in Latin America showed a high incidence of candidemia, high percentage of children, typical species distribution, with C. albicans, C. parapsilosis and C. tropicalis accounting for the majority of episodes, and low resistance rates.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0059373PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601956PMC
September 2013

Increasing prevalence of extended-spectrum-beta-lactamase among Gram-negative bacilli in Latin America--2008 update from the Study for Monitoring Antimicrobial Resistance Trends (SMART).

Braz J Infect Dis 2011 Jan-Feb;15(1):34-9

International Center for Medical Research and Training, Cali, Colombia.

Objectives: This analysis of the Study for Monitoring Antimicrobial Resistance Trends (SMART) evaluated the susceptibility patterns of Enterobacteriaceae in Latin America in 2008, with emphasis on susceptibility trends of E. coli and K. pneumoniae.

Methods: Clinical isolates were recovered from intra-abdominal infections (IAI) from 23 centers in 10 Latin American countries. Isolates were sent to a central laboratory for confirmation of identification, antimicrobial susceptibility and ESBL testing, following the Clinical Laboratory Standards Institute (CLSI) guidelines.

Results: Of 1,003 Gram-negative bacilli collected from intra-abdominal infections, E. coli and K. pneumoniae were the most commonly isolated organisms, and 26.8% of E. coli and 37.7% of K. pneumoniae were ESBL positive. Ertapenem and imipenem were the most consistently active agents tested; 99% of ESBL-positive E. coli isolates were susceptible to ertapenem and 100% to imipenem as well, and 91% of ESBL-positive K. pneumoniae were susceptible to ertapenem and 98% to imipenem. Quinolones and cephalosporins were less active, achieving 1.5% to 76% inhibition against ESBL-producing E. coli and 3.5% to 61% inhibition against K. pneumoniae.

Conclusions: Local and unit-specific surveillance data is particularly important for selection of empiric therapy and in community-acquired infections as they can help the clinician with antibiotic selection by providing guidance regarding the likely pathogens and their resistance profiles. Our data also confirm the increasing frequency with which ESBL-producing organisms are found in the community setting, with 31.4% of community-acquired and 24.9% of hospital-acquired infections found to produce ESBLs. Imipenem and ertapenem are the most active agents tested for ESBL-positive E. coli and K. pneumoniae.
View Article and Find Full Text PDF

Download full-text PDF

Source
September 2011

Diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus in Latin America.

Braz J Infect Dis 2010 Dec;14 Suppl 2:S97-106

Latin American Working Group on Gram Positive Resistance, Hospital Vozandes, Quito, Ecuador.

Strategies to monitor and control the spread of methicillin-resistant Staphylococcus aureus (MRSA) infections are dependent on accurate and timely diagnosis of MRSA in both hospital and community settings. In Latin America, significant diversity in diagnostic and susceptibility testing procedures exists at the regional, national and local levels. Various tests for S. aureus and MRSA are available in clinical settings, but the application of these techniques differs between and within countries, and quality control measures are not uniformly applied to verify diagnoses. To optimize the diagnosis of MRSA infections across Latin America, a more consistent approach is required. This may include: adoption and appropriate adaption of specific guidelines for MRSA testing, depending on local resources; establishment of a coordinated system for quality control; regional access to central reference facilities; education of medical and healthcare professionals in best practices; and development of systems to evaluate the implementation of guidelines and best practices.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s1413-86702010000800005DOI Listing
December 2010

Epidemiology and surveillance of methicillin-resistant staphylococcus aureus in Latin America.

Braz J Infect Dis 2010 Dec;14 Suppl 2:S79-86

Latin American Working Group on Gram Positive Resistance, Hospital Roosevelt, Guatemala City, Guatemala.

Surveillance systems monitoring the spread and divergence of methicillin-resistant Staphylococcus aureus (MRSA) strains are critical if preventive and therapeutic measures targeting MRSA infection are to be employed optimally. Surveillance provides information on the spread of MRSA, on the emergence of new strains within hospitals and communities, on the antibiotic resistance profile and virulence of strains, and on the risk factors associated with infection. These data help clinicians to provide appropriate empiric treatment of infections circulating in their region, leading to improved patient outcomes. While information on MRSA epidemiology in Latin America is growing, significant gaps exist in the available data, especially in local areas where fewer resources are available for characterizing and reporting MRSA strains. Here, we describe current knowledge of healthcare- and community-associated MRSA epidemiology in the region, and provide recommendations for future development of surveillance systems with a view to providing robust data at regional, national and local levels.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s1413-86702010000800003DOI Listing
December 2010

[Diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA) in Latin America].

Rev Chilena Infectol 2010 Aug;27 Suppl 2:S70-80

Servicio de Microbiología y Tuberculosis, Hospital Vozandes, Quito, Ecuador.

Strategies to monitor and control the spread of MRSA infections are dependent on accurate and timely diagnosis of MRSA in both hospital and community settings. In Latin America, significant diversity in diagnostic and susceptibility testing procedures exists at the regional, national and local levels. Various tests for S. aureus and MRSA are available in clinical settings, but the application of these techniques differs between and within countries, and quality control measures are not uniformly applied to verify diagnoses. To optimize the diagnosis of MRSA infections across Latin America, a more consistent approach is required. This may include: adoption and appropriate adaption of specific guidelines for MRSA testing, depending on local resources; establishment of a coordinated system for quality control; regional access to central reference facilities; education of medical and healthcare professionals in best practices; and development of systems to evaluate the implementation of guidelines and best practices.
View Article and Find Full Text PDF

Download full-text PDF

Source
August 2010

[Epidemiology and surveillance of methicillin-resistant Staphylococcus aureus in Latin America].

Rev Chilena Infectol 2010 Aug;27 Suppl 2:S51-8

División de Enfermedades Infecciosas, Hospital Roosevelt, Ciudad de Guatemala, Guatemala.

Surveillance systems monitoring the spread and divergence of MRSA strains are critical if preventive and therapeutic measures targeting MRSA infection are to be employed optimally. Surveillance provides information on the spread of MRSA, on the emergence of new strains within hospitals and communities, on the antibiotic resistance profile and virulence of strains, and on the risk factors associated with infection. These data help clinicians to provide appropriate empiric treatment of infections circulating in their region, leading to improved patient outcomes. While information on MRSA epidemiology in Latin America is growing, significant gaps exist in the available data, especially in local areas where fewer resources are available for characterizing and reporting MRSA strains. Here, we describe current knowledge of healthcare- and community-associated MRSA epidemiology in the region, and provide recommendations for future development of surveillance systems with a view to providing robust data at regional, national and local levels.
View Article and Find Full Text PDF

Download full-text PDF

Source
August 2010

Evolution of methicillin-resistant Staphylococcus aureus clones in Latin America.

Int J Infect Dis 2010 Jul 3;14(7):e560-6. Epub 2010 Jan 3.

Hospital Civil de Guadalajara, Fray Antonio Alcalde, Instituto de Patología Infecciosa y Experimental, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Jalisco, Mexico.

Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is a prominent nosocomial bacterial pathogen, associated with significant morbidity and mortality. The global incidence is increasing, and Latin America is no exception. This article reviews MRSA clonal distribution in Latin America and implications for clinical practice.

Design: A PubMed literature search (1966-2008) identified 32 articles that characterized MRSA clones in Latin America.

Results: Data from these articles show that since 1990, several epidemic MRSA clones have spread in Latin America. The multidrug-resistant Brazilian clone is widespread, especially in Brazil and Argentina, but more recently clones with susceptibility to a range of antibiotics have been detected in Brazil, whereas in Argentina, as in Chile, Colombia and Paraguay, the multidrug-resistant Cordobes/Chilean clone prevails. In Mexico, the New York/Japan clone is most frequent. Data were not available from every country and, despite the increasing prevalence of community MRSA infections, most were collected from tertiary care centers.

Conclusions: A variety of epidemic MRSA clones are circulating in Latin America, some of which harbor genes that encode multidrug resistance or enhanced pathogenicity. Continued collection and reporting of epidemiological data is crucial for effective prevention and treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijid.2009.08.018DOI Listing
July 2010

Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Latin America.

Int J Antimicrob Agents 2009 Oct 21;34(4):304-8. Epub 2009 Jul 21.

Centro Médico de Caracas, Caracas, Venezuela.

Methicillin-resistant Staphylococcus aureus (MRSA) has become a serious threat to public health worldwide. Ongoing surveillance is essential to support infection control committees and clinicians in the prevention and treatment of infection. However, in Latin America, resources for monitoring the changing epidemiology of MRSA remain limited. In this article, we review the current situation of MRSA in Latin America in order to highlight the need for a more harmonised effort to improve its management. Literature in the PubMed and SciELO databases as well as the website of the Pan American Health Organization were searched for articles and information about the epidemiology of MRSA in Latin America. MRSA is already the leading cause of nosocomial infection in the Latin American region, and the number of reports of community-acquired MRSA infections is also rising. However, the extent of the problem is not fully understood, especially since data tend to come from large hospitals whereas much of the population is served by small community healthcare centres that do not have extensive facilities for performing microbiological surveillance. In conclusion, wider-reaching and co-ordinated programmes to provide regular MRSA surveillance reports are required across the Latin American region.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijantimicag.2009.06.005DOI Listing
October 2009