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Frequency and antimicrobial susceptibility profile of vancomycin-resistant enterococci from Latin America: a report from the SENTRY Antimicrobial Surveillance Program (1997–2006)

Abstract number: P689

Gales A., Sader H., Santiago K., Pgnatari A., Jones R.

Objective: To evaluate the prevalence and susceptibility profile of vancomycin-resistant enterococci (VRE) in Latin America. VRE emerged nearly twenty years ago in the United States (USA) and rapidly disseminated in many USA hospitals; however, its prevalence seems to remain relatively low in Latin America.

Methods: As part of the SENTRY Antimicrobial Surveillance Program, a total of 2026 enterococci isolated between January 1997 and December 2006 from Latin American hospitals were studied. The susceptibility profile to nine antimicrobial agents was determined by CLSI broth microdilution methods and results interpreted according to CLSI document M100-S17 (2007).

Results:E. faecalis (78.2%) and E. faecium (12.7%) were the most frequently isolated species. Blood (41.4%) and skin/soft tissue (11.0%) represented the most frequent body sites of infection. A total of 112 (5.5%) strains were identified as VRE, with 46% of them being isolated in Brazil. The VRE frequency increased from 0.0% (1997 and 1998) to 10.3% (2006), with an important increase after 2002. Although the numbers of E. faecalis and E. faecium exhibiting the VRE phenotype were similar, the percentage of vancomycin-resistant E. faecium (VR-EFM; 19.7%) was proportionally higher than vancomycin-resistant E. faecalis (VR-EF; 3.3%). A significant increase in VR-EFM isolates was detected in Brazil between 2005 and 2006. VRE was most frequently isolated from urine (18.5%). The antimicrobial susceptibility profile of VRE isolates is summarised in the table. Linezolid and tigecycline were the most active compounds tested against VRE. In contrast, the majority of VRE were resistant to teicoplanin (vanA pattern).

Conclusions: An important increase in the frequency of VRE has been observed in Latin America and appears to be associated with the dissemination of endemic clones expressing the vanA. Linezolid and tigecycline were the only antimicrobials with broad activity against Enterococcus spp. independent of the species identification or glycopeptide phenotype.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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