Subject(s)
Anti-Bacterial Agents/pharmacology , Bacteremia/epidemiology , Carbapenems/pharmacology , Critical Illness , Gram-Negative Bacterial Infections/epidemiology , beta-Lactam Resistance , Bacteremia/microbiology , Bacteremia/mortality , Child , Child, Preschool , Female , Gram-Negative Bacterial Infections/microbiology , Gram-Negative Bacterial Infections/mortality , Hospitals, Teaching , Humans , Infant , Male , Risk Factors , South America/epidemiology , Survival Analysis , Tertiary Care Centers , Treatment OutcomeABSTRACT
Meningococcal disease is mostly endemic in Latin America, with periodic occurrences of outbreaks and epidemics over the last few decades. This literature review summarizes the available epidemiological data for this region between 1945 and 2010. Incidence rates and serogroup distribution differ from country to country and over time. Serogroups A, B, and C have all been major causes of meningococcal disease since the 1970s. In the last decade serogroups W135 and Y may now be emerging in certain countries, with serogroup A virtually disappearing. Although progress has been made in improving and coordinating the surveillance of invasive disease, the uniformity and quality of reported data reflect the fact that the current surveillance systems focus on passive rather than active reporting, hence the reliability of data may vary between countries. Consideration of vaccination policies to control meningococcal disease can only be made with a sufficient understanding of the changing epidemiology in the region.
Subject(s)
Meningococcal Infections/epidemiology , Meningococcal Infections/microbiology , Neisseria meningitidis , Carrier State/epidemiology , Disease Notification , Health Policy , Humans , Incidence , Latin America/epidemiology , Meningococcal Infections/mortality , Meningococcal Infections/prevention & control , VaccinationABSTRACT
We evaluated the performance of several methods for the detection of methicillin resistance in Staphylococcus aureus using 101 clinical S. aureus isolates from pediatric patients in a tertiary hospital in Brazil; 50 isolates were mecA-positive and 51 were mecA-negative. The Etest and oxacillin agar screening plates were 100% sensitive and specific for mecA presence. Oxacillin and cefoxitin disks gave sensitivities of 96 and 92%, respectively, and 98% specificity. Alterations of CLSI cefoxitin breakpoints increased sensitivity to 98%, without decreasing specificity. Our results highlight the importance of a continuing evaluation of the recommended microbiological methods by different laboratories and in different settings. If necessary, laboratories should use a second test before reporting a strain as susceptible, especially when testing strains isolated from invasive or serious infections. With the new (2007) CLSI breakpoints, the cefoxitin-disk test appears to be a good option for the detection of methicillin resistance in S. aureus.
Subject(s)
Anti-Bacterial Agents/pharmacology , Cefoxitin/pharmacology , Methicillin Resistance , Oxacillin/pharmacology , Staphylococcus aureus/drug effects , Bacterial Proteins/analysis , Child , Diffusion , Humans , Microbial Sensitivity Tests/methods , Penicillin-Binding Proteins , Reproducibility of Results , Staphylococcus aureus/isolation & purificationABSTRACT
We evaluated the performance of several methods for the detection of methicillin resistance in Staphylococcus aureus using 101 clinical S. aureus isolates from pediatric patients in a tertiary hospital in Brazil; 50 isolates were mecA-positive and 51 were mecA-negative. The Etest and oxacillin agar screening plates were 100 percent sensitive and specific for mecA presence. Oxacillin and cefoxitin disks gave sensitivities of 96 and 92 percent, respectively, and 98 percent specificity. Alterations of CLSI cefoxitin breakpoints increased sensitivity to 98 percent, without decreasing specificity. Our results highlight the importance of a continuing evaluation of the recommended microbiological methods by different laboratories and in different settings. If necessary, laboratories should use a second test before reporting a strain as susceptible, especially when testing strains isolated from invasive or serious infections. With the new (2007) CLSI breakpoints, the cefoxitin-disk test appears to be a good option for the detection of methicillin resistance in S. aureus.
