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Executive Summary

List of Participants

Full Text
(138 pages, PDF; for full text of chapter headings translated below, see report in Spanish)

Cover and Contents
Executive Summary
Glossary, Abbreviations

Inaugural Session, Country Presentations

Costa Rica
El Salvador
English-Speaking Caribbean

Evaluations and references
Performance Evaluation
Laboratory Evaluation
Quality-Control Systems


List of Participants

Annual Regional Meeting of the Countries Participating in the Network for Monitoring/Surveillance of
Resistance to Antibiotics

Reunión Anual Regional ... Red de Monitoreo/Vigilancia de la Resistencia a los Antibióticos

(Asunción, Paraguay, 31 Jan.–2 Feb. 2001)


The presentations of the participants and the ensuing discussions yielded the following recommendations:

1. Reports on resistance should include an indication of the category, either I (intermediate) or R (resistant).

2. In the future, the presentation of the data should follow a basic scheme modeled after the presentation used at the Malbrán Institute in Argentina. All the countries are familiar with this model. Each country, however, can include more information than is requested. The information will be organized as indicated in the PAHO publication "Cómo escribir y publicar un artículo" (How to Write and Publish an Article).

3. The information will be broken down into hospital strains and community strains. The former must cover data on Acinetobacter spp , Enterococcus spp, Pseudomonas spp, Klebsiella spp, Enterobacter spp, and Staphylococcus aureus; hospital data on E. coli will be optional. For bacteria of community origin, information on Salmonella, Shigella, Vibrio cholerae, Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitides, and E. coli must be included.

4. The monitoring of Campylobacter spp and strains of verotoxigenic E. coli will be strengthened. For the time being, monitoring the antibiotic resistance of the latter is not considered necessary.

Antisera for Typing Strains of Salmonella and Shigella

5. A survey of the participating countries' need for these antisera should be made. Countries that produce antisera should send them to the NLEP, so that this institution can carry out the quality control it offered.

Monitoring/Surveillance of Gonococci

6. Each country will inform PAHO about its national situation with respect to this activity, indicating how the network functions, the name of the national institution that conducts external quality control of the participating institutions--including performance evaluation, and the information published by the ministry of health in the past four years, indicating susceptibility of gonococcus isolates to antibiotics. If the information is provided in percentages, the denominators should be indicated, along with the name of the institution responsible for external quality control of the national reference laboratory. If external quality control of the national reference laboratory is not carried out, the date of its interruption should be indicated.

Evaluating the Performance of Participants in the Network of Each Country

7. Twice a year at the very least, participants will be sent a panel consisting of five samples of different species. In addition, an inspection visit will be conducted in which personnel from other similar institutions will participate.

Human Resources Development

8. Each country should promote the organization of local courses and take advantage of the training opportunities that exist in other countries.

Surveillance Policy

9. Each ministry of health will take the necessary steps to ensure that the information obtained from the monitoring of the species mentioned in the paragraphs above is part of the routine of the reference and service centers with recognized experience in microbiology. This information should be geographically representative, of verified quality, and disseminated periodically, both in the geographical area in which it was obtained and in other areas in the country.

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