• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

Animal & Veterinary

  • Print
  • Share
  • E-mail

Latin American Pan Health Organization, PHAC by Jorge Matheu

DR. MATHEU: Good morning, everyone. Thank you for the invitation to attend this important meeting.

(Slide)

I will be covering the background of the antimicrobial resistance network in Latin America. The performance in products of this network. And to future steps forward.

(Slide)

The Latin American antimicrobial surveillance network consists of multiple countries. The main goal of the surveillance network is to provide better information so that actions can be taken to prevent and control antimicrobial resistance. In order to achieve that goal, quality control in laboratories is essential and we have been focused on that activity since the beginning of this project.

(Slide)

This program was launched by PAHO in 1996. And established with Salmonella, Shigella and Vibro cholera, until 2000 when the surveillance was extended to hospital microorganisms. Countries joined the program along the way. And by 2008 there were 18 Latin American countries.

The laboratory has been the emphasis including quality control assessment and the software program WHONET had been promoted as a way to store and analyze clinical and microbiology data.

(Slide)

These are the pathogens that are monitored in this surveillance system. They include enteric and non-enteric infections in the community settings and hospital acquired infections, such as Streptococcus pneumoniae and Pseudomona aeruginosa.

All the laboratories have been approved and have created --- for the continued development of quality in each network in each country. Most countries in Latin America introduce this diffusion technique. Performance and products.

(Slide)

In 2003 an expert community prepared a guide for the assessment of laboratories. This guide included critical competence necessary to perform the diffusion method of Kirby-Bauer. Followed this assessment were done in multiple countries including Paraguay, Bolivia, Guatemala, Honduras, Uruguay, Dominican Republic and Peru.

(Slide)

Is one of these assessments include national internal experts, was one week in duration and included standardized questionnaire.

(Slide)

This tool enabled the teams to recognize the weakness of the laboratories and to focus on the recommendations for improvement in each one.

(Slide)

How I maintain the network. We have created manuals for quality assurance and training activities to help guide the laboratories for sustaining quality improvement. We have an annual meeting and annual report.

(Slide)

These are some documents and protocol for the network.

(Slide)

We have a program of extended quality control conducted by the CG Malbran Institute of Argentina and National Microbiology Laboratory of Canada until 2005. After that the network has been working with --- of global Salmonella surveillance, now called Global Foodborne Network.

(Slide)

This chart shows the number of isolates in each year including community and hospital isolates.

(Slide)

And this chart shows the number of isolates by --- settings. We see here that there are more hospital isolates that it does from the community.

(Slide)

Looking forward. There are a number of limitations of the network. First, the network is not using a representative sample based technique in choosing isolates to collect. Second, the accuracy of the antimicrobial vary from local to local, depending on the quality control of the laboratory, although laboratory are improving there is still significant differences in quality among laboratories in the network.

(Slide)

There are many challenges going forward. First, there must be a process to improve the quality of data and make sure that is representative. There needs to be an emphasis on the analysis and publication of results of the country level, which will foster better use of the data to prevent and control resistance.

Finally, the data should be used as evidence to promote advocacy at the national level and strengthen the initiatives for the rational use of antibiotics. Thank you very much.

(Applause)

DR. BARZILAY: Thank you very much to Doctor Matheu for his presentation. Are there any questions before we move to the final presentation before lunch? Okay. Go ahead, please.

MR. ROACH: Yes, this is Steve Roach from Food Animal Concerns. I just have a quick question. So you mentioned you have reports, but have you -- do those reports actually have data on resistance in the countries or through the system, and you know, where can we find that information for this?

DR. MATHEU: The report is in the website of PAHO. That -- and this is all the reports is in the website from PAHO.

MR. ROACH: Thank you.

DR. BARZILAY: Our final speaker for this session is Doctor Richard Reid-Smith, he’s the researcher for the Antimicrobial Use Monitoring Coordinator for the Antimicrobial Resistance Surveillance Unit of the Laboratory for Foodborne Zoonoses in the Public Health Agency of Canada.