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A percentage of annual decline of serotypes causing IPD and NIPD included in PCV was detected among groups not targeted to receive the vaccine, probably due to herd effect. Considering pneumococcal serotype distribution is a dynamic process, we highlight the importance of surveillance programs.

Resistance to trimethoprim-sulfamethoxazole and ciprofloxacin used for empiric treatment in community urinary infections is high, and there are few available treatment options.

Letters to the Editor First Report of Community-Associated Methicillin-Resistant Staphylococcus aureus (USA300) in Mexico ᰔ Methicillin-resistant Staphylococcus aureus (MRSA) constitutes an important threat to hospitalized patients worldwide. In the late 1990s, community-associated-MRSA (CA-MRSA) emerged in previously healthy patients in many countries and is now endemic in several U.S. hospitals (6). In Latin America, CA-MRSA has been described to occur in Uruguay (7), Brazil (11), and the Andean Region of South America (1, 10). We describe five cases of CA-MRSA infections in patients in the

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Pseudomonas aeruginosa ha sido considerada por la Organización Mundial de la Salud (OMS) de importancia para la investigación de nuevos antibióticos. Revisamos la susceptibilidad in vitro y la producción de carbapenemasas de ceftolozano-tazobactam (C-T) y ceftazidima-avibactam (CZA), a P. aeruginosa no susceptible a carbapenémicos. Se recolectaron aislados clínicos de P. aeruginosa resistentes a carbapenémicos. La susceptibilidad a C-T y CZA se determinó mediante el método de Kirby-Bauer, además, se utilizó la técnica de inhibición de carbapenémicos modificada. Cuarenta y siete de 330 cepas (14,2%) fueron resistentes a carbapenémicos (> 90% MDR), 30 (63,8%) fueron susceptibles a CZA y 12 (25,2%) a C-T. Se detectaron carbapenemasas en 11 de 37 cepas (29,7%) y metalo-β-lactamasas (MBL) en diez. Las cepas de P. aeruginosa resistentes a carbapenémicos fueron MDR y susceptibilidad a C-T y CZA de menos del 80%.