Latin American and Caribbean Network for Antimicrobial Resistance Surveillance - ReLAVRA+ - PAHO/WHO

The Latin American Network for Antimicrobial Resistance Surveillance (by its Spanish acronym) was formally established in 1996 by the PAHO/WHO regional office and partnering Member States.

The goal is to substantiate Antimicrobial Resistance (AMR) prevention and control policies and interventions in the Region, through the continuous collection of reliable, comparable, and reproducible AMR data.

Initially, the network constituted 8-designated national reference laboratories (NRLs), in 8-member states. The surveillance scope was limited to reporting AMR data for few targeted foodborne pathogens (Salmonella, Shigella and V. cholerae). Each NRL, reported antimicrobial susceptibility testing information (mainly for stool specimens isolates) from sentinel laboratories in each of the participating countries in addition to isolates analyzed in theses NRLs.

During the following years, the network size, as well as the scope of surveillance, continued to expand. By the year 2000, 15 NRLs, in 15-member states were reporting on an additional 7 nosocomial pathogens (E. coli, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella spp. Pseudomonas aeruginosa, Enterobacteriaceae, Enterococci spp.); and 5 community acquired pathogens (Salmonella, Shigella, S. pneumoniae, N. meningitidis, Haemophilus influenzae).

25th anniversary of ReLAVRA!

ReLAVRA celebrated its 25th anniversary (1996-2021). At the heart of the network’s work are values of technical excellence, equity and solidarity.

Currently, the network is one of the oldest, and largest regional AMR surveillance networks in the world. It constitutes 20 countries, namely: Antigua and Barbuda, Argentina, Bahamas, Barbados, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominica, Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Granadines, Surinam, Trinidad & Tobago, Uruguay, and Venezuela. Each country is represented by a national reference laboratory (NRL), officially designated by each the national authority in that country. Aggregates level data on antibiotic resistance is collected and reported annually, on number of priority pathogens-drugs combination (see dashboard link).

The number of participating microbiology laboratories varies between countries, as well as within a country from year-to-year. PAHO estimates that between the years 2000-2014, over 750 laboratories within the region have reported AST data on a total of ~2,633,000 isolates, to the ReLAVRA network through their corresponding NRLs. Compiled AST data are reported to PAHO regional office through the PAHO country offices in each of the 19 countries in the network.

The pathogen-drug combinations are reported to PAHO in accordance with the ReLAVRA surveillance protocol. These combinations are determined based on evidence and expert consultations within the ReLAVRA countries and in coordination with NRL focal points. The development of theses pathogen-drugs combinations takes the context into account (regional situational analyses), country needs and current and future capacities. The protocol is reviewed and updated periodically (last reviewed in 2015).

A reporting template was created and is designed to ensure standardized and accurate reporting. Guidelines for species identification and antimicrobial susceptibility testing (AST) such as CLSI, are used across countries in the region, to enable comparisons between countries.

PAHO Promotes Collaboration Among Member Countries of the Latin American and Caribbean Network for Antimicrobial Resistance Surveillance (ReLAVRA+) in Colombia

Country members

Argentina Belize Bolivia Brazil
Chile Colombia Cuba Ecuador
El Salvador Guatemala Honduras
Costa Rica Mexico Nicaragua
Panama Paraguay Peru
Dominican Republic Uruguay
Venezuela

Meetings

ReLAVRA holds meetings with all its members on a regular basis for the exchange of information on resistance surveillance in the countries. During the first years, a face-to-face meeting was held each year in a different country where, among others, its annual report was discussed and analyzed.

Biennal meetings

Medellin, Colombia | 11-13 julio 2023: Meeting of the Latin American and Caribbean Network for Antimicrobial Resistance Surveillance (ReLAVRA+)
Brasilia, Brazil | 21-23 October 2019: Biennial Meeting of The Latin American (ReLAVRA) and the Caribbean Network for Antimicrobial Resistance Surveillance
Montevideo, Uruguay | 28-30 November 2017: Biennial Joint Meeting of the Latin American Network for Antimicrobial Resistance Surveillance and the Inter-American Network of Food Testing Laboratories (Spanish only)

Technical documents

Contact

Communicable Diseases and Environmental Determinants of Health
Email: amrhq@paho.org

Latin American and Caribbean Network for Antimicrobial Resistance Surveillance - ReLAVRA+