South America exhibits some of the higher rates of antimicrobial resistance in Enterobactericeae worldwide. This continent includes 12 independent countries with huge socioeconomic differences, where the ample access to antimicrobials, including counterfeit ones, coexists with ineffective health systems and sanitation problems, favoring the emergence and dissemination of resistant strains. This work presents a literature review concerning the evolution and current status of antimicrobial resistance threats found among Enterobacteriaceae in South America. Resistance to β-lactams, fluoroquinolones and aminoglycosides was emphasized along with description of key epidemiological studies that highlight the success of specific resistance determinants in different parts of the continent. In addition, a discussion regarding political and socioeconomic factors possibly related to the dissemination of antimicrobial resistant strains in clinical settings and at the community is presented. Finally, in order to assess the possible sources of resistant bacteria, we compile the current knowledge about the occurrence of antimicrobial resistance in isolates in South American' food, food-producing animals and off-hospitals environments. By addressing that intensive intercontinental commerce and tourism neutralizes the protective effect of geographic barriers, we provide arguments reinforcing that globally integrated efforts are needed to decelerate the emergence and dissemination of antimicrobial resistant strains.

中文翻译：

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南美肠杆菌科细菌的耐药性：历史，当前传播状况和相关的社会经济因素。

南美在全球肠杆菌科中表现出较高的抗药性。该大陆包括12个独立的国家，这些国家的社会经济差异很大，在这些国家中，充足的获取包括假冒产品在内的抗菌药物的机会与无效的卫生系统和卫生问题共存，有利于耐药菌株的出现和传播。这项工作提供了有关南美肠杆菌科中发现的抗菌素耐药性威胁的演变和现状的文献综述。强调了对β-内酰胺类，氟喹诺酮类和氨基糖苷类药物的耐药性，以及对重点流行病学研究的描述，这些研究突出了该大陆不同地区特定耐药性决定因素的成功。此外，讨论了与可能在临床环境和社区中传播抗药性菌株有关的政治和社会经济因素。最后，为了评估耐药菌的可能来源，我们汇编了有关南美食品，产食动物和医院环境中分离株中抗菌素耐药性的最新知识。通过解决密集的洲际贸易和旅游业抵消了地理障碍的保护作用，我们提出了一些论点，以加强需要全球整合的努力以减缓抗菌素耐药菌株的出现和传播。最后，为了评估耐药菌的可能来源，我们汇编了有关南美食品，产食动物和医院环境中分离株中抗菌素耐药性的最新知识。通过解决密集的洲际贸易和旅游业抵消了地理障碍的保护作用，我们提出了一些论点，以加强需要全球整合的努力以减缓抗菌素耐药菌株的出现和传播。最后，为了评估耐药菌的可能来源，我们汇编了有关南美食品，产食动物和医院环境中分离株中抗菌素耐药性的最新知识。通过解决密集的洲际贸易和旅游业抵消了地理障碍的保护作用，我们提出了一些论点，以加强需要全球整合的努力以减缓抗菌素耐药菌株的出现和传播。