In the first session, devoted to surveillance networks and moderated by Dr. Ximena Aguilera, three different experiences were presented, two of them with involvement on the part of the countries of the Region: The Regional characteristics of S. pneumoniae, H. influenzae and N. meningitidis in invasive processes, SIREVA II 2000-2005 presented by Dr. Jean Marc Gabastou; Global Salm/Surv (WHOGSS)  Experience in the Region, presented by Dr. Lai King Ng; and a third on the experience of the European Resistance Surveillance Network (EARSS), presented by Dr. Hajo Grundmann. 

In the second session on surveillance experiences in the countries, moderated by Raquel de Bolaños, the experiences of three countries were presented: Panama, by the same moderator, with a brief introduction on the  progress of the network in the country; El Salvador, presented by María José Boza; and the presentation of a pilot plan for comprehensive monitoring of resistance in Colombia, with involvement on the part of the livestock area (COIPARS) in three key areas: human health, animal health, and food. Responsible for the latter presentation was Pilar Donado, project coordinator in Colombia. 

For the third session on new technologies and surveillance, moderated by Damarys Sánchez, the following presentations were made: application of new technologies in monitoring antimicrobial resistance, by Marcelo Galas; Utilization of molecular biology techniques in monitoring microorganisms, by Gustavo Chamorro Cortesi; and application of molecular biology techniques in surveillance of community MRSA in Canada, by Lai King Ng. The presentations provided an up-to-date panorama of advances made in molecular techniques and their possible benefit in certain areas, e.g. for outbreak detection in hospitals. 

The fourth session was dedicated to performance evaluation, with performance evaluations by two main coordinating laboratories, the National Institute for Infectious Diseases (Instituto Nacional de Enfermedades Infecciosas Carlos Malbrán / INEI/Malbrán) in Argentina, by Marcelo Galas, and that of enteric pathogens in Canada, by Lai King Ng. Results obtained from past years were presented by the laboratories participating in both programs. In general, greater involvement on the part of the countries was observed, as well as improvements in the results obtained. In this same session, a presentation was made by Damarys Sánchez on the role of the national reference center in quality control vis-à-vis the sentinel centers, with details on the experience of the Rafael Rangel National Institute of Hygiene in Caracas, Venezuela. 

This same session included a round table on quality assurance in sentinel laboratories in the countries, moderated by Dr. Jeannete Zurita. The first presentation by Brazil was divided into two parts, one on the integration of laboratories and hospital centers into antimicrobial resistance surveillance activities, by Janaína Salas, and another on surveillance of resistance in enterobacteria in Brazil, by Dahlia Dos Praceres. Moreover, in the second presentation by Ecuador, Dr. Zurita summarized the shipments of strains to the sentinel laboratories of the network, pointing out certain important technical points to take into account for their performance at local level, where often they cannot count on reagents or standards, and feedback from these national centers to their sentinel laboratories; and a third presentation by Maria Paz Adé of PAHO/WHO on the methodology and usefulness of external evaluations, showing the results of some recent ones. Although the quality of the countries’ reference laboratories has improved in recent years, serious problems can still be identified with the local laboratories, such that it is necessary to strengthen national networks through supervision visits and training, as well as getting them involved in the performance evaluations, always respecting the maximum 30-day response time. 

In the fifth session on information review, presentation were made on the progress of the WHONET software by of John Stelling, who shared the progress that this will undergo in coming years thanks to a grant from the National Institutes of Health (NIH) of the United States. The progress of the program as a system of expert and microbiological rules will allow for cleaning, correcting, and purifying data, in addition to other functions. 

Subsequently, the review was continued to include a review of the 2007 data. The methodology was to plan a database offscreen with participants’ review of both community and hospital species. Recommendations made as a result of this exercise indicated that when data emerges that falls outside the norm, what should be done to confirm them before they are incorporated into the databases. 

In the last (sixth) session, the rapporteurs and president of the meeting presented the conclusions and recommendations. These were reviewed and discussed by the participants, who reached a consensus satisfactory to the group. 

Once the conclusions and recommendations were approved, the event came to an end, with the handing out of certificates and thanks being expressed by PAHO, the Ministry of Health of El Salvador, and the USAID Office of Development Cooperation in El Salvador.