Clinical Microbiology and Antimicrobial Chemotherapy. 2014; 16(1):57-69
To study antimicrobial resistance of Haemophilus influenzae and its trends in different Russian regions over the period of 2004–2009.
This study included consecutive clinical strains of H. influenzae obtained from patients with different infections (pneumonia, acute otitis media, meningitis, bacteremia, COPD exacerbation, etc.) in Central, Volga, Ural, and Siberian federal districts of Russia over the period of 2004–2009. Susceptibility to 12 antimicrobial agents was determined by broth microdilution method according to the Clinical Laboratory Standards Institute guidelines (CLSI 2013).
A total of 691 H. influenzae strains were isolated over the period of 2004–2009. All beta-lactams were highly active against H. influenzae isolates tested. Resistance to amoxicillin, amoxicillin/clavulanate, ceftriaxone/cefotaxime and ceftibuten was 3.8, 0, 0 and 0%, respectively. Macrolides were also active against tested strains: 0.5% and 0% of isolates were non-susceptible to clarithromycin and azithromycin, respectively (during the 2006–2009). No levofloxacin- or moxifloxacin-resistant strains were isolated over the 6-year study period. Chloramphenicol and tetracycline exhibited high activity against H. influenzae strains tested (resistance to these antibiotics was less than 5% over the study period). Activity of co-trimoxazole was constantly low (32.8% and 29.8% of non-susceptible strains during the 2004–2005 and 2006–2009, respectively).
Beta-lactams (amoxicillin, amoxicillin/clavulanate, ceftriaxone, cefotaxime, ceftibuten), macrolides, levofloxacin and moxifloxacin are the most active drugs against H. influenzae in Russia. Despite the high activity of tetracycline and chloramphenicol against H. influenzae, use of these drugs should be limited due to unfavorable safety profile. Given the low activity of cotrimoxazole, it is not recommended for empiric therapy of infections caused by H. influenzae.