Antimicrobial Resistance of Streptococcus Pneumoniae in Different Regions of Russia: Results of Prospective Multicentre Study (phase А of project PeHAS-I) | CMAC

Antimicrobial Resistance of Streptococcus Pneumoniae in Different Regions of Russia: Results of Prospective Multicentre Study (phase А of project PeHAS-I)

Clinical Microbiology and Antimicrobial Chemotherapy. 2002; 4(3):267-277

​ Kozlov R.S., Krechikova O.I., Sivaya O.V., Akhmetova L.I., Vishnyakova L.A., Gugutsidze E.N., Ilyina V.N., Katosova L.K., Kurchavov V.A., Kuzin V.B., Marusina N.E., Molodova E.A., Multyh I.G., Pavlov A.L., Sinopalnikov A.I., Smirnov I.V., Tihonov Yu.G., Faustova M.E., Larchenko V.A., Stratchounski L.S.
Streptococcus pneumoniae pneumococci antimicrobial resistance
Section
Antimicrobial Resistance
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2002; 4(3):267-277

Objective.

To determine the structure of antimicrobial resistance of clinical isolates of pneumococci in different regions of Russia.

Materials and Methods.

A total of 210 Streptococcus pneumoniae strains isolated in 15 centres of Central (Moscow – 5 centers, Kazan, Nizniy Novgorod, Ryzan), North-Western (Smolensk, Saint-Petersburg), Southern (Krasnodar) regions, Urals (Ekaterinburg) and Siberia (Novosibirsk, Tomsk) were included in this study. Susceptibility to 19 antimicrobials – penicillin G, amoxicillin, amoxicillin/clavulanate, cefotaxime, cefepime, erythromycin, azithromycin, clarithromycin, midecamycin, midecamycin acetate, spiramycin, clindamycin, tetracycline, ciprofloxacin, levolfloxacin, chloramphenicol, co-trimoxazole, rifampicin and vancomycin – was determined by broth microdilution in accordance with NCCLS recommendations.

Results.

β-Lactams sustain high in vitro activity against studied population of pneumococci: nonsusceptibility (percentage of both intermediate and fully resistant isolates) to amoxicillin and amoxicillin/clavulanate was 0,5%, to cefotaxime and cefepime – 2%, to penicillin G – 9%. Resistance to studied macrolides/azalide (erythromycin, azithromycin, clarithromycin, midecamycin, midecamycin acetate, spiramycin) varied from 2 to 6%. Chloramphenicol, clindamycin and rifampicin also sustained high activity (proportion of non-susceptible strains was 5, 2 and 1% respectively). No resistance to levofloxacin and vancomycin was found. The highest percentage of non-susceptible isolates (27 and 33% respectively) was determined to tetracycline and co-trimoxazole. Multi-resistance (defined as resistance to 3 and more classes of antimicrobials) was found in 8% of strains.

Conclusions.

β-Lactams and macrolides might be recommended as drugs of choice for the therapy of pneumococcal infections. Respiratory fluoroquinolones (levofloxacin) are highly active against pneumococci. High resistance to co-trimoxazole and tetracycline dictates the necessity to limit use of these antimicrobials for the therapy of the above infections.

  • 1. Bronzwaer S., Cars O., Buchholz U., Molstad S., Goettsch W., Veldhuijzen I., et al. A European study on relationship between use and antimicrobial resistance. Emerg Infect Dis 2002;8:278-82.
  • 2. Doern G.V., Heilmann K.P., Huynh H.K., Rhomberg P.R., Coffman S.L., Brueggemann A.B. Antimicrobial resistance among clinical isolates of S. pneumoniae in the United States during 1999–2000, including a comparison of resistance rates since 1994–1995. Antimicrob Agents Chemother 2001;45:1721-9.
  • 3. National Committee for Clinical Laboratory Standards. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically – M100-S12. MIC testing supplemental tables. NCCLS, Villanova, PA; 2002. р. 110-2.
  • 4. Chen D.K., McGeer A., Azavedo J.C., Low D.E. Decreased susceptibility of Streptococcus pneumoniae to fluoroquinolones in Canada. N Engl J Med 1999;341:233-9.
  • 5. Appelbaum P.C. Resistance among Streptococcus pneumoniae [RTF bookmark start: z8]: Implications for Drug Selection. Clin Infect Dis 2002; 34:1613-20.
  • 6. Baquero F., Granizo J.J., Aguilar L., Casal J., Garsia-Rey C., Dal-Rel R. S. pneumoniae resistance to erythromycin and penicillin in relation to macrolide and β-lactam consumption in Spain. J Antimicrob Chemother 2000; 46:767-73.
  • 7. Reinert R.F., Lahlam A., Tenholte C., Briefs C., Haupts S. Emergence of macrolide and penicillin resistance among invasive pneumococcal isolates in Germany. J Antimicrob Chemother 2001;49:61-8.
  • 8. Neeling A.J., Overbeek B.P., Horrevorts A.M., Ligtvoet E.J., Goettsch W.G. Antibiotic use and resistance of S. pneumoniae in the Netherlands during the period 1994–199
  • 9. J Antimicrob Chemother 2001;48:441-4. 9. Hoban D.J., Doern V.G., Fluit A.C., Roussel-Delvallez M., Jones N.R. Worldwide prevalence of antimicrobial resistance in S. pneumoniae, H. influenzae and M. catarrhalis in the SENTRY antimicrobial surveillance program 1997–1999. Clin Infect Dis 2001;32 (Suppl 2):81-93.
  • 10. Nagai K., Appelbaum P.C., Davis T.A., Kelly L.M., Hoellman D.B., Andrasevic A.T., et al. Susceptibilities to telithromycin and six other agents and prevalence of macrolide resistance due to L4 ribosomal protein mutation among 992 pneumococci from 10 Central Eastern European countries. Antimicrob Agents Chemother 2002;46:371-7.
  • 11. Schmitz F.J., Verhoef J., Milatovic D., Fluit A.C. Treatment options for Streptococcus pneumoniae strains resistant to macrolides, tetracycline, quinolones or trimethoprim/sulfamethoxazole. Eur J Clin Microbiol Infection Dis 2001;20:827-9.
  • 12. Legg J.M., Bint A.J. Will pneumococci put quinolones in their place? J Antimicrob Chemother 1999; 44:425-7.
  • 13. Coyle E.A., Kaatz G.W., Rybak M.J. Activities of newer fluoroquinolones against ciprofloxacin-resistant Streptococcus pneumoniae. Antimicrob Agents Chemother 2001;45:1654-9.
  • 14. Klugman K.P. Antibiotic selection of multiply resistant pneumococci. Clin Infect Dis 2001;33:489-91.
  • 15. Statement 1996 CA-SFM. Zone sizes and MIC breakpoints for non-fastidious organisms. Clin Microbiol Infect 1996; 2 (Suppl 1): S46-8.
Views
0 Abstract
0 PDF
0 Crossref citations
Shared