Epidemiology of Antimicrobial Resistance of Nosocomial Strains of Staphylococcus aureus in Russia: Results of Prospective Multicenter Study | CMAC

Epidemiology of Antimicrobial Resistance of Nosocomial Strains of Staphylococcus aureus in Russia: Results of Prospective Multicenter Study

Clinical Microbiology and Antimicrobial Chemotherapy. 2002; 4(4):325-336

​ Dekhnich A.V., Edelstein I.A., Narezkina A.D., Afinogenov G.E., Akhmetova L.I., Boronina L.G., Gugutsidze E.N., Gudkova L.V., Zdzitovetckiy D.E., Ilyina V.N., Krechikova O.I., Marusina N.E., Multyh I.G., Pylaeva S.I., Smirnov I.V., Suborova T.N., Taraban V.K., Furletova N.M., Hasanova S.G., Schetinin E.V., Stratchounski L.S.
Staphylococcus aureus antimicro+ bial resistance antimicrobial resistance nosocomial infections MRSA vancomycin linezolid mupirocin fusidic acid
Section
Antimicrobial Resistance
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2002; 4(4):325-336

Objective.

To determine in vitro activity of antimicrobials against S. aureus isolated from hospitalized patients from different regions of Russia.

Materials and Methods.

A total of 879 clinical strains of S. aureus isolated in 2000–2001 from patients hospitalized in 17medical institutions in different parts of Russia. Susceptibility to 18 antimicrobials: oxacillin, vancomycin, teicoplanin, linezolid, erythromycin, clindamycin, lincomycin, gentamicin, mupirocin, fusidic acid, ciprofloxacin, levofloxacin, moxifloxacin, quinupristin/dalfopristin, rifampicin, trimethoprim/sulfamethoxazole, tetracycline, chloramphenicol was determined by agar dilution method in accordance with the NCCLS recommendations.

Results.

The most potent antimicrobials were vancomycin, linezolid, teicoplanin and fusidic acid to which no resistance was found. The other antimicrobials with low frequency of resistance were mupirocin, trimethoprim/sulfamethoxazole, quin+ upristin/dalfopristin and rifampicin (0,3, 0,8, 1,9 and 4,1% of strains were non+susceptible, respectively). Fluoroquinolones have shown moderate activities. The prevalence of MRSA among tested strains was 33,5% and varied from 0% to 89,5% in different hospitals. The high rates of resistance were found to clindamycin (27,1%), gentamicin (30,7%), tetracycline (37,1%), erythromycin (39,6%) and chloramphenicol (43,1%). Most frequently MRSA were isolated in the burn units (77,5%), ICU (54,8%), traumatology/orthopedics (42,1%). All MRSA were susceptible to vancomycin, teicoplanin, linezolid, fusidic acid and mupirocin; trimethoprim/sulfamethoxazole has shown the high activity as well.

Conclusions.

(1) In the units with low frequency of MRSA (general medical and general surgical units) antistaphylococcal β+lactams can be considered as drugs of choice, alternative can be clindamycin and linezolid. (2) In the units with high frequency of MRSA (burn units, ICU, traumatology/orthopedics) vancomycin is a drug of choice, alternative can be linezolid and combination of fusidic acid and trimethoprim/sulfamethoxazole. (3) For the topical therapy of superficial S. aureus infections mupirocin and fusidic acid can be considered as drugs of choice. (4) The use of macrolides, tetracyclines, and, especially, of chloramphenicol should be significantly reduced.

  • 1. Gardner P., Carles D.G. Infections acquired in a pediatrichospital. J Pediatr 1972; 81:1205-10.
  • 2. Emori T.G., Gaynes R.P. An overview of nosocomialinfections, including the role of the microbiology labora-tory. Clin Microbiol Rev 1993; 6:428-42.
  • 3. Mandell L.A. In: Mandell G.L., Bennett J.E., Raphael D.,editors. Mandell, Douglas, and Bennett’s principles andpractice of infectious diseases. 5th ed. Philadelphia:Churchill Livingston; 2000. p. 306-7.
  • 4. Jorgensen J.H. Laboratory and epidemiologic experiencewith methicillin-resistantStaphylococcus aureusin theUSA. Eur J Clin Microbiol 1986; 5:693-6.
  • 5. Kallen A., Driscoll T., Thornton S., Olson P., Wallace M.Increase in community-acquired methicillin-resistantStaphylococcus aureusat a naval medical center. InfectControl Hosp Epidemiol 2000; 21:223-6.
  • 6. O’Brien F., Pearman J., Gracey M., Riley T., Grubb W.Community strain of methicillin-resistantStaphylo!coccus aureusinvolved in a hospital outbreak.J Clin Microbiol 1999; 37:2858-62.
  • 7. Gosbell I.B., Mercer J.L., Neville S.A., Chant K.G.,Munro R. Community-acquired, non-multiresistantoxacillin-resistantStaphylococcus aureus(NORSA) insouth western Sydney. Pathology 2001; 33:206-10.
  • 8. Presterl E., Mueller-Uri P., Grisold A., Georgopoulos A.,Graninger W. Ciprofloxacin- and methicillin-resistantStaphylococcus aureussusceptible to moxifloxacin, le-vofloxacin, teicoplanin, vamcomycin and linezolid. Eur JClin Microbiol Infect Dis 2001; 20:486-9.
  • 9. National Committee for Clinical Laboratory Standards.Performance standards for antimicrobial susceptibilitytesting; Twelfth informational supplement. NCCLSDocument M100-S4. 2002; 22(1).
  • 10. Statement 1996 CA-SFM. Zone sizes and MIC break-points for non-fastidious organisms. Clin MicrobiolInfect 1996; 2 (Suppl 1):46-9.
  • 11. Богданович Т.М., Страчунский Л.С. Мупироцин:уникальный антибиотик для местного применения.Клин микробиол антимикроб химиотер 1999;1(1):57-65.
  • 12. Turnidge J., Collignon P. Resistance to fusidic acid. Int JAntimicrob Agents 1999; 12 (Suppl 2):35–44.
  • 13. Samra Z., Gadba R., Ofir O. Antibiotic susceptibility andphage typing of methicillin-resistant and sensitiveStaphylococcus aureusclinical isolates at the period du-ring 1991–1997. Eur J Clin Microbiol Infect Dis 2001;20:425-7.
  • 14. O’Neill A.J., Cove J.H., Chopra I. Mutation frequenciesfor resistance to fusidic acid and rifampicin inStaphylococcus aureus. J Antimicrob Chemother 2001;47:647-50.
  • 15. Schmitz F.-J., Fluit A.C., Hafner D., et al. Developmentof resistance to ciprofloxacin, rifampin, and mupirocin inmethicillin-susceptible and -resistantStaphylococcusaureusisolates. Antimicrob Agent Chemother 2000;44:3229-31.
  • 16. Kochman M., Fordymacki P., Lawrynowicz-Pacior M.,et al. Susceptibility to selected chemotherapeuticsStaphylococcus aureusstrains resistant to methicillin iso-lated from clinical materials in the years 1991–1992 and1997. Med Dosw Microbiol 1999; 51:187-98.
  • 17. Perez-Fontan M., Rosales M., Rodriguez-Carmona A.,Falcon T.G., Valdes F. Mupirocin resistance after long-term use forStaphylococcus aureuscolonization inpatients undergoing chronic peritoneal dialysis. Am JKidney Dis 2002; 39:337-41.
  • 18. Swarz M.N. Use of antimicrobial agents and drug resis-tance. N Engl J Med 1997; 337:491-2.
  • 19. Nishijima S., Kurokawa I. Antimicrobial resistance ofStaphylococcus aureusisolated from skin infections. Int JAntimicrob Agents 2002; 19:241-3.
  • 20. Guerin F., Buu-Hoi A., Mainardi J.-L., et al. Outbreak ofmethicillin-resistantStaphylococcus aureuswith reducedsusceptibility to glycopeptides in Parisian hospital. J ClinMicrobiol 2000; 38:2985-8.
  • 21. Rohani M.Y., Raudzah A., Lau M.G., et al. Susceptibilitypattern ofStaphylococcus aureusisolated in Malaysianhospitals. Int J Antimicrob Agents 2000; 13:209-13.
  • 22. Hamilton-Miller J.M.T., Shah S. Patterns of phenotypicresistance to the macrolides-lincosamide-ketolide-strep-togramin group of antibiotics in staphylococci.J Antimicrob Chemother 2000; 46:941-9.
  • 23. Kantzanou M., Tassios P.T., Tseleni-Kotsovili A., et al.A multi-centre study of nosocomial methicillin-resistantStaphylococcus aureusin Greece. Int J Antimicrob Agent1999; 12:115–9.
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