Clinical Microbiology and Antimicrobial Chemotherapy. 2002; 4(4):325-336
To determine in vitro activity of antimicrobials against S. aureus isolated from hospitalized patients from different regions of Russia.
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.
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.
(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.