Clinical Microbiology and Antimicrobial Chemotherapy. 2006; 8(1):33-47
Objective: To assess the level, structure and phenotypes of antimicrobial resistance of Streptococcus pneumoniae in different regions of Russia and to evaluate their dynamics in period from 1999 to 2005.
A total of 1704 S. pneumoniae from 23 cities of Central, North-Western, Southern, Privolgsk, Ural, Siberian and Far-Eastern regions of Russia were included into the study from 1999 to 2005. Susceptibility to 17 antimicrobials was determined by microdilution in accordance with Clinical and Laboratory Standards Institute/National Committee for Clinical Laboratory Standards (CLSI/NCCLS).
β-Lactams retained high activity against S. pneumoniae: resistance to penicillin, amoxicillin, amoxicillin/clavulanic acid and ceftriaxone/cefotaxime was 9.7%, 0.1%, 0%, 1.8% in 1999–2003 and 8.1%, 0.3%, 0.3%, and 2% in 2004–2005, respectively. Resistance to macrolides varied from 2.0% to 8.2% in 1999–2003 and from 4.3% to 6.6% in 2004–2005. Proportion of clindamycin-resistant isolates in above mentioned periods was 2.9% and 3.6%. Susceptibility to chloramphenicolvaried from 92.3% to 94.1%. Resistance to tetracycline was high during 1999–2005 (27.3–29.6%). Resistance to co-trimoxasole increased from 31.7% in 1999–2003 to 40.8% in 2004–2005 (р<0.0001). Vancomycin, levofloxacin, moxifloxacin retained high activity against S. pneumoniae. Proportion of multiresistant S. pneumoniae was 11.8% in 1999–2003 and 9.6% in 2004–2005.
β-Lactams (penicillin, amoxicillin, amoxicillin/clavulanic acid and cefotriaxone/cefotaxime), macrolides, lincosamides, levofloxacin, moxifloxacin, chloramphenicol and vancomycin were the most active against S. pneumoniae. High resistance to co-trimoxasole and tetracycline dictates the necessity to limit the use of these antimicrobials for the treatment of pneumococcal infections.