Antimicrobial Resistance of Streptococcus pneumoniae in Russia over the 1999–2009: Results of Multicenter Prospective Study PEHASus | CMAC

Antimicrobial Resistance of Streptococcus pneumoniae in Russia over the 1999–2009: Results of Multicenter Prospective Study PEHASus

Clinical Microbiology and Antimicrobial Chemotherapy. 2010; 12(4):329-341

​ Kozlov R.S., Sivaya O.V., Krechikova O.I., Ivanchik N.V., Study Group «PEHASus»
Streptococcus pneumoniae pneumococci antimicrobial resistance
Section
Antimicrobial Resistance
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2010; 12(4):329-341

Objective.

To assess antimicrobial resistance and its trends among Streptococcus pneumoniae in different regions of Russia over the 1999-2009.

Materials and Methods.

A total of 2419 S. pneumoniae strains from different cities of Central, NorthWestern, Southern, Volga, Ural, Siberia, Far-Eastern regions of Russia were included into the study over the period from 1999 to 2009. Susceptibility to 23 antimicrobials was determined using microdilution method according to Clinical and Laboratory Standards Institute (CLSI) guidelines.

Results.

Beta-lactams keep active against pneumococci. Over the period of 1999-2009, resistance rates to penicillin, amoxicillin, amoxicillin/clavulanic acid, amoxicillin/sulbactam, cefixime, ceftibuten, ceftriaxone/ cefotaxime, and ertapenem did not exceed 11%, 0.4%, 0.4%, 0.4%, 6.8%, 12.9%, 1.0% and 0%, respectively. Resistance to 14⁄15-membered and 16-mebered macrolides was stable over the study period (no more than 8.2% and 6.3%, respectively). Proportion of clindamycin non-susceptible strains varied from 2.9% in 1999–2003 to 4.5% in 2006–2009. The most active (100%) against S. pneumoniae were respiratory fluoroquinolones (levofloxacin, moxifloxacin, gemifloxacin). There was found a 2-fold decrease in ciprofloxacin resistance from 16.1% in 1999–2003 to 7.8% in 2006–2009. In vitro activity of chloramphenicol had no significant changes over the study period (92.3 to 94.1% of strains were susceptible). Over the 1999–2009, resistance to tetracycline remained high: 27.3% in 1999–2003 and 24.6% in 2006–2009. Co-trimoxazole demonstrated constantly lower activity against tested pneumococci (31.7 to 39% of strains were resistant). All S. pneumoniae strains (100%) were susceptible to vancomycin.

Conclusions.

Therefore, beta-lactams (amoxicillin, amoxicillin/clavulanic acid, amoxicillin/sulbactam, cefixime, ceftriaxone/cefotaxime, ertapenem), macrolides, lincosamides, levofloxacin, moxifloxacin, chloramphenicol, and vancomycin are the most active antimicrobial agents against S. pneumoniae. High resistance rates to tetracycline and co-trimoxazole require limiting their use for the treatment of pneumococcal infections.

  • 1. Гаращенко Т.И., Богомильский М.Р., Стребкова О.А. Рос. ринология 2002; (2):108-11.
  • 2. Boronina L.G. Aetiology of community-acquired pneumoniae in children // Poster Abstract / Int J Antimicrobl Agents 24S. 2004; S124-252.
  • 3. Musher D.M., Breiman R.F., Tomasz A. Streptococcus pneumoniae: At the Threshold of the 21st Century. Streptococcus pneumoniae: molecular biology & mechanisms of disease. Tomasz A., editor. Larchmont: Mary Ann Liebert Inc.; 2000. p. 485-91.
  • 4. Severin A., Severina E., Tomasz A. Abnormal physiological properties and altered cell wall composition in Streptococcus pneumoniae grown in the presence of clavulanic acid. Antimicrob Agents Chemother 1997; 41:504- 10.
  • 5. Turner D., Leibovitz E., Aran A., et al. Acute otitis media in infants younger than two months of age: microbiology, clinical presentation and therapeutic approach. Pediatr Infect Dis J 2002; 21:669-74.
  • 6. Vishniakova L.A., Nikitina M.A., Petrova S.I., Vydumkina S.P., Papaian A.V. Etiology of the epidemic outbreak of community-acquired pneumoniaa in children in St. Petersburg. Zh Microbial Epidemiol Immunobiol 2004; (5):7-12.
  • 7. Чучалин А.Г. Предисловие // Пневмония / Под ред. Чучалина А. Г., Синопальникова А. И., Черняховской Н. Е.  М.: Экономика и информация; 2002. C. 7-8.
  • 8. Principi N., Marchisio P. Schito G.C., Mannelli S. Risk factors for carriage of respiratory pathogens in the nasopharynx of healthy children. Pediatr Infect Dis J 1999; 18:517-23.
  • 9. Bartlett J.С., Mundy L.M. Community-acquired pneumonia. N Engl J Med 1995; 33:1618-24.
  • 10. Heffelfinger J.D., Dowell S.F., Jorgensen J.H., et al. Management of community-acquired pneumoniae in the era of pneumococcal resistance: a report from the drugresistance Streptococcus pneumoniae therapeutic working group. Arch Intern Med 2000; 160:1399-408.
  • 11. Gooch III W.M., Golanty S.A. A Review of Treatment Guidelines in an Era of Drug-Resistant Pneumococcal Pathogens: a Review of Otitis Media Guidelines. Laguna Niguel, CA: The Institute of Medical Studies, 2000: p. 1- 19.
  • 12. CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Nineteenth Informational Supplement. CLSI document M100-S19. Wayne, PA: Clinical and Laboratory Standards Institute; 2009; 72-75.
  • 13. Statement 2003 CA-SFM. Zone sizes and MIC breakpoints for non-fastidious organisms. Clin Microbiol Infect 2003; 2:S46-S48.
  • 14. Jenkins S.G., Brown S.D., Farrell D.J. Trends in antimicrobial resistance among Streptococcus pneumoniae isolated in the USA: update from PROTEKT US Years 1-4. Ann Clin Microbiol Antimicrob 2008; 11:7-11.
  • 15. Perez Trallero E., Martin Yerrero J.E. Mazon A., et al. Antimicrobial resistance among respiratory pathogens in Spain: latest data and changes over 11 years (1996-1997 to 2006-2007). Antimicrob Agents Chemother 2008; 54:2953-9.
  • 16. Inoue M., Farrell D.J., Kaneko K., et al. Antimicrobial susceptibility of respiratory tract pathogens in Japan during PROTEKT years 1-5 (1999-2004). Microb Drug Resist 2008; 14:109-17.
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