Clinical Microbiology and Antimicrobial Chemotherapy. 2010; 12(4):329-341
To assess antimicrobial resistance and its trends among Streptococcus pneumoniae in different regions of Russia over the 1999-2009.
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.
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.
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.