Clinical Microbiology and Antimicrobial Chemotherapy. 2014; 16(1):33-38
Objectives. To analyze etiology and antimicrobial resistance of pathogens causing complicated community-acquired urinary tract infections (cUTI) in adult patients in different regions of Russia.
Uropathogens isolated from urine samples of patients of both gender older than 18 years of age with community-acquired UTI were collected in 21 centers of 17 cities in Russia during 2010–2011 and included in the «DARMIS» study.
Among the collected 518 strains isolated from adult patients 282 strains (54,4%) were isolated from urine of patients with cUTI. Enterobacteriaceae (79,8%) and E. coli (61,4%) were the most prevalent identified microorganisms causing cUTI in adults. Antimicrobial resistance rates of E. coli were as follows: ampicillin — 53,2%; amoxicillin/clavulanic acid — 46,2%; ampicillin/ sulbactam — 46,8%; piperacillin — 47,4%; piperacillin/tazobactam — 4,6%; cefotaxime — 13,9%; ceftazidime — 11,0%; cefixime — 18,5%; ceftibuten — 12,1%; cefepime — 10,4%; amikacin — 0,6%; gentamicin — 11,0%; ciprofloxacin — 27,7%; levofloxacin — 27,1%; cotrimoxazole — 31,8%; nitrofurantoin — 2,9%; fosfomycin — 1,7%; ertapenem — 0,6%. No resistant strains of E. coli were detected. ESBL-production was found in 13,9% of E. coli and in 19,6% of all Enterobacteriaceae strains.
The most active oral drug against E. coli were fosfomycin, nitrofurantoin and furazidin. However, out of oral antibiotics only fosfomycin demonstrated activity against more than 90% of all Enterobacteriaceae spp. strains. Out of parenteral drugs the most active against E. coli were carbapenems (meropenem, imipenem and ertapenem), amikacin and piperacillin/tazobactam. Carbapenems were also the most active parenteral antimicrobials against all Enterobacteriaceae strains.