Antimicrobial resistance of pathogens causing community-acquired urinary tract infections in Russia: results of the multicenter study “DARMIS-2018”

Clinical Microbiology and Antimicrobial Chemotherapy. 2019; 21(2):134-146

Type
Original Article

Objective.

To study in vitro activity of antimicrobials against clinical isolates from patients with communityacquired urinary tract infections (UTIs) in different regions of Russia in 2017–2018.

Materials and Methods.

A total of 1052 Enterobacterales isolates collected in the Russian Federation as part of a multicenter, prospective, epidemiological study of the antimicrobial resistance of uropathogens causing community-acquired UTI in different subsets of patients (“DARMIS-2018”) were included in the analysis. Uropathogens were isolated from children and adults of both sexes in all age groups with acute (and recurrences of chronic) community-acquired UTIs, including pregnant women with asymptomatic bacteriuria in 32 centers of 24 cities of Russia in 2017–2018.

Results.

Enterobacterales comprised a total of 90.6% of all isolated bacterial pathogens (90.6% in the adult subset; 89.3% in the pregnant women subset and 93.8% in the children and adolescents subset). The most prevalent species were Escherichia coli (71.3% in the adult subset; 73.6% in the pregnant women subset; 79.7% in the children and adolescents subset) and Klebsiella pneumoniae (11.7% in the adult subset; 10.4% in the pregnant women subset; 7.8% in the children and adolescents subset). The highest activity against E. coli among the oral antimicrobials was demonstrated for fosfomycin (97.7% in the adult subset; 95.9% in the pregnant women subset; 99.0% in the children and adolescents subset) and nitrofurantoin (98.1% in adult subset; 100% in the pregnant women subset; 97.1% in the children and adolescents subset). Among the parenteral antimicrobials, meropenem and amikacin showed the highest activity (99.4% and 97.9% in the adult subset; 99.5% and 99.1% in the pregnant women subset; 100% and 97.1% in the children and adolescents subset, respectively). Ampicillin, amoxicillin/clavulanic acid and trimethoprim/sulfamethoxazole demonstrated the lowest in vitro activity against E. coli (less than 80% per each patient subset). The susceptibility of E. coli isolates to ciprofloxacin was 60.6% in the adult subset; 80.0% in the pregnant women subset and 80.4% in the children and adolescents subset. The rates of extended spectrum beta-lactamase production based on the results of phenotypic tests were 27.0% in the adult subset; 8.6% in the pregnant women subset and 23.5% in the children and adolescents subset.

Conclusions.

Results of this study indicated the increase in resistance of community-acquired isolates of Enterobacterales (particularly E. coli) to the most of antimicrobials in Russia.

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