Results from the Survey of Antibiotic Resistance (SOAR) 2014-16 in Russia
Results from the Survey of Antibiotic Resistance (SOAR) 2014-16 in Russia
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DOI：
10.1093/jac/dky065
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发表时间：
2018-04-01
影响因子：
5.2
通讯作者：
Morrissey, I.
中科院分区：
文献类型：
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作者：
Torumkuney, D.;Mayanskiy, N.;Morrissey, I.
目的：为确定2014-16年从俄罗斯收集的肺炎链球菌和流感嗜血杆菌分离株的抗生素敏感性。方法：采用CLSI肉汤微量稀释法测定MIC，并使用CLSI、EUCAST和药代动力学/药效学（PK/PD）折点评估敏感性。pneumoniae和279株H.收集流感病毒。总的来说，67.0%的S.根据CLSI口服/EUCAST和CLSI静脉（iv）折点，肺炎链球菌对青霉素敏感率为93.2%。所有患者均对氟喹诺酮类药物敏感，根据CLSI和PK/PD折点，阿莫西林、阿莫西林/克拉维酸和头孢曲松敏感性>= 92.8%。对头孢呋辛、头孢克洛、大环内酯类和复方新诺明的敏感率分别为85.0%、76.7%、68.8%和67.7%。一般来说，根据EUCAST标准，敏感性略低，但头孢克洛除外，其敏感性差异更大。青霉素耐药分离株的敏感性较低（≥ 97.5%为阿莫西林/克拉维酸敏感（CLSI、EUCAST和PK/PD折点））。根据现行EUCAST标准，4株分离株对氟喹诺酮类药物不敏感。发现CLSI（99.3%）与EUCAST和PK/PD（2.2%）折点之间的阿奇霉素敏感性存在重大差异。结论：沙门氏菌对青霉素（口服）、大环内酯类和甲氧苄啶/磺胺甲恶唑的敏感性较低。来自俄罗斯的肺炎。然而，分离株对氟喹诺酮类药物完全敏感，>= 92.8%的分离株对阿莫西林、阿莫西林/克拉维酸和头孢曲松敏感。分离到H.流感病毒仅对氨苄西林、头孢克洛、克拉霉素和甲氧苄啶/磺胺甲恶唑敏感性降低。在CLSI、EUCAST和PK/PD折点之间检测到一些差异，尤其是头孢克洛、头孢呋辛和大环内酯类。这些数据表明，需要进一步努力统一国际折点。
Objectives: To determine antibiotic susceptibility in isolates of Streptococcus pneumoniae and Haemophilus influenzae collected in 2014-16 from Russia.Methods: MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.Results: A total of 279 S. pneumoniae and 279 H. influenzae were collected. Overall, 67.0% of S. pneumoniae were penicillin susceptible by CLSI oral/EUCAST and 93.2% by CLSI intravenous (iv) breakpoints. All were fluoroquinolone susceptible, with amoxicillin, amoxicillin/clavulanic acid and ceftriaxone susceptibility >= 92.8% by CLSI and PK/PD breakpoints. Isolates showed lower susceptibility to cefuroxime, cefaclor, macrolides and trime-thoprim/sulfamethoxazole by CLSI criteria: 85.0%, 76.7%, 68.8% and 67.7%, respectively. Generally, susceptibility was slightly lower by EUCAST criteria, except for cefaclor, for which the difference in susceptibility was much greater. Penicillin-resistant isolates had low susceptibility (= 97.5% were amoxicillin/clavulanic acid susceptible (CLSI, EUCAST and PK/PD breakpoints). Four isolates were fluoroquinolone nonsusceptible by current EUCAST criteria. A major discrepancy was found with azithromycin susceptibility between CLSI (99.3%) and EUCAST and PK/PD (2.2%) breakpoints. Trimethoprim/sulfamethoxazole was poorly active (62.7% susceptible).Conclusions: Susceptibility to penicillin (oral), macrolides and trimethoprim/sulfamethoxazole was low in S. pneumoniae from Russia. However, isolates were fully susceptible to fluoroquinolones and >= 92.8% were susceptible to amoxicillin, amoxicillin/clavulanic acid and ceftriaxone. Isolates of H. influenzae only showed reduced susceptibility to ampicillin, cefaclor, clarithromycin and trimethoprim/sulfamethoxazole. Some differences were detected between CLSI, EUCAST and PK/PD breakpoints, especially with cefaclor, cefuroxime and macrolides. These data suggest further efforts are required to harmonize international breakpoints.