RESUMEN
A prospective epidemiological study of the spectrum of causative agents (CA) of uncomplicated urinary tract infections (UTI) in adult patients and CA resistance to antimicrobial drugs was conducted in nine cities of the Russian Federation in 2004-2005. Minimum inhibiting concentrations were ascertained by dilution in agar according to NCCLS (2000-2002) recommendations. The study has found that uncomplicated UTI are most frequently caused by E.coli (73.9%). Other CA occur much less frequently: K.pneumoniae--6.4%, E. faecalis--4.4%, S. epidermidis--4.1%, Staphylococcus spp--3.4%, others--2% patients. E. coli demonstrated high resistance to ampicilline (33.1%), co-trimoxasol (19.4%). Most active against E. coli were fluoroquinolones (norfloxacin, ciprofloxacin, levofloxacine), the resistance being 4.8%; cefalosporins of the second and third generation (cefuroxim, ceftibuten), nitrofurantoin, no resistant strains were found.
Asunto(s)
Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Bacterias Gramnegativas/efectos de los fármacos , Infecciones por Bacterias Gramnegativas/microbiología , Bacterias Grampositivas/efectos de los fármacos , Infecciones por Bacterias Grampositivas/microbiología , Infecciones Urinarias/microbiología , Adolescente , Adulto , Antibacterianos/farmacología , Femenino , Bacterias Gramnegativas/aislamiento & purificación , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Gramnegativas/etiología , Bacterias Grampositivas/aislamiento & purificación , Infecciones por Bacterias Grampositivas/epidemiología , Infecciones por Bacterias Grampositivas/etiología , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Estudios Prospectivos , Infecciones Urinarias/epidemiología , Infecciones Urinarias/etiología , Orina/microbiologíaRESUMEN
A total of 879 Staphylococcus aureus clinical isolates from 17 medical institutions in different regions of Russia were tested. Susceptibility to 18 antimicrobials was determined by agar dilution in accordance with the NCCLS recommendations. The most potent antimicrobials were glycopeptides, linezolid, and fusidic acid, to which no resistance was found. Other antimicrobials with low frequency of non-susceptibility were mupirocin (0.3%), trimethoprim/sulfamethoxazole (0.8%), quinupristin/dalfopristin (1.8%) and rifampicin (7.0%). Fluoroquinolones displayed moderate activity (5.8% of non-susceptible strains to moxifloxacin, 9.1% to levofloxacin, 13.1% to ciprofloxacin). High rates of non-susceptibility were found to clindamycin (27.1%), gentamicin (30.7%), tetracycline (37.1%), erythromycin (39.6%) and chloramphenicol (43.1%). The prevalence of oxacillin-resistant S. aureus (ORSA) was 33.5% and varied from 0% to 89.5% in different hospitals. ORSA were isolated most frequently in the burn units (77.5%), intensive care units (54.8%), trauma and orthopedics units (42.1%). This is the first multicenter study published of antimicrobial resistance of S. aureus in Russia which meets international standards.
Asunto(s)
Antibacterianos/farmacología , Infección Hospitalaria/microbiología , Farmacorresistencia Bacteriana , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificación , Infección Hospitalaria/epidemiología , Humanos , Pruebas de Sensibilidad Microbiana , Estudios Prospectivos , Federación de Rusia/epidemiología , Infecciones Estafilocócicas/epidemiologíaRESUMEN
During the 6-year observation period from 1998 to 2003 in Moscow there was recorded in 2000-2001 a decrease in the emergence of Streptococcos pneumoniae resistance to many antibacterials, while during the following years the respective index increased. The above dynamics in the resistance emergence was likely due to a decrease in the use of antibiotics in 1998-1999. In 2003 the rate of resistance to penicillin was 18.6%, 0.4 and 2.1% of the isolates were resistant to amoxicillin and cefotaxime respectively, the rate of resistance to erythromycin reached 19%, 65.4% of the resistant strains showed M phenotype. High rates of resistance were as well observed with respect to tetracycline (40.1%), co-trimoxazole (29.1%) and chloramphenicol (18.6%). Resistance to levofloxacin and moxifloxacin was detected only in rare strains.
Asunto(s)
Antibacterianos/farmacología , Streptococcus pneumoniae/efectos de los fármacos , Amoxicilina/farmacología , Antibacterianos/uso terapéutico , Cefotaxima/farmacología , Cloranfenicol/farmacología , Resistencia a Medicamentos , Eritromicina/farmacología , Humanos , Moscú , Dinámicas no Lineales , Penicilinas/farmacología , Fenotipo , Infecciones Neumocócicas/tratamiento farmacológico , Infecciones Neumocócicas/microbiología , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/aislamiento & purificación , Tetraciclina/farmacología , Combinación Trimetoprim y Sulfametoxazol/farmacologíaRESUMEN
AIM: To investigate the spectrum of gram-negative agents causing acute and recurrent cystitis in outpatients and sensitivity of uropathogenic E. coli to antibacterial drugs; to compare drug resistance of uropathogenic E. coli isolated in Russia and other countries. MATERIAL AND METHODS: The spectrum of gram-negative bacteria was identified in 299 cases of acute and recurrent cystitis in Moscow, Smolensk and Novosibirsk. 271 E. coli uropathogenic strains were examined according to CA-SFM and NCCLS criteria for sensitivity to ampicilline, gentamycin, trimetoprim, co-trimoxasol, nitrofurantoine, nalidixic acid, pipemidine acid, norfloxacine, ciprofloxacine, nitroxoline. RESULTS: E. coli, K. pneumoniae, K. oxytoca, P. mirabilis, P. vulgaris caused acute and recurrent cystitis in 90.6, 6.4, 1, 1.7, 0.3% of the examinees, respectively. For Moscow relative agents were: E. coli (80.8%), K. pneumoniae (13.1%), K. oxytoca (2.3%), P. mirabilis (3.1%), P. vulgaris (0.7%). In Smolensk E. coli, K. pneumoniae, P. mirabilis were isolated in 96.3, 2.5 and 1.2%, respectively. E. coli occurred in 100% of Novosibirsk cases. Mean Russian values of the resistance to ampicilline, gentamycin, trimetoprim, co-trimoxasol, nitrofurantoin, nalidixic acid, pipemidine acid, norfloxacine, ciprofloxacine, nitroxoline were the following: 33.3, 5.9, 20.3, 18.4, 2.9, 5.5, 4.4, 2.6, 2.6 and 94.1%, respectively. Resistance to 2 and more drugs was registered in 18.4% of E. coli strains. CONCLUSION: Cystitis in women was in most cases caused by E. coli. The highest resistance among uropathogenic strains E. coli was observed to nitroxoline, ampicilline, trimetoprim and co-trimoxasole; maximal antibacterial activity against uropathogenic E. coli was shown by fluoroquinolones (norfloxacin and ciprofloxacin).
Asunto(s)
Farmacorresistencia Microbiana , Bacterias Gramnegativas/efectos de los fármacos , Infecciones por Bacterias Gramnegativas/microbiología , Pacientes Ambulatorios , Infecciones Urinarias/microbiología , Antibacterianos , Quimioterapia Combinada/uso terapéutico , Femenino , Bacterias Gramnegativas/aislamiento & purificación , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Infecciones por Bacterias Gramnegativas/epidemiología , Humanos , Incidencia , Pruebas de Sensibilidad Microbiana , Pacientes Ambulatorios/estadística & datos numéricos , Federación de Rusia/epidemiología , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiología , Orina/microbiologíaRESUMEN
The comparative study of the signs of pathogenicity in 724 enterobacterial strains and in some species of nonfermenting microorganisms isolated from the feces of 115 somatic patients with intestinal dysbacteriosis and 80 healthy persons (565 strains) has revealed that microorganisms belonging to the same species may essentially differ in their occurrence, in the activity of the enzymes (DNAase, RNAase, phosphatase) which they release into the culture medium, as well as in their capacity to give the positive reaction with Congo red. At the same time, the cultures isolated in cases of intestinal dysbacteriosis have been found to be biologically more active.