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

• Main Authors: Palagin I.S., Sukhorukova M.V., Dekhnich A.V., Edelstein M.V., Perepanova T.S., Kozlov R.S., “DARMIS-2018” Study Group
• Format: Article
• Language: Russian
• Published: Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy 2019-10-01
• Series: Клиническая микробиология и антимикробная химиотерапия
• Subjects: community-acquired urinary tract infections; uropathogens; escherichia coli; antimicrobial resistance
• Online Access: https://cmac-journal.ru/publication/2019/2/cmac-2019-t21-n2-p134/cmac-2019-t21-n2-p134.pdf

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.