Results from the Survey of Antibiotic Resistance (SOAR) 2016–17 in Ukraine: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints

Torumkuney, D. and Bratus, E. and Yuvko, O. and Pertseva, T. and Morrissey, I. (2020) Results from the Survey of Antibiotic Resistance (SOAR) 2016–17 in Ukraine: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. Journal of Antimicrobial Chemotherapy, V. 75 (1). i100-i111. ISSN 0305-7453 (Print), 1460-2091 (Online)

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Abstract

Objectives: To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates from community-acquired respiratory tract infections (CA-RTIs) collected in 2016–17 from Ukraine. Methods: MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. Results: A total of 177 viable clinical isolates, including 78 S. pneumoniae and 99 H. influenzae, were collected. Overall, 98% of S. pneumoniae isolates were susceptible to penicillin by CLSI IV or EUCAST high-dose breakpoints and 73.1% were susceptible by CLSI oral or EUCAST low-dose IV breakpoints. Susceptibility rates of 76.9%–100% were observed for most antibiotics by all breakpoints except trimethoprim/sulfamethoxazole (41%–69.2%) and cefaclor, which showed the greatest difference between breakpoints: 0% by EUCAST, 28.2% by PK/PD and 73.1% by CLSI. All S. pneumoniae isolates were susceptible to amoxicillin/clavulanic acid by CLSI and PK/PD breakpoints. H. influenzae isolates were almost all b-lactamase negative (90.9%). One isolate was blactamase negative and ampicillin resistant (BLNAR) by CLSI and four isolates were BLNAR by EUCAST criteria. Susceptibility of isolates was high (90.9%) by CLSI breakpoints for all antibiotics tested except trimethoprim/ sulfamethoxazole (61.6%). Susceptibility using EUCAST breakpoints was similar for ampicillin (90.9%) and amoxicillin/clavulanic acid (95%) but was low for cefuroxime (oral), where only 10.1% of isolates were susceptible. All S. pneumoniae and H. influenzae isolates were susceptible to the fluoroquinolones by all breakpoints. Susceptibility to ceftriaxone was also 100% for H. influenzae and 91% for S. pneumoniae isolates by all breakpoints. The application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. Conclusions: Antibiotic susceptibility in these respiratory tract pathogens was generally high in Ukraine. These data are important for empirical therapy choices in the treatment of CA-RTIs.

Item Type:	Article
Additional Information:	Cite D Torumkuney, E Bratus, O Yuvko, T Pertseva, I Morrissey, Results from the Survey of Antibiotic Resistance (SOAR) 2016–17 in Ukraine: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints, Journal of Antimicrobial Chemotherapy, Volume 75, Issue Supplement_1, April 2020, Pages i100–i111, https://doi.org/10.1093/jac/dkaa087 Идентификационный номер: WOS:000537424100008 Идентификатор PubMed: 32337596
Uncontrolled Keywords:	amoxicillin, ampicillin, antibiotics, ceftriaxone, erythromycin, antibiotic resistance, bacterial, penicillin, cefuroxime, clarithromycin, amoxicillin-potassium clavulanate combination, cefaclor, fluoroquinolones, trimethoprim-sulfamethoxazole combination, ukraine, levofloxacin, pharmacodynamics, pathogenic organism, antimicrobial susceptibility, multi-antibiotic resistance
Subjects:	Pharmacology Infectious diseases Microbiology
Divisions:	Departments > Department of Internal Medicine 1 (formerly - Faculty Therapy and Endocrinology)
Depositing User:	Елена Шрамко
Date Deposited:	14 May 2021 13:52
Last Modified:	18 May 2021 12:26
URI:	http://repo.dma.dp.ua/id/eprint/6503

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