Profile and phenotypes of resistance of microorganisms from pregnant women with asymptomatic bacteriuria in Russia
Abstract number: p724
Shevelev A., Kulakov V., Ankirskaya A., Nikonov A., Belokrysenko S., Krasnopolski V., Dvoinikova E., Ailamazyan E., Savicheva A., Ershov G., Nikiforovski N., Stratchounski L.
Asymptomatic bacteriuria (ASB) is common during pregnancy. But their adequate empirical antimicrobial treatment is possible only if resistance of the UTI pathogens in region is well established.
During the 20022003 prospective epidemiological study involved 132 pregnant women aged 16 to 43 years with ASB (>105 CFU/ml) at 6 Russian community health-care centres in Moscow, Smolensk, Volgograd and St-Petersburg. After re-identification, MICs for 7 of antimicrobials were determined by agar dilution method and interpreted using NCCLS/CLSI 2003 guidelines.
129 urine isolates with ASB were collected. E. coli was the predominant pathogen (65.1%), followed by Klebsiella spp. (9.3%), Enterobacter spp. (8.5%), P. mirabilis (6.2%), Staphylococcus spp. (3.1%) and Enterococcus spp. (2.3%). Antimicrobial resistance rates of E. coli were as follows: ampicillin29.8%; co-trimoxazole12.0%; gentamicin6.0%; cefuroxime4.8%; amoxicillin/clavulanate3.6%; nitrofurantoin3.6% and fosfomycin0%. The most active antimicrobials (sensitivity 91100%) against Klebsiella spp. were cefuroxime, cefotaxime, gentamicin and fosfomycin; against P. mirabilisamoxicillin/clavulanate, cefuroxime, cefotaxime, gentamicin and fosfomycin; against Enterobacter spp. cefotaxime, gentamicin and fosfomycin.
The main problem with uropathogens in Russia is a high level of E. coli resistance to aminopenicillins and co-trimoxazole. These antimicrobials should no longer be used as drugs of choice in the treatment of ASB. The most active antimicrobials against non-E. coliEnterobacteriaceae isolates were cefotaxime, gentamicin and fosfomycin.
|Session name:||XXIst ISTH Congress|
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