Frequency of strains with multiple antibiotic resistance in the structure of opportunitistic pathogens

   Background. The problem of antibiotic resistance has remained significant for the medical community for more than half a century, since the first cases of resistance to penicillin were registered.
   The aim. Analysis of the long-term dynamics of changes in the antibacterial resistance of microorganisms and the creation of a collection of multi-resistant strains of opportunistic microorganisms.
   Materials and methods. The study included data from 3173 bacteriological samples of various loci of the human body for 2010 and 2020–2021. The sensitivity of isolated cultures was determined by the disk diffusion method to antimicrobial drugs of the following groups: penicillins, cephalosporins, fluoroquinolones, aminoglycosides, carbapenems, tetracyclines, macrolides, lincosamides, oxazolidinones, glycopeptides and others.
   Results. In the general structure of conditionally pathogenic microorganisms, a significant increase in the frequency of isolation of multidrug-resistant representatives of the genus Staphylococcus by two or more times was observed in 2021 compared to 2010 and 2020. We also observed a significant increase in the proportion of multidrug-resistant Streptococcus spp. and non-fermenting gram-negative bacteria. These changes marked the beginning of the creation of a collection of conditionally pathogenic microorganisms with multiple antibacterial resistance. In the structure of multiresistant microorganisms included in the “Collection of human microbiota of the Irkutsk region”, the leading positions belong to Klebsiella pneumoniae (23.81 %), Escherichia coli (19.05 %) and Staphylococcus aureus (22.22 %).
   Conclusion. Antibiotic resistance monitoring is an important measure to control the resistance of community-acquired and nosocomial (nosocomial) microorganisms both within a particular country and globally.

1. Ferri M., Ranucci E., Romagnoli P., Giaccone V. Antimicrobial resistance: a global emerging threat to public health systems. Crit Rev Food Sci Nutr. 2017; 57 (13): 2857-2876. doi: 10.1080/10408398.2015.1077192

2. Sultan I., Rahman S., Jan A. T., Siddiqui M. T., Mondal A. H., Haq Q. M. Antibiotics, resistome and resistance mechanisms: A bacterial perspective. Front Microbiol. 2018; 9: 2066. doi: 10.3389/fmicb.2018.02066

3. Chaudhary A. S. A review of global initiatives to fight antibiotic resistance and recent antibiotics’ discovery. Acta Pharm Sin B. 2016; 6 (6): 552-556. doi: 10.1016/j.apsb.2016.06.004

4. Beloborodova V. B., Brusina E. B., Kozlov R. S., Eliseeva E. V., Suvorova M. P., Zamyatin M. N., et al. SCAT program (antimicrobial control strategy) in the provision of inpatient care: Clinical recommendations. Moscow: Pero; 2018. (In Russ.).

5. Rao P., Stroup S., Mirawdaly S., Aartsen D., Dillingham R., Heysell S. K., et al. Urine colometry for levofloxacin pharmacokinetic and personalized dosing in people with drug-resistant tuberculosis. Int J Mycobacteriol. 2020; 9 (4): 411-416. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034232/

6. Kuz’menkov A. Yu., Vinogradova A. G., Trushin I. V., Edelstejn M. V., Avramenko A. A., Dekhnich A. V., et al. AMRmap – antibiotic resistance surveillance system in Russia. Clinical Microbiology and Antimicrobial Chemotherapy. 2021; 23 (2): 198-204. (In Russ). doi: 10.36488/cmac.2021.2.198-204

7. Efimenko T. A., Terekhova L. P., Efremenkova O. V. Current state the problem of antibiotic resistance of pathogens. Antibiotics and Chemotherapy. 2019; 64: 5-6. (In Russ). URL: https://www.antibiotics-chemotherapy.ru/jour/article/view/144/0?locale=ru_RU

8. Savilov E. D., Astaf’ev V. A., Zhdanova S. N., Zarudnev E. A. Epidemiological analysis. Methods of statistical processing of material. Novosibirsk; 2011. (In Russ.).

9. Sukhorukova M. V., Sekleenova E. Yu., Ivanochik N. V., Timohova A. V., Ejdel’shtejn M. V., Dekhnich A. V., et al. Antimicrobial resistance of nosocomial Staphylococcus aureus isolates in Russia: Results of National Multicenter Surveillance Study «MARATHON» 2011–2012. Clinical Microbiology and Antimicrobial Chemotherapy. 2014; 16 (4): 280-286. (In Russ.).

10. Fesenko O. V., Shvajko S. N. Pneumonia caused by Klebsiella pneumoniae (Friedlander’s pneumonia). The Journal of Practical Pulmonology. 2019; 1: 22-31. (in Russ.).

11. Fyodorova A. V., Klyasova G. A., Frolova I. N., Khrulnova S. A., Vetokhina A. V., Kaporskaya T. S., et al. Antimicrobial resistance of Enterococcus faecium and Enterococcus faecalis, isolated from blood culture of patients with hematological malignancies during different study periods. Oncohematology. 2021; 16 (1): 54-63. (In Russ.). doi: 10.17650/1818-8346-2021-16-1-54-63

12. Boucher H. W., Talbot G. H., Bradley J. S., Edwards J. E., Gilbert D., Riceet L. B., et al. Bad bugs, no drugs: No ESKAPE! An update from the Infectious Diseases Society of America. Clin Infect Dis. 2009; 48 (1): 1-12. doi: 10.1086/595011

13. World Health Organization (WHO). Global priority list of antibiotic- resistant bacteria to guide research, discovery, and development of new antibiotics. URL: URL: https://www.doherty.edu.au/news-events/news/who-global-priority-pathogens-list-of-antibiotic-resistant-bacteria#:~:text=They%20include%20Acinetobacter%2C%20Pseudomonas%20and,as%20bloodstream%20infections%20and%20pneumonia [date of access: 25. 06. 2022].

14. Sukhorukova M. V., Edelstein M. V., Ivanchik N. V., Skleenova E. Yu., Shajdullina E. R., Azizov I. S., et al. Antibiotic resistance of nosocomial strains of Enterobacterales in Russian hospitals: Results of the multicenter epidemiological study “MARATHON 2015–2016”. Clinical Microbiology and Antimicrobial Chemotherapy. 2019; 21(2): 147-159. (In Russ.). doi: 10.36488/cmac.2019.2.147-159

15. Noskova O. A., Agapova E. D., Baturina E. A., Gvak G. V. Microbiological monitoring in the system of epidemiological surveillance of purulent-septic infections in a multidisciplinary hospital. Acta biomedica scientifica. 2019; 4 (5): 122-126. (In Russ.). doi: 10.29413/ABS.2019-4.5.19

16. Vereshchagina S. A., Fedoseeva M. V., Radnaeva G. G., Belokhvostikova T. S., Fadeeva T. V. Dynamics of antibiotic resistance of nosocomial pathogens and state of antibiotic therapy in multifield clinic. Acta biomedica scientifica. 2012; 4 (86): 186-189. (In Russ.).

17. Andreeva S. V., Bakhareva L. I., Valeeva D. M. Dynamics of antibiotic resistance in the leading pathogens of burn infections. Vestnik Chelyabinskogo gosudarstvennogo universiteta. 2013; 7 (298): 60-61. (In Russ.).

18. Grebenyuk V. V., Kovtunov K. A., Nazarov A. A., Cumachenko I. V. Resistance of pathogenic microflora to antibiotic therapy in patients with surgical sepsis. Eurasian Union of Scientists. 2015; 10-1 (19): 73-76. (In Russ.).

19. Al-Tawfiq J. A., Rabaan A. A., Saunar J. V., Bazzi A. M. Antimicrobial resistance of gram-negative bacteria: A six-year longitudinal study in a hospital in Saudi Arabia. J Infect Public Health. 2020; 13 (5): 737-745. doi: 10.1016/j.jiph.2020.01.004