ARIMB – Multicentre prospective epidemiologic research of antibiotic resistance in urinary tract infection pathogens in pregnancy
6 medical centers from 4 Russian cities took part in the project.
- Moscow (3)
- St. Petersburg
- Smolensk
- Volgograd
Pregnant women with acute cystitis (AC) and asymptomatic bacteriuria (AB), who had a pathogen in diagnostic titre during urine microbacteriological work-up, were enrolled in this research.
All collected microorganisms (186) were sent to the central laboratory IAC, where it was carried out re-identification of 100% strains and determination of susceptibility to 8 antibiotics by agar dilution method according to NCCLS, 2003 [10].
The received data were put down in the Clinical Report Forms (CRF) and in electronic data-base, made in Microsoft Access 2000. Calculation of the comparative figures of antibiotic resistance was performed by M-Lab program.
Over the period of investigation (March - October 2002) 190 pregnant women were enrolled - 58 (30,5%) with AC and 132 (69,5%) - with AB, who had a pathogen in diagnostic titre during urine microbacteriological work-up. The average age of the patients was 26.53±5.13.
The main pathogens of AC and AB in pregnant are representatives of genus Enterobacteriaceae, found in 86,0% cases. The most frequent uropathogen is E.coli, met in 62,9% patients. The other pathogens were isolated much more seldom - Klebsiella spp. in 9,7%, P.mirabilis - in 6,5%, Enterobacter spp. - in 6,5%, Staphylococcus spp. - in 4,8% and others.
Among tested antibiotics the most active in relation of E.coli was fosfomicin (100%). A little lower percent of resistant strains was isolated to gentamicin (4,3%), nitrofurantion (4,3%), amoxiclav (4,3%) cefuroxim (3,4%), cefotaxim (1,7%). The highest level of resistance in tested strains E.coli was noted to ampecilin (31,6%) and co-trimoxazol (14,5%).
In relation of Klebsiella spp. and P.mirabilis the most active medicine was fosfomicin (100%), cefuroxim (94,1 and 100,0%), cefotaxim (100,0%) and gentamicin (100,0%), in relation to Enterobacter spp. - cefotaxim (100,0%) and gentamicin (100,0%), the activity of fosfomicin was 91,7%.
If you are interested in obtaining the results, please, contact study coordinator Dr. Alexey Shevelev at shevelev@antibiotic.ru
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