ANTIMICROBIAL RESISTANCE OF <i>Klebsiella pneumonia</i> ISOLATES IN REPUBLIC OF SAKHA (YAKUTIA)

Abstract

The aim of the study was to evaluate the susceptibility to antibiotics of Klebsiella pneumoniae isolates in the Republic of Sakha (Yakutia), according to the AMRmap database. Material and methods. Data of online platform AMRmap in 2010-2016 have been used for evaluation of the sensitivity of K. pneumoniae isolates to antibiotics. Results and discussion. K. pneumoniae isolates comprised 35,7 % of all bacterial nosocomial isolates ( n = 195) and 30,1 % of community-acquired isolates ( n = 382) respectively. Most of the isolates were insusceptible to common antibiotics: aminoglycosides (gentamicin, tobramycin, netilmicin) - 50-78 %; chloramphenicol - 36-43 %, cephalosporins III-V generation (ceftazidime, cefotaxime, zepefin, ceftarolin) - 83-100 %, penicillin drugs with inhibitor of beta-lactamases (ticarcillin-clavulanate, amoxicillin-clavulanate) - 83-98 % monobactams (aztreonam) - 87-95 %, semi-synthetic penicillins of broad spectrum of action (ampicillin) - 100 %, sulfonamides (trimethoprim-sulfamethoxazole) - 53-76 %, fluoroquinolones (ciprofloxacin) - 77 %. At present the next preparations can be effective against K. pneumonia: amikacin (sensitivity 96-100 %), ceftazidime-avibactam (95-97 %), tigecycline (97-100 %), carbapenems (87-97 %), in some cases, phosphomycin (77 %) and piperacillin-tazobactam (64-71 %). Conclusion. The spectrum of drugs for the treatment of infections caused by K. pneumoniae is extremely limited. The further spread of resistance to carbapenems poses a threat of ineffectiveness in the treatment of severe infections. In these conditions, measures are needed to limit the unjustified use of carbapenems. The indicators of resistance of K. pneumoniae to antibiotics should be taken into account not only for the effective treatment of patients, but also for optimizing the costs of regional health care, for example when planning procurement of medicines for hospitals

Keywords

• klebsiella pneumoniae
• klebsiella pneumoniae
• antimicrobial resistance
• nosocomial infections
• community-acquired infection
• republic of sakha (yakutia)
• carbapenems