Антибиотики и Химиотерапия (May 2020)
The Etiological Structure and Antibiotic Resistance of Pathogens of Community-Acquired Infections of the Urinary Tract in St. Petersburg, 2013-2015
Abstract
A retrospective analysis of the results of diagnosis of urinary tract infections and antibiotic susceptibility of pathogens isolated from patients from outpatient clinics in 2013-2015 was conducted. 1118 isolates (76.6%) were obtained from women aged 18 to 91 years (mean age 46.3+22.2 years) and 341 (23.4%) from men aged 19 to 85 years (mean age 52.1+19.7 years). Among 1459 uropathogens, representatives of the Enterobacteriaceae family (77.0%) prevailed, while, gram-positive bacteria (18.3%) and non-fermenting gram-negative bacteria (4.2%) were less common. The lowest level of resistance was exhibited by isolates of E.coli: 45.7% of isolates were resistant to ampicillin, 39.7% - to inhibitor-protected penicillins, up to 21.7% - to fluoroquinolones, 17.5-18.7% - to cephalosporins, up to 10,7% - to aminoglycosides. Along with carbapenems, high activity against Escherichia coli was retained by nitrofurantoin, to which only 7.0% of isolates were insensitive. The greatest level of resistance was detected among enterobacteria of Citrobacter freundii, Morganella spp., Serratia spp., Cedecea spp., Providencia spp. Resistance to oxacillin showed more than 40% of both Staphylococcus aureus and coagulase-negative staphylococci. The spread of resistance to cephalosporins of III-IV generations among Enterobacteriaceae should be considered as the most unfavorable trend, which is probably associated with production of extended-spectrum beta-lactamases.
