Results from the Survey of Antibiotic Resistance (SOAR) 2015-17 in Turkey: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints
| Autor: | Zerrin Aktaş, Belgin Altun, Asiye Bıçakçıgil, Cigdem Bal Kayacan, D Torumkuney, Ian Morrissey, Alper Tünger, Banu Sancak |
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| Přispěvatelé: | Ege Üniversitesi |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Turkey 030106 microbiology Microbial Sensitivity Tests Cefpodoxime Microbiology 03 medical and health sciences 0302 clinical medicine Ampicillin Clavulanic acid Drug Resistance Bacterial polycyclic compounds medicine Humans Pharmacology (medical) 030212 general & internal medicine Respiratory Tract Infections Pharmacology business.industry Sulfamethoxazole Broth microdilution Amoxicillin Trimethoprim Haemophilus influenzae Anti-Bacterial Agents Infectious Diseases Streptococcus pneumoniae Epidemiological Monitoring business Cefuroxime medicine.drug |
| Zdroj: | The Journal of antimicrobial chemotherapy. 75(Suppl 1) |
| ISSN: | 1460-2091 |
| Popis: | Objectives: To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates from community-acquired respiratory tract infections (CA-RTIs) collected in 2015-17 from Turkey. Methods: MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. Results: A total of 179 S. pneumoniae and 239 H. influenzae isolates were collected. Few (27.9%) pneumococci were penicillin susceptible by CLSI oral or EUCAST low-dose breakpoints, but by EUCAST high-dose or CLSI IV breakpoints 84.4% were susceptible. the most active antibiotics (excluding penicillin IV) by CLSI breakpoints were fluoroquinolones (98.9% of isolates susceptible), ceftriaxone (83.2%), amoxicillin (78.8%) and amoxicillin/clavulanic acid (78.8%). Pneumococcal susceptibility to amoxicillin and amoxicillin/clavulanic acid was lower using EUCAST low-dose breakpoints (49.7%), although susceptibility increased when using EUCAST high-dose (57.0%-58.1%) and PK/PD (78.8%-87.7%) breakpoints. Twenty-three H. influenzae isolates were beta-lactamase positive, with 11 characterized as beta-lactamase negative and ampicillin resistant following EUCAST criteria and 5 by CLSI criteria. Generally antibiotic susceptibility was high using CLSI breakpoints: >= 92.9% for all antibiotics except ampicillin (87% by CLSI and EUCAST breakpoints) and trimethoprim/sulfamethoxazole (67.4% and 72% by CLSI and EUCAST breakpoints, respectively). Susceptibility using EUCAST breakpoints (where these are published) was similar, except for cefuroxime (oral) with 3.8% of isolates susceptible. PK/PD breakpoints indicated low susceptibility to macrolides (5.9%-10%) and cefaclor (13%). the application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. Conclusions: Antibiotic susceptibility of S. pneumoniae was generally low, which is in keeping with evidence of inappropriate and high antibiotic use in Turkey. H. influenzae susceptibility was high. These data are important for empirical therapy of CA-RTIs. GlaxoSmithKlineGlaxoSmithKline This study was funded by GlaxoSmithKline. |
| Databáze: | OpenAIRE |
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