ArticleThe Journal of antimicrobial chemotherapy2025
Results from the Survey of Antibiotic Resistance (SOAR) 2018-21 in Ukraine: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.
Article in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo determine the antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae from community-acquired respiratory tract infections (CA-RTIs) collected in 2018-21 from Ukraine.
methodsMICs were determined by CLSI broth microdilution test, and susceptibility data were interpreted using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.
resultsS. pneumoniae (n = 64) and H. influenzae (n = 76) isolates were collected in 2018-21. Antibiotic susceptibility was 82.8% for pneumococci penicillin-susceptible by CLSI oral/EUCAST low-dose breakpoints and 98.4% by EUCAST high-dose/CLSI intravenous breakpoints. Fluoroquinolones were the most active (100% susceptible). CLSI susceptibility of 85.9%-96.9% was also observed for amoxicillin, amoxicillin/clavulanic acid and cephalosporins. Tetracycline and macrolide susceptibility was 73.4%-76.6%, and trimethoprim/sulfamethoxazole was 59.4%. EUCAST susceptibility was similar if high-dose regimens were chosen, although susceptibility to trimethoprim/sulfamethoxazole was 79.7%. Most H. influenzae isolates were β-lactamase negative (n = 72, 94.7%) with >94.7% susceptibility, except for trimethoprim/sulfamethoxazole (61.8% by CLSI/EUCAST low-dose, 68.4% by EUCAST high-dose). Susceptibility using EUCAST breakpoints was similar to CLSI, except cefuroxime (oral) with 0% of isolates susceptible versus 100% by CLSI. Cefaclor susceptibility was 11.8% using PK/PD breakpoints.
conclusionsFor H. influenzae, 100% susceptibility (CLSI) was observed to amoxicillin/clavulanic acid, macrolides, most cephalosporins and tetracycline. S. pneumoniae susceptibility was 100% to fluoroquinolones, 90.6%-96.9% to third-generation cephalosporins and 96.9% to amoxicillin and amoxicillin/clavulanic acid. This is consistent with previous resistance surveillance in Ukraine. Continued surveillance of antibiotic susceptibility is important for guiding empiric therapy of CA-RTIs.
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