G Soyletir1, G Altinkanat1, D Gur2, B Altun2, A Tunger3, S Aydemir3, C Kayacan4, Z Aktas4, M Gunaydin5, A Karadag5, H Gorur6, I Morrissey7, D Torumkuney8. 1. Marmara University Medical Faculty, Department of Medical Microbiology, Istanbul, Turkey. 2. Hacettepe University Medical Faculty, Department of Medical Microbiology, Ankara, Turkey. 3. Ege University Medical Faculty, Department of Medical Microbiology, Izmir, Turkey. 4. Istanbul University, Istanbul Medical Faculty, Department of Medical Microbiology, Istanbul, Turkey. 5. Ondokuz Mayıs University Medical Faculty, Department of Medical Microbiology, Samsun, Turkey. 6. GlaxoSmithKline Turkey, Buyukdere Cad. 1. Levent Plaza, No. 173, B Blok, 34394, Istanbul, Turkey. 7. IHMA Europe Sàrl, 9A route de la Corniche, Epalinges 1066, Switzerland. 8. GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK didem.x.torumkuney@gsk.com.
Abstract
OBJECTIVES: Data are presented from the Survey of Antibiotic Resistance (SOAR) for respiratory tract infection pathogens collected in 2011-13 from Turkey. METHODS: MICs were determined using Etest(®). Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) interpretive criteria. RESULTS: Rates of antibiotic susceptibility were very low among 333 isolates of Streptococcus pneumoniae tested: penicillin 38% using CLSI (oral) and EUCAST breakpoints; erythromycin 51% using CLSI and EUCAST criteria; and cefuroxime 64.6% using CLSI and PK/PD and 46.9% using EUCAST. Of the isolates, >90% were susceptible to amoxicillin/clavulanic acid, ceftriaxone (except using EUCAST criteria: 76%), levofloxacin and high-dose intravenous penicillin. Among 339 Haemophilus influenzae isolates, 6.8% were β-lactamase positive while 9.1% were β-lactamase negative but ampicillin resistant (BLNAR) by CLSI (14.7% by EUCAST) criteria. Amoxicillin/clavulanic acid susceptibility was ∼90% by CLSI (with or without BLNAR adjustment, EUCAST and high-dose PK/PD) but lower, at 82.9%, by EUCAST with BLNAR adjustment. Levofloxacin susceptibility was 96% using all three breakpoints. Dramatic differences in rates of susceptibility, depending on the breakpoints used, were seen for cefaclor [94% by CLSI (86.4% BLNAR adjusted), 23% by PK/PD] and cefuroxime [97% by CLSI (89.1% BLNAR adjusted), 85% by PK/PD, 15% by EUCAST (13.0% BLNAR adjusted)]. Streptococcus pyogenes (n = 222) and Moraxella catarrhalis (n = 40) isolates remained highly susceptible to amoxicillin/clavulanic acid, cephalosporins and levofloxacin, with only erythromycin susceptibility dropping below 95% for S. pyogenes. CONCLUSIONS: Overall, amoxicillin/clavulanic acid and levofloxacin were the most active antibiotics based on all three breakpoints against these pathogens. Although susceptibility was not universally low in Turkey, high resistance rates were found in S. pneumoniae and, when using PK/PD and EUCAST breakpoints, in other respiratory pathogens.
OBJECTIVES: Data are presented from the Survey of Antibiotic Resistance (SOAR) for respiratory tract infection pathogens collected in 2011-13 from Turkey. METHODS: MICs were determined using Etest(®). Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) interpretive criteria. RESULTS: Rates of antibiotic susceptibility were very low among 333 isolates of Streptococcus pneumoniae tested: penicillin 38% using CLSI (oral) and EUCAST breakpoints; erythromycin 51% using CLSI and EUCAST criteria; and cefuroxime 64.6% using CLSI and PK/PD and 46.9% using EUCAST. Of the isolates, >90% were susceptible to amoxicillin/clavulanic acid, ceftriaxone (except using EUCAST criteria: 76%), levofloxacin and high-dose intravenous penicillin. Among 339 Haemophilus influenzae isolates, 6.8% were β-lactamase positive while 9.1% were β-lactamase negative but ampicillin resistant (BLNAR) by CLSI (14.7% by EUCAST) criteria. Amoxicillin/clavulanic acid susceptibility was ∼90% by CLSI (with or without BLNAR adjustment, EUCAST and high-dose PK/PD) but lower, at 82.9%, by EUCAST with BLNAR adjustment. Levofloxacin susceptibility was 96% using all three breakpoints. Dramatic differences in rates of susceptibility, depending on the breakpoints used, were seen for cefaclor [94% by CLSI (86.4% BLNAR adjusted), 23% by PK/PD] and cefuroxime [97% by CLSI (89.1% BLNAR adjusted), 85% by PK/PD, 15% by EUCAST (13.0% BLNAR adjusted)]. Streptococcus pyogenes (n = 222) and Moraxella catarrhalis (n = 40) isolates remained highly susceptible to amoxicillin/clavulanic acid, cephalosporins and levofloxacin, with only erythromycin susceptibility dropping below 95% for S. pyogenes. CONCLUSIONS: Overall, amoxicillin/clavulanic acid and levofloxacin were the most active antibiotics based on all three breakpoints against these pathogens. Although susceptibility was not universally low in Turkey, high resistance rates were found in S. pneumoniae and, when using PK/PD and EUCAST breakpoints, in other respiratory pathogens.
Authors: Jeff Powis; Allison McGeer; Carla Duncan; Ryan Goren; Joyce C S de Azavedo; Darrin J Bast; Sylvia Pong-Porter; Tony Mazzulli; Karen Green; Barbara Willey; Donald E Low Journal: Antimicrob Agents Chemother Date: 2005-05 Impact factor: 5.191
Authors: D Torumkuney; D Gur; G Soyletir; N Gurler; Z Aktas; B Sener; A Tunger; G Bayramoglu; I Koksal; A N Yalcin; Y Tanriver; I Morrissey; K Barker Journal: J Antimicrob Chemother Date: 2016-05 Impact factor: 5.790
Authors: D Torumkuney; R Chaiwarith; W Reechaipichitkul; K Malatham; V Chareonphaibul; C Rodrigues; D S Chitins; M Dias; S Anandan; S Kanakapura; Y J Park; K Lee; H Lee; J Y Kim; Y Lee; H K Lee; J H Kim; T Y Tan; Y X Heng; P Mukherjee; I Morrissey Journal: J Antimicrob Chemother Date: 2016-05 Impact factor: 5.790