Scientific Center of the Ministry of Health of the Russian Federation of Monitoring Antimicrobial Resistance
Scientific Center of Monitoring Antimicrobial Resistance of the Ministry of Health of Russia was founded on the basis of Department of Clinical Pharmacology, Smolensk State Medical Academy according to order N 50 of Ministry of Health issued on 9 February 2000.
The main objectives of the center
- Methodological and organizational work on antimicrobial resistance monitoring in Russian Federation and harmonization with various international surveillance programs
- Development the evidence-based guidelines for the Ministry of Health on optimization of antimicrobial use in various infections in different Russian regions in respect with interregional distinctions in the spread and level of resistance
The main activities
- Planning, organization, coordination and implementation of antimicrobial resistance surveys in Russian Federation
- Collection and analysis of data on antimicrobial resistance among community-acquired and nosocomial pathogens
- Maintenance and renewal the collection of clinical and control strains
- Organization and conducting conferences, professional meetings, lectures, scientific workshops elucidating the problems of antimicrobial resistance for enhancing interaction between microbiologists and clinicians, exchanging information and stimulation of new researches.
NPRS - Nosocomial gram-negative bacteria Prevalence and Resistance Survey in units with intensive use of antimicrobials (mainly in ICUs). The prevalence of nosocomial gram-negative pathogens was evaluated and minimal inhibitory concentrations of 12 antimicrobials from different groups (beta-lactams, aminoglycosides, fluoroquinolones) were determined by E-tests. There were three phases of the study.
Phase I began in 1994. There were 3 participating centers: Scientific Center of Surgery and State Research Center of Antibiotics in Moscow and State Medical Academy in Smolensk. A total of 300 gram-negative nosocomial strains were studied and analyzed.
Phase II of the survey was carried out in 1995-1996 in 10 centers: Moscow (2 centers), St-Petersburg, Nizhnij Novgorod, Krasnodar, Ekaterinburg, Kazan, Novosibirsk, Krasnoyarsk. A total of 1005 gram-negative nosocomial strains were collected. An Information Bulletin («Current status of antimicrobial resistance in gram-negative nosocomial bacteria in ICUs») was published joined with Interdepartmental Scientific Board on hospital-acquired infections of the Russian Academy of Medical Sciences and Ministry of Health of Russian Federation, also data were presented as an article in the Journal of Clinical Microbiology and Infection (J Clin Microbiol Infect 1998; 4:497-507). [Poster]
Phase III was carried out in 1997-2000 in 28 ICUs from 15 centers of different regions of Russia including Moscow (9 centers), St-Petersburg (3 centers), Smolensk, Ryazan, Nizhnij Novgorod, Krasnodar (2 centers), Stavropol, Kazan (2 centers), Ekaterinburg (2 centers), Tomsk, Novosibirsk, Ufa, Omsk, Krasnoyarsk (2 centers), Vladivostok. A total of 2664 aerobic NGNB were isolated. Recommendations for the Ministry of Health for optimization of antimicrobial chemotherapy of gram-negative nosocomial infections are developed. Results of the study are presented at the 41st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, USA [Poster 007/67].
Survey of antimicrobial resistance in Shigella flexneri and S.sonnei. A total of 200 Shigella spp strains were isolated during 1998-1999 in two centers of Smolensk region [Poster 1241].
UTIAP - multicenter prospective surveillance of bacterial etiology of urinary tract infections and antimicrobial resistance of urinary tract pathogens in adults.
In 1998 in the frame of phase I 299 gram-negative bacteria isolated from outpatients with acute uncomplicated urinary tract infections (UTI) were collected from the 4 Russian centers in Moscow (2 centers), Smolensk and Novosibirsk [Poster P0344].
During phase II both uncomplicated and complicated UTIs were studied. Four centers in Ekaterinburg, Rostov-na-Donu, Saint-Petersburg and Smolensk took part in this study providing a total of 295 strains of urinary pathogens.
Strains from both phases were evaluated for the resistance to 10 antimicrobials commonly used for the treatment of UTIs: ampicillin, gentamicin, trimethoprim, co-trimoxazole, nitrofurantoin, pipemidic and nalidixic acids, niroxolin, norfloxacin and ciprofloxacin.
ARMID-2000 - Multicenter surveillance of antimicrobial resistance of urinary pathogens in children. During that study in 11 centers from different parts of Russia (Moscow, Saint-Petersburg, Smolensk, Kazan, Ekaterinburg, Orenburg, Irkutsk, Nizhnij Novgorod) a total of 770 strains were collected. Minimal inhibitor concentrations of 21 antimicrobials (including beta-lactams, aminoglycosides, quinolones, co-trimoxazole, nitroxoline, fosfomycine, nitrofuranoine) were determined using agar dilution method.
ARGon - surveillance of the antimicrobial resistance in N.gonorrhoeae (Antibiotic Resistance in GONococci) is intended to determine the level of antimicrobial resistance in N.gonorrhoeae. It is the pilot study of such kind in Russia. Susceptibility of 100 strains isolated from ambulatory patients was determined to penicillin G, tetracycline, ciprofloxacin, ceftriaxone. On the base of obtained results an Information Bulletin «Antibiotic Susceptibility of Gonococci and the Optimum treatment of gonococcal infection» was issued in 1998 by the IACMAC in collaboration with Russian Association for Prophylaxis of Sexually Transmitted Diseases, results of the study was also presented on 21 Interntional congress on Chemotherapy, Birmingham, 4-7 July 1999. [Poster P188]
The antimicrobial resistance monitoring of N.gonorrhoeae will be proceeded in several geographically separated areas of Russia. On the time being 150 strains from Moscow and Smolensk are collected.
PeGASus is the first multicenter prospective study of the antibiotic resistance in of the common pathogens causing upper respiratory tract infections (S.pneumoniae, H.influenzae and S.pyogenes) in Russia started in 1998. It involves 18 participating microbiological laboratories in 12 cities of various Russian regions including Moscow (6 centers), St-Petersburg (2 centers), Kazan, Ekaterinburg (2 centers), Omsk, Novosibirsk, Tomsk, Krasnodar, Smolensk, Nizhnij Novgorod, Ryazan, Ufa and total of 500 strains were collected and studied.
CRoChA («Baby») - the study of nasopharyngeal carriage of S.pneumoniae and H.influenzae in healthy children attending day care centers. The rate of nasopharyngeal carriage of S.pneumoniae and H.influenzae in healthy children attending day-care centers in Moscow, Smolensk and Yartcevo (Smolensk region) was studied and the antimicrobial resistance determined in 1997-1998.
A total of 733 children at the age of 1-6 years from 10 day-care centers in Moscow, Smolensk and Yartstevo were examined and 410 strains of S.pneumoniae and 321 strains of H.influenzae were isolated. The resistance to beta-lactams, macrolides, tetracycline and co-trimoxazole was determined with Etests method. The obtained data were published in Pediatric Infectious Diseases Journal (Pediatr Infect Dis J, 2000; 19:196-20), in International Journal of Antimicrobial Agents (Int J Antimicrob Agents 2001; 18: 347-351) and were also presented on 9th ESCMID, Berlin, 21-25 March, 1999 [Poster P0581].
EQA - WHO/CDC/IACMAC external quality assurance program. Since 1997 External Quality Assurance Program has been conducted to assess quality and to determine the overall accuracy of antimicrobial susceptibility testing in Russian microbiological laboratories. The program is established under the permission of WHO/CDC which provided us with the schedule and the control strains.
In Phase I 18 laboratories in Smolensk (5 labs), in Smolensk region (4 labs), Moscow, Kazan, Nizhnekamsk, Ekaterinburg, Novosibirsk were asked to perform antimicrobial susceptibility testing of control strains E.coli ATCC 25922 and S.aureus ATCC 25923 daily during 10 days and of control strains of K.pneumoniae, S.aureus, E.faecium and E.cloacae granted by WHO/CDC once. Obtained results were presented on 9th ESCMID, Berlin, 21-25 March, 1999 [Poster P1196].
In phase II 53 laboratories in 28 Russian cities performed identification and antimicrobial susceptibility testing of 5 control strains of gram-positive bacteria granted by CDC (CDC-103 - CDC-107) to a defined set of antimicrobials. The results of this phase were presented on International Congress on Chemotherapy in Amsterdam, 2001 [Poster].
StEnt is a prospective multicenter study of epidemiology and antimicrobial resistance in nosocomial strains of staphylococci and enterococci.
Since 1997 17 centers in 13 Russian cities and towns became participants of the study. More than 900 S.aureus and more than 300 Enterococcus spp. were collected. Antimicrobial sensitivity testing was performed by the agar dilution method to antibiotics most commonly used in the treatment of staphylococcal and enterococcal infections. Completed data will be published soon.
[Poster P1034] [Poster 443]
- European Surveillance of Antibiotic Consumption (ESAC).
- Multicenter surveillance nasopharyngeal carriage of S.pneumoniae in closed communities (SPARS, 11 centers).
- Multicenter surveillance of antimicrobial resistance in pathogens of acute bacterial sinusitis in adults (SSSR).
- External quality assurance program for identification and antimicrobial susceptibility testing (IACMAC-EQA).