title: Results from the Survey of Antibiotic Resistance (SOAR) 2011-13 in Ukraine.
abstract: OBJECTIVE
  To determine the antibiotic susceptibility of respiratory isolates of Streptococcus pneumoniae and Haemophilus influenzae collected in 2011-13 from Ukraine.
  
  
  METHODS
  MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.
  
  
  RESULTS
  A total of 134 isolates of S. pneumoniae and 67 of H. influenzae were collected from eight sites in Ukraine. Overall, 87.3% of S. pneumoniae were penicillin susceptible by CLSI oral breakpoints and 99.3% by CLSI iv breakpoints. Susceptibility to amoxicillin/clavulanic acid (amoxicillin), ceftriaxone and levofloxacin was 100% by CLSI and PK/PD breakpoints. Cephalosporin and macrolide susceptibility was ≥95.5% and 88.1%, respectively using CLSI breakpoints. Trimethoprim/sulfamethoxazole was essentially inactive against pneumococci. Of the 67 H. influenzae tested, 4.5% were β-lactamase positive and all H. influenzae were fully susceptible to amoxicillin/clavulanic acid, ceftriaxone, ciprofloxacin, cefixime and levofloxacin (all breakpoints). Cefuroxime susceptibility was 100% by CLSI but 73.1% by EUCAST and PK/PD breakpoints. A discrepancy was found in macrolide susceptibility between CLSI (∼100% susceptible), EUCAST (22%-43% susceptible) and PK/PD (0%-22% susceptible) breakpoints. Trimethoprim/sulfamethoxazole was poorly active (59.7% susceptible).
  
  
  CONCLUSIONS
  Generally, antibiotic resistance was low in respiratory pathogens from Ukraine. However, only amoxicillin/clavulanic acid (amoxicillin), ceftriaxone and levofloxacin were fully active against both species. Trimethoprim/sulfamethoxazole was the least active, particularly against S. pneumoniae. Some susceptibility differences were apparent between CLSI, EUCAST and PK/PD breakpoints, especially with macrolides against H. influenzae. These data suggest that further efforts are required to harmonize these international breakpoints. Future studies are warranted to monitor continued low resistance levels in Ukraine compared with other parts of Eastern Europe.
authors.affiliation: State Organization National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky, National Academy of Medical Sciences of Ukraine, 10 Amosova Str., 03680, Kiev, Ukraine.
authors.forename: Y
authors.initials: Y
authors.lastname: Feshchenko
authors.affiliation: State Organization National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky, National Academy of Medical Sciences of Ukraine, 10 Amosova Str., 03680, Kiev, Ukraine.
authors.forename: A
authors.initials: A
authors.lastname: Dzyublik
authors.affiliation: Dnepropetrovsk State Medical Academy, 4 Dzovtneva Square 49027, Dnepropetrovsk, Ukraine.
authors.forename: T
authors.initials: T
authors.lastname: Pertseva
authors.affiliation: Dnepropetrovsk State Medical Academy, Diagnostic Center, 4 Dzovtneva Square 49027, Dnepropetrovsk, Ukraine.
authors.forename: E
authors.initials: E
authors.lastname: Bratus
authors.affiliation: State Organization National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky, National Academy of Medical Sciences of Ukraine, 10 Amosova Str., 03680, Kiev, Ukraine.
authors.forename: Y
authors.initials: Y
authors.lastname: Dzyublik
authors.affiliation: GlaxoSmithKline Ukraine, Pavla Tychyny Avenue, 1-V, 02152, Kiev, Ukraine.
authors.forename: G
authors.initials: G
authors.lastname: Gladka
authors.affiliation: IHMA Europe Sàrl, 9A route de la Corniche, Epalinges 1066, Switzerland.
authors.forename: I
authors.initials: I
authors.lastname: Morrissey
authors.affiliation: GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK didem.x.torumkuney@gsk.com.
authors.forename: D
authors.initials: D
authors.lastname: Torumkuney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D062665:Epidemiological Monitoring; D005260:Female; D006192:Haemophilus Infections / Q000453:epidemiology / Q000382:microbiology*; D006193:Haemophilus influenzae / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D014455:Ukraine / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents