Results from the Survey of Antibiotic Resistance (SOAR) 2018-21 in India: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints
Abstract
OBJECTIVES: Antibiotic susceptibility determination of community-acquired respiratory tract infection (CA-RTI) isolates of Streptococcus pneumoniae and Haemophilus influenzae were collected from India (2018-21).
METHODS: MICs were determined by CLSI broth microdilution; susceptibility data were interpreted using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.
RESULTS: S. pneumoniae (n = 177) and H. influenzae (n = 171) isolates were collected from four hospital laboratories and two private laboratories in India. Only 41.2% pneumococci were penicillin susceptible by CLSI oral/EUCAST low-dose breakpoints, but 94.4% were susceptible by EUCAST high-dose/CLSI IV breakpoints. Good activity (≥89.8%, CLSI or PK/PD breakpoints) was observed for amoxicillin, amoxicillin/clavulanic acid, cefotaxime, ceftriaxone, levofloxacin, and moxifloxacin. Cefdinir and second-generation cephalosporins were less active (27.7%-64.4%). Tetracyclines, macrolides and trimethoprim/sulfamethoxazole showed poor activity (18.6%-31.1%). EUCAST breakpoints indicated >90% susceptibility to high-dose ceftriaxone and penicillin, moxifloxacin and high-dose levofloxacin. Lower susceptibility to other cephalosporins and aminopenicillins was observed with EUCAST versus CLSI or PK/PD breakpoints. Most H. influenzae isolates (91.8%) were β-lactamase negative; 13 and 5 were β-lactamase-negative ampicillin-resistant following EUCAST and CLSI criteria, respectively. Antibiotic susceptibility was…
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