Objective. To review the basic principles and functionality of the AMRmap online resource. Materials and Methods. The AMRmap platform was developed using the R programming language and various downloadable modules – packages. The current annually updated version of EUCAST clinical breakpoints was applied for determination of categories of susceptibility to antimicrobial agents. Descriptive analysis includes calculation of absolute and relative frequencies, median values, and confidence intervals using the Wilson method. Categorical variables are compared using Fisher’s exact test and Holm correction method for multiple comparisons. The algorithms are used to visualize multiple comparisons, kernel regression for trend analysis, and algorithms for finding associative rules. Results. The developed surveillance system includes modules for filtering, analyzing and visualizing antibiotic resistance data. The filters allow creating a sample of data with a specific list of parameters. A tab-based separation of analysis and visualization options ensure efficient stepwise evaluation of results. Data saving and sharing functions are also provided. Conclusions. This web-based informatics system provides a convenient way to AMR data from prospective microbiological surveillance studies in Russia. AMRmap can be accessed at https://amrmap.ru.

Objective. To assess rates of antimicrobial resistance and production of the clinically important acquired resistance mechanisms (extended spectrum beta-lactamases [ESBL] and carbapenemases) in nosocomial strains of Enterobacterales, and to determine genotypes and prevalence of “international high-risk clones” among carbapenemase-producing Klebsiella pneumoniae isolated in various Russian regions within the “MARATHON 2015–2016“ study. Materials and Methods. A total of 2786 non-duplicate nosocomial isolates of Enterobacterales, including 1316 isolates of K. pneumoniae and 837 isolates of Escherichia coli isolated in 49 hospitals from 25 cities in Russia in 2015–2016 were studied.

Antimicrobial resistance is a growing threat to global public health and requires closer attention from the medical community. Antibiotic resistance monitoring systems play a key role in observing the antimicrobial susceptibility changes for rational prescribing antimicrobial therapy. Most current systems use data on a global scale; however, local data evaluation is more important for practical application. Unique AMRcloud online platform (http://amrcloud.net) was developed to process user data on antimicrobial resistance. Structural modules are modified to address the needs of researchers. The application has powerful graphic capabilities, data analysis system with automated interpretation of the antimicrobial susceptibility testing results. Geocoding is performed in a double way, and information exchange of results is adjusted by user. The use of AMRcloud allows researchers to create their own methodology for organizing primary data and their evaluation.

Objective. To study the prevalence and mechanisms of antibiotic resistance, including carbapenemase production, in clinical isolates of Klebsiella pneumoniae and Escherichia coli isolated in different regions of Russia as part of the sentinel multicenter surveillance study in 2020–2021, and to explore the population structure of K. pneumoniae and the impact of “high-risk clones” on antibiotic resistance. Materials and Methods. Consecutive, non-duplicate isolates of K. pneumoniae (n = 2503) and E. coli (n = 2055) isolated from various specimens (blood, cerebrospinal fluid, respiratory samples, urine, wound secretions, etc.) of hospitalized patients with clinical signs of infection in 55 hospitals of 29 cities of Russia were studied. Species identification of isolates was performed by matrix-assisted laser desorption/ ionization time-of-flight mass spectrometry (MALDI-TOF MS). Antibiotic susceptibilities were determined by serial broth microdilution or, in the case of fosfomycin, by agar dilution method, and results were interpreted according to EUCAST v13 MIC breakpoints. Carbapenemase production was determined phenotypically by carbapenem inactivation method (CIM), the presence of genes of the most common serine carbapenemases (KPC, OXA-48) and metallo-β-lactamases (VIM, IMP, NDM) was determined by real-time PCR. K. pneumoniae clinical isolates were genotyped and assigned to the known clonal complexes (CC) and sequence types (ST) using SNP typing and multilocus sequencing typing (MLST) methods. K- and O-serotypes, acquired resistance and virulence genes, and plasmids carrying these genes were characterized using whole-genome sequencing of selected isolates (n = 215). Results. The resistance rates of nosocomial/community-acquired isolates of K. pneumoniae were as follows: amoxicillin-clavulanate – 88.63⁄57.99%, piperacillin-tazobactam – 82.92⁄45.49%, cefotaxime – 87.74⁄56.97%, ceftazidime – 84.76⁄53.07%, cefepime – 81.43⁄49.18%, aztreonam – 1.63⁄53.28%, ceftazidime-avibactam – 30, 88⁄9.22%, ceftolozan-tazobactam – 70.06/31.35%, ertapenem – 72.10⁄28.69%, meropenem – 49.60⁄15.16%, imipenem – 44.54⁄13.73%, gentamicin – 60.82⁄30.33%, amikacin – 42.06/17.21%, ciprofloxacin – 85.10⁄49.39%; trimethoprimsulfamethoxazole – 74.38⁄48.16%, colistin – 5.96⁄2.25%. The resistance of nosocomial/outpatient isolates of E. coli were: ampicillin – 84.93⁄67.67%, amoxicillin-clavulanate – 57.37⁄39.73%, piperacillin-tazobactam – 19.48⁄8.70%, cefotaxime – 63.83⁄34.19%, ceftazidime – 45.32⁄20.34%, cefepime – 35.95⁄16.61%, aztreonam – 51.78⁄26.11%, ceftazidime-avibactam – 5.71⁄0.80%, ceftolozane-tazobactam – 11, 95⁄2.22%, ertapenem – 8.18⁄1.42%, meropenem – 5.17⁄0.53%, imipenem – 4.95⁄0.36%, gentamicin – 24.54⁄13.68%, amikacin – 5.49⁄1.42%, ciprofloxacin – 54, 14⁄32.50%, trimethoprim-sulfamethoxazole – 52.21⁄38.54%, fosfomycin – 2.48⁄1.43%, colistin – 1.60⁄1.07%, tigecycline – 6.35⁄3.11%. The frequency of carbapenemase production among K. pneumoniae nosocomial isolates was 65.32% (OXA-48 – 40.75%, NDM – 30.28%, KPC – 8.74%, OXA-48 + NDM – 10.62%, OXA-48 + KPC – 2.98%, NDM + KPC – 0.45%, OXA-48 + NDM + KPC – 0.20%). More than 70% of nosocomial isolates of K. pneumoniae belonged to only 7 major genetic lineages known as “high-risk international clones”: CC395 – 37.40%, CC23 – 9.59%, CC307 – 8.64%, CC147 – 7.61%, CC15 – 2.95%, CC258 – 2.92%, and CC11 – 2.41%. The population of community-acquired K. pneumoniae was characterized by significantly greater genetic diversity (Simpson diversity index: D = 0.919; 95% CI: 0.904 to 0.933) compared with the population of nosocomial strains (Simpson diversity index: D = 0.815; 95% CI: 0.802 to 0.827). Strains of the “hypervirulent” genetic lineage of K. pneumoniae CC23 were more common in community-acquired infections. Conclusions. The extremely high frequency of resistance to cephalosporins in K. pneumoniae (> 80%) and E. coli (> 60%), as well as the high frequency of combined resistance to aminoglycosides and fluoroquinolones precludes their empirical use for the treatment of serious nosocomial infections caused by these pathogens. K. pneumoniae shows a rapid increase in resistance to carbapenems, mainly due to the spread of carbapenemases of three major groups: OXA-48, NDM and KPC. The overall increase in the frequency of carbapenemase production is accompanied by the growing diversity of carbapenemases, the increasing prevalence of strains producing NDM and KPC enzymes and those co-producing multiple carbapenemases simultaneously. In community-acquired infections, the high prevalence of resistance to cephalosporins in E. coli (> 30%) and K. pneumoniae (> 50%) remains the most important problem.

Objective. Objectives. To assess the rates of antibiotic resistance and production of acquired carbapenemases in nosocomial strains of Acinetobacter spp., and to determine the genotypes and prevalence of “international high-risk clones” among nosocomial strains of Acinetobacter baumannii isolated in various regions of Russia within the “MARATHON 2015–2016” study. Materials and Methods. A total of 1005 non-duplicate nosocomial isolates of Acinetobacter spp., including 975 isolates of A. baumannii, collected in 44 hospitals from 25 cities in Russia in 2015– 2016 were studied.

Objective. Objectives. To assess the rates of antibiotic resistance, production of acquired carbapenemases, genotypes and prevalence of «international high-risk clones» among nosocomial strains of Pseudomonas aeruginosa isolated in various regions of Russia within the «MARATHON 2015–2016» study. Materials and Methods. A total of 1006 non-duplicate nosocomial isolates of P. aeruginosa collected in 44 hospitals from 25 cities in Russia in 2015–2016 were studied. Species identification of isolates was performed by means of MALDI-TOF mass-spectrometry.