Russia is recording a rise in antibiotic resistance across all types of enterobacteria, according to a report by the Methodological Verification Center for Antimicrobial Resistance of the Ministry of Health cited by Vedomosti. The most acute problem is the resistance of Klebsiella pneumoniae and Escherichia coli strains to widely used classes of antibiotics: cephalosporins, fluoroquinolones, and inhibitor-protected penicillins.
Enterobacteria cause more than half of all hospital-acquired infections (55%), states the document. Their most common pathogens are considered to be Klebsiella pneumoniae (30%), E. coli (15%), and Pseudomonas aeruginosa (14%). Klebsiella pneumoniae and E. coli are part of the normal microflora of the human intestine, but when they enter other organs, they can become pathogens of severe infections, especially in people with weakened immune systems.
Resistance to cephalosporins is demonstrated by 59-70% of enterobacteria species and 84–86% of hospital-acquired Klebsiella pneumoniae strains. A high level of resistance is also observed regarding fluoroquinolones and inhibitor-protected penicillins: 64% of enterobacteria and 83% of Klebsiella pneumoniae to the former, and 75% and 87% to the latter, respectively.
The resistance rates of these bacteria continue to grow, but the situation does not cause critical concern, said Roman Kozlov, chief consultantspecialist of the Ministry of Health in clinical microbiology and antimicrobial resistance. He says E. coli and Klebsiella pneumoniae are characterized by clonal spread (sudden appearance and rapid spread of resistant strain-clones), and their resistance rates depend on how successfully bacterial strains establish themselves in new habitats. Nevertheless, specialists recommend reducing the use of third- and fourth-generation cephalosporins and fluoroquinolones.
Strains of enterobacteria with multiple resistance are increasingly being detected: 27% of them produce two types of carbapenemases (enzymes providing resistance to last-line defense antibiotics, carbapenems), and 0.34% produce three types. For the treatment of such infections, ceftazidime-avibactam and its combination with aztreonam are used. Nevertheless, strains of E. coli and Klebsiella pneumoniae resistant to them have been recorded in Russia.
In the first 10 months of 2025, according to DSM Group, spending on antibiotics increased by 3.8% compared to the same period in 2024, reaching 55.53 billion rubles. 15% of this volume was accounted for by purchases of amoxicillin-clavulanate (belongs to the class of inhibitor-protected penicillins), another 10% by purchases of cefixime (a third-generation cephalosporin). The volume of government purchases increased by 11.3% — from 10.87 billion to 12.1 billion rubles.
