Antimicrobial Resistance in Russia 2025: Key Results from the Analytical Report of the Methodological Verification Center on AMR (MVC) – the Ministry of Health’s Reference Center for Clinical Pharmacology

Report overview

Title: “Antibiotic Resistance of Bacterial Pathogens Causing Human Infections in the Russian Federation. Analytical Report”
Year: 2025
Prepared by: the Methodological Verification Center on Antimicrobial Resistance (MVC) – the Ministry of Health of Russia’s Reference Center for Clinical Pharmacology

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Data and methodology

The report includes 12,374 clinically significant bacterial isolates collected from 73 medical organizations (36 cities, 7 federal districts). The analysis is based on non-duplicate isolates: no more than one isolate of each species per patient per year. This approach reduces the impact of repeated isolations and improves comparability across time periods and organizations.

Main findings: hospitalized patients

1) Overall pathogen structure among hospitalized patients

The leading pathogens in the overall structure (hospitalized patients) were:

2) Nosocomial infections: predominance of Gram-negative pathogens

For nosocomial infections, the report notes a predominance of Gram-negative bacteria (83.27% of all isolates).
Key groups and pathogens include:

• Enterobacterales – 55.37%, with leading species:
  K. pneumoniae – 30.32%; E. coli – 15.76%.
• Pseudomonas spp. – 14.37%, including P. aeruginosa – 14.32%.
• Acinetobacter spp. – 11.77%, including A. baumannii – 11.00%.

Resistance profiles: key inpatient observations

The indicators below are most relevant for empiric therapy selection, correct interpretation of antibiograms, and infection prevention and control planning.

1) Enterobacterales and Klebsiella pneumoniae: high resistance to β-lactams

The report shows high resistance levels among Enterobacterales (especially K. pneumoniae) to commonly used β-lactams:

• Enterobacterales resistance to amoxicillin/clavulanic acid – 73.68%,
  and to piperacillin/tazobactam – 53.96%;
• for K. pneumoniae, these rates are even higher: 87.23% and 83.17%, respectively.

Other clinically important resistance levels are also noted:

• co-trimoxazole – 55.48% (Enterobacterales) and 61.94% (K. pneumoniae),
• amikacin – 30.75% (Enterobacterales) and 35.82% (K. pneumoniae),
• gentamicin – 40.69% (Enterobacterales) and 55.22% (K. pneumoniae).

2) Carbapenemases in Klebsiella pneumoniae: critical for therapy selection

Among carbapenem-resistant K. pneumoniae, carbapenemases were detected in 64.03% of isolates.
Distribution of carbapenemase types (among carbapenemase producers):

• OXA-48 – 63.46%
• NDM – 48.15%
• KPC – 16.91%
• combinations of carbapenemases from different classes – 28.52%

Practical implication: selection of effective β-lactam/β-lactamase inhibitor options and regimens depends on the resistance mechanism. Therefore, laboratory interpretation and antibiogram comments must be reproducible and methodologically transparent.

3) Acinetobacter baumannii: extremely high resistance to carbapenems

For A. baumannii in the nosocomial setting, the report demonstrates extremely high resistance rates:

• imipenem – 91.34%,
• meropenem – 89.90%,
• ciprofloxacin – 85.82%.

At the same time, among tested treatment options, polymyxins retained activity:
susceptibility to polymyxin B was 98.56%, and no colistin-resistant isolates were detected (in the analyzed dataset).

4) Staphylococcus aureus: proportion of methicillin-resistant isolates

Among S. aureus isolates from hospitalized patients with nosocomial infections, oxacillin resistance (MRSA) was 19.69%.
In the combined hospitalized dataset (community-acquired + nosocomial infections), MRSA prevalence was 13.63%.

Community-acquired infections: what the report shows

The report emphasizes that in several community-acquired scenarios the resistance profile is more favorable; however, important limitations for empiric therapy remain for certain pathogens.

1) Community-acquired urinary tract infections: E. coli and K. pneumoniae

For E. coli in the community-acquired setting, the report notes:

• high resistance to 3rd–4th generation cephalosporins: cefotaxime – 44.44%, cefepime – 27.78%,
• resistance to fluoroquinolones: ciprofloxacin – 45.68%,
• while carbapenem resistance was much less frequent:
  ertapenem – 2.17%, meropenem and imipenem – 0.95% each.

2) Enterococcus faecium: significant constraints for therapy

For E. faecium, the report shows high resistance rates:

• ampicillin – 92.57%,
• vancomycin – 40.00%,
• high-level gentamicin resistance – 59.63%.

Conclusions of the report: what is stated about antibiotics (management relevance)

The report’s conclusions include points important for procurement planning and formulary work:

1. Increased demand is expected for certain agents and combinations used in severe infections with high resistance rates, including:

• aztreonam/avibactam,
• ceftazidime/avibactam (including in combination with aztreonam under specific resistance mechanisms),
• polymyxins,
• tigecycline,
• sulbactam,
• piperacillin/tazobactam.

2. Demand for carbapenems will remain high.

3. The report also states that, for a number of newer antibacterial agents, clinical advantages should be assessed strictly in the context of local resistance structure and available alternatives (to avoid unjustified replacement of effective regimens).

Brief practical summary

The report provides a large-scale, comparable national picture and helps identify pathogen groups and antimicrobial classes requiring priority attention. At the same time, decision-making in a specific healthcare organization requires local data, stratified by wards, patient profiles, and clinical scenarios.

Even a high-quality national report cannot fully represent local epidemiology. The most objective assessment for a hospital is achieved when it has a validated local microbiological report and regular surveillance with minimal delay.

In other words, the report provides a framework, while the accuracy of clinical and management decisions depends on local data. This is why the key practical tasks are reproducible antibiogram interpretation and real-time AMR surveillance. The ABioGram system is designed to address these tasks.