Susceptibilities of Yersinia pestis to Twelve Antimicrobial Agents in China

Streptomycin is the preferred choice for therapy of plague in China and other countries. However, Yersinia pestis exhibiting plasmid-mediated antimicrobial agent–resistant traits had been reported in Madagascar. In this study, we evaluated the susceptibility of traditional or newer antimicrobial agents used for treatment and/or prophylaxis of plague. Following Clinical and Laboratory Standards Institute (CLSI) recommendations, the susceptibility of 12 antimicrobial agents was evaluated by the agar microdilution method in 1,012 strains of Y. pestis isolated from 1943 to 2017 in 12 natural plague foci in China. One clinical Y. pestis isolate (S19960127) was found to be highly resistant to streptomycin, while the strain was still sensitive to other 11 antibiotics, that is, ciprofloxacin, ofloxacin, kanamycin, chloramphenicol, ampicillin, ceftriaxone, cefuroxime, trimethoprim-sulfamethoxazole, tetracycline, spectinomycin and moxifloxacin. The remaining 1,011 Y. pestis strains in this study demonstrated susceptibility to the above-mentioned 12 antimicrobial agents. Antimicrobial sensitivity surveillance of Y. pestis isolates, including dynamic monitoring of streptomycin resistance during various clinical plague treatments, should be carried out routinely.