Emergence of Metronidazole-Resistant<i>Bacteroides fragilis</i>, India

Chaudhry, Rama; Mathur, Purva; Dhawan, Benu; Kumar, Lalit

doi:10.3201/eid0703.017332

Cited by 26 publications

(12 citation statements)

References 11 publications

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“…The results of current research showed isolated B. fragilis are sensitive to metronidazole and imipenem, which is in accordance with the findings of some researchers (12,13). However, totally resistant strains obtained from animals and human against imipenem (15,16), and strains resistant to metronidazole were also found in different studies (17,18).…”

Section: Discussionsupporting

confidence: 89%

Determination of Antibiotic Sensitivity of Bacteroid fragilis Isolated from Patients and Healthy Individuals in Imam Reza Center of Medical Teaching and Treatment-Tabriz

Akhi

Shirinzadeh

Ghotaslou

et al. 2013

Jundishapur J Microbiol

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Background:Bacteroides fragilis are among the most important anaerobic bacteria behind most of the anaerobic infections. They have acquired resistance to essential treatment antibiotics of anaerobic infections, more than other anaerobic bacteria. Objectives: The goal of this study is to determine the resistance of isolated B. fragilis against common anaerobic infections treatment antibiotics. Patients and Methods: A total of 188 fecal samples including 59 samples from hospitalized patients, 84 samples from outpatients, and 45 samples from healthy individuals were collected. The samples were cultured in Bacteroides-Bile-Esculine agar and KanamycinVancomycin-Laked Blood media and were incubated in anaerobic atmosphere at 37°C for at least 48 hours. Suspected one millimeter sized colonies with black surroundings, were selected and further studied using MID8, as well as biochemical tests. For MIC determination of antibiotics against isolated B. fragilis, Etest was used. Results: There wasn't any difference between antibiotic resistance patterns of isolated B. fragilis from hospitalized patients or outpatients, including diarrheal and non-diarrheal cases, and resistant pattern of isolates from healthy individuals. All or most of isolated B. fragilis were susceptible to imipenem (100%), metronidazole (95%), rifampin (100%) and piperacillin/tazobactam (95%). On the contrary, they exhibited resistance to other antibiotics such as clindamycin (90%), and chloramphenicol (55%). Conclusions:In the present study, we have figured out that a number of the important anaerobic infections treatment antibiotics have lost partly or totally their effectiveness on B. fragilis.

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Section: Discussionsupporting

confidence: 89%

Determination of Antibiotic Sensitivity of Bacteroid fragilis Isolated from Patients and Healthy Individuals in Imam Reza Center of Medical Teaching and Treatment-Tabriz

Akhi

Shirinzadeh

Ghotaslou

et al. 2013

Jundishapur J Microbiol

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“…Resistance genes nimA to -F, which have been implicated in sporadic cases of metronidazole resistance in several hospitals worldwide, have been identified on transferable plasmids (56,148,279). Transferable plasmid-linked chloramphenicol acetyltransferase conferring high-level resistance was observed in a clinical isolate of Bacteroides uniformis (152).…”

Section: Mobile Genetic Elements In Bacteroidesmentioning

confidence: 99%

“…Resistance is generally attributed to changes in the nim genes or associated genes (e.g., IS) (30,56,75,259). The nim gene can be "silent" unless activated by IS elements (111).…”

Section: Continued On Facing Pagementioning

confidence: 99%

Bacteroides: the Good, the Bad, and the Nitty-Gritty

2007

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SUMMARY Summary: Bacteroides species are significant clinical pathogens and are found in most anaerobic infections, with an associated mortality of more than 19%. The bacteria maintain a complex and generally beneficial relationship with the host when retained in the gut, but when they escape this environment they can cause significant pathology, including bacteremia and abscess formation in multiple body sites. Genomic and proteomic analyses have vastly added to our understanding of the manner in which Bacteroides species adapt to, and thrive in, the human gut. A few examples are (i) complex systems to sense and adapt to nutrient availability, (ii) multiple pump systems to expel toxic substances, and (iii) the ability to influence the host immune system so that it controls other (competing) pathogens. B. fragilis, which accounts for only 0.5% of the human colonic flora, is the most commonly isolated anaerobic pathogen due, in part, to its potent virulence factors. Species of the genus Bacteroides have the most antibiotic resistance mechanisms and the highest resistance rates of all anaerobic pathogens. Clinically, Bacteroides species have exhibited increasing resistance to many antibiotics, including cefoxitin, clindamycin, metronidazole, carbapenems, and fluoroquinolones (e.g., gatifloxacin, levofloxacin, and moxifloxacin).

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“…15,[23][24][25][26] Bacteroides spp resistance to fluoroquinolones has also increased from 1.5-12% during the past few years. 27,28 Metronidazole-resistant strains of B. fragilis have been reported in many countries, including Brazil, 29 India, 30 United States, 31 Hungary 32 and Poland, 33 and some Indian strains show very high levels of resistance (MIC 512 mg/L). 34 Therefore, anaerobic infections have reemerged as a serious health threat, and Bacteroides spp are now recognized as important pathogens.…”

Section: Introductionmentioning

confidence: 99%