Fourth Belgian multicentre survey of antibiotic susceptibility of anaerobic bacteria

Wybo, Ingrid; Piérard, Denis; Verschraegen, Inge; Reynders, Marijke; Vandoorslaer, Kristof; Claeys, Geert; Delmée, Michel; Glupczynski, Youri; Gordts, B.; Ieven, M.; Melin, Pierrette; Struelens, Marc; Verhaegen, Jan; Lauwers, Sabine

doi:10.1093/jac/dkt344

Cited by 90 publications

(52 citation statements)

References 21 publications

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“…However, given that resistance among anaerobic organisms is increasing, susceptibility data are important to guide therapy (18)(19)(20). There are limited published data on the susceptibility profile of E. lenta, and breakpoints are extrapolated from those determined for other species.…”

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confidence: 99%

Clinical and Microbiological Characteristics of Eggerthella lenta Bacteremia

et al. 2015

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e Eggerthella lenta is an emerging pathogen that has been underrecognized due to historical difficulties with phenotypic identification. Until now, its pathogenicity, antimicrobial susceptibility profile, and optimal treatment have been poorly characterized. In this article, we report the largest cohort of patients with E. lenta bacteremia to date and describe in detail their clinical features, microbiologic characteristics, treatment, and outcomes. We identified 33 patients; the median age was 68 years, and there was no gender predominance. Twenty-seven patients (82%) had serious intra-abdominal pathology, often requiring a medical procedure. Of those who received antibiotics (28/33, 85%), the median duration of treatment was 21.5 days. Mortality from all causes was 6% at 7 days, 12% at 30 days, and 33% at 1 year. Of 26 isolates available for further testing, all were identified as E. lenta by both commercially available matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) systems, and none were found to harbor a vanA or vanB gene. Of 23 isolates which underwent susceptibility testing, all were susceptible to amoxicillin-clavulanate, cefoxitin, metronidazole, piperacillin-tazobactam, ertapenem, and meropenem, 91% were susceptible to clindamycin, 74% were susceptible to moxifloxacin, and 39% were susceptible to penicillin.

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confidence: 99%

Clinical and Microbiological Characteristics of Eggerthella lenta Bacteremia

et al. 2015

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“…In light of these findings, the patient was switched to intravenous clindamycin treatment (600 mg/8 h), and the in vitro susceptibility of the isolates was assessed with the Etest (bioMérieux, Marcy l'Etoile, France), as previously described (6). Interpreted according to EUCAST breakpoints (7), the results revealed susceptibility to amoxicillin-clavulanate (MIC, 0.06 mg/liter), piperacillin-tazobactam (MIC, 0.12 mg/liter), meropenem (MIC, 0.002 mg/liter), clindamycin (MIC, 0.016 mg/liter), metronidazole (MIC, 0.06 mg/liter), and chloramphenicol (MIC, 2 mg/liter) and full resistance to penicillin (MIC, Ͼ0.5 mg/liter).…”

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confidence: 99%

“…Twenty-four hours later, the appropriateness of this empirical decision was confirmed by in vitro susceptibility data. However, clindamycin resistance in Prevotella species is reportedly on the rise, so antibiogram guidance is imperative in severe infections caused by these organisms (6).…”

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confidence: 99%

Empyema Caused by Prevotella bivia Complicating an Unusual Case of Spontaneous Chylothorax

et al. 2014

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b Spontaneous chylothorax is rare in adults. We present an unusual case that was complicated by Prevotella bivia empyema. Full recovery was achieved with chest tube drainage and prompt treatment with intravenous clindamycin. CASE REPORTA 78-year-old man was admitted to the hospital with a 1-month history of weight loss (10 kg), asthenia, dyspnea, dry cough, right chest pain, and low-grade fever (37.1°C on admission). He was an exsmoker (60 packs/year) with moderately severe chronic obstructive pulmonary disease that was not associated with chronic respiratory failure. He also suffered from chronic periodontitis, was known to harbor the factor V Leiden mutation, and had been treated 3 months earlier for an episode of pulmonary microembolism. The physical examination revealed diminished chest expansion, tachypnea (24 breaths/min), reduced vesicular breathing on the right, and bilateral rales. The white blood cell (WBC) count was 14.8 ϫ 10 9 /liter with 94% neutrophils. Arterial blood gas analysis on room air revealed severe hypoxemia-compensated respiratory acidosis. A chest X-ray showed a right pleural effusion without clear evidence of consolidation (Fig. 1a). Ultrasound analysis disclosed two loculated pleural effusions in the right hemithorax. Computed tomography (CT) revealed two large right pleural effusions (anterior and lateral), a small posterior effusion, right middle lobe consolidation, and diffuse, bilateral "ground-glass" opacities ( Fig. 1b). Empirical treatment with intravenous levofloxacin (750 mg every 24 h [q24h]) was started, and a chest tube was inserted on the right midaxillary line. A 50-ml sample of purulent fluid was characterized by a pH of 6.8, a lactate dehydrogenase (LDH) level of 1,320 IU/liter, a WBC count of 10,840 cells/l (96% neutrophils), high triglyceride levels (270 mg/dl versus serum level of 67 mg/dl), a low cholesterol level (10 mg/dl), and no identifiable cholesterol crystals. Microscopic examination of the fluid showed numerous neutrophils but no parasites or ova (1-4). Gram staining revealed short rod-shaped bacteria, and cytology was negative for malignancy. Ziehl-Nielsen staining detected no acid alcohol-resistant bacteria. A diagnosis of chylothorax with pleural infection was made. Two other chest tubes were inserted, and drainage samples from each were sent to the microbiology laboratory. In accordance with our routine protocol, the pleural fluid specimens were subjected to aerobic cultures on MacConkey (35°C) and Sabourad (30°C) agars; microaerobic cultures (35°C in air with 5% CO 2 ); anaerobic cultures in an anaerobic growth chamber (Forma Scientific, Marietta, OH) containing 10% vol/vol hydrogen, 10% carbon dioxide, and 80% nitrogen on brucella blood, Columbia, and Schaedler agars (35°C); and aerobic and anaerobic cultures on enriched thioglycolate medium with vitamin K and hemin (plates and slants from Becton, Dickinson Diagnostic Systems, Sparks, MD, and bioMérieux, Marcy l'Etoile, France). Specimens were also inoculated onto Lowenstein-Jensen solid medium and in...

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“…The rates of positive beta-lactamase Prevotella strains reported in the literature are widely different. Thus, Whybo et al at the end of a multicentre Belgian survey of antibiotic susceptibility of anaerobic bacteria, carried out in the period: 2011e2012, found 73% betalactamase producers among 45 Prevotella strains isolated from different types of infections [37]. Rams at al.…”

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confidence: 99%