Lessons Learned from the Anaerobe Survey: Historical Perspective and Review of the Most Recent Data (2005–2007)

Snydman, David R.; Jacobus, Nilda V.; McDermott, L. A.; Golan, Yoav; Hecht, David W.; Goldstein, Ellie J. C.; Harrell, Lizzie J.; Jenkins, Stephen G.; Newton, Duane W.; Pierson, Carl L.; Rihs, John D.; Yu, Victor L.; Venezia, Richard A.; Finegold, Sydney M.; Rosenblatt, Jon E.; Gorbach, Sherwood L.

doi:10.1086/647940

Cited by 149 publications

(98 citation statements)

References 20 publications

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“…Resistance to even the most active drugs, such as imipenem, piperacillin-tazobactam, ampicillin-sulbactam, and metronidazole, has been reported (23,25,26). Furthermore, there are clear differences in the geographic patterns of resistance and even differences in resistance patterns in different hospitals in a single city, perhaps due in part to the variability in prescribing patterns (27). Numbers of reports of broadly multidrug-resistant B. fragilis strains as well as numbers of reports of resistance arising during treatment have increased (6,11,14,22,28).…”

Section: Susceptibilty Testing Of Anaerobic Bacteriamentioning

confidence: 99%

“…Surveillance tests have been conducted for years by groups worldwide and reflect sweeping general trends (18,24,27,33,34,147) However, these results will not necessarily reflect the patterns of specific patients or hospitals. Because of this, the CLSI strongly recommends that hospitals conduct at least annual surveillance antimicrobial susceptibility testing to elucidate their local patterns.…”

Section: Surveillance Tests For Particular Hospitals or Geographic Rementioning

confidence: 99%

“…fragilis group species are generally resistant to penicillins (average, 90%), piperacillin (25%), cefoxitin (25%), cefotetan (30 to 85%), and third-generation cephalosporins (27,88).…”

Section: ␤-Lactam Antibioticsmentioning

confidence: 99%

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Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

2013

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SUMMARY Susceptibility testing of anaerobic bacteria recovered from selected cases can influence the choice of antimicrobial therapy. The Clinical and Laboratory Standards Institute (CLSI) has standardized many laboratory procedures, including anaerobic susceptibility testing (AST), and has published documents for AST. The standardization of testing methods by the CLSI allows comparisons of resistance trends among various laboratories. Susceptibility testing should be performed on organisms recovered from sterile body sites, those that are isolated in pure culture, or those that are clinically important and have variable or unique susceptibility patterns. Organisms that should be considered for individual isolate testing include highly virulent pathogens for which susceptibility cannot be predicted, such as Bacteroides , Prevotella , Fusobacterium , and Clostridium spp.; Bilophila wadsworthia ; and Sutterella wadsworthensis . This review describes the current methods for AST in research and reference laboratories. These methods include the use of agar dilution, broth microdilution, Etest, and the spiral gradient endpoint system. The antimicrobials potentially effective against anaerobic bacteria include beta-lactams, combinations of beta-lactams and beta-lactamase inhibitors, metronidazole, chloramphenicol, clindamycin, macrolides, tetracyclines, and fluoroquinolones. The spectrum of efficacy, antimicrobial resistance mechanisms, and resistance patterns against these agents are described.

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Section: Susceptibilty Testing Of Anaerobic Bacteriamentioning

confidence: 99%

Section: Surveillance Tests For Particular Hospitals or Geographic Rementioning

confidence: 99%

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Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

2013

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“…In the latter species, metronidazole and carbapenem resistance have recently been described (22). Since the growth of B. vulgatus on BFS agar is inhibited (Table 1), the medium is not suitable for recovery of this antibiotic-resistant species (23). In the validation with clinical specimens, 59 of the 1,209 specimens had growth of Enterobacteriaceae, but their colony morphologies were different from the morphology of B. fragilis.…”

Section: Resultsmentioning

confidence: 99%

A Novel Selective Medium for Isolation of Bacteroides fragilis from Clinical Specimens

Yau

et al. 2017

J Clin Microbiol

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A novel Bacteroides fragilis selective (BFS) medium, consisting of a brain heart infusion agar base supplemented with yeast extract, cysteine hydrochloride, bile salts, vitamin K, hemin, glucose, esculin, ferric ammonium citrate, bromothymol blue, gentamicin, kanamycin, and novobiocin, was evaluated. When BFS agar was tested with a collection of 303 bacteria of different genera, it allowed the growth of B. fragilis as large yellow colonies, with blackening of the medium after 48 h of anaerobic incubation, while the growth of most other anaerobes, facultative anaerobes, and aerobes was inhibited. In a prospective comparison of BFS agar with a routinely used medium (neomycin blood agar) in 1,209 clinical specimens, 60 B. fragilis bacteria were detected on BFS agar while 46 were detected on the routine agar (McNemar's test, P ϭ 0.008). In conclusion, this novel medium may be added to improve the recovery of B. fragilis in clinical specimens and to facilitate surveillance of antimicrobial-resistant strains.

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“…It has been observed that resistance to beta-lactams in obligate and facultative anaerobic organisms is maily associated with Extended Spectrum Beta Lactamase (ESBL) and Metallo Beta Lactamse (MBL) production (Snydman et al, 2010). Whereas mechanism for metronidazole resistance in B. fragilis include the presence of nim genes, which encode 5-nitroimidazole reductases that convert metronidazole to a non-toxic amino derivative (Pumbwe et al, 2008), overexpression of the DNA repair protein, RecA (Steffens et al, 2010) and disruption of the electron transport chain (Lynch et al, 2013).…”

Section: But Comprising Least Common Bacteroides Occur Inmentioning

confidence: 99%

Emerging Metronidazole Resistance in Anaerobes and Mapping Their Susceptibility Behaviour

Chaudhary¹

2014

American Journal of Infectious Diseases

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In the present study, anaerobic clinical isolates of Bacteroides fragilis, Escherichia coli, Staphylococcus aureus and Yersinia enterocolitica were obtained from different clinical specimens and were subjected to molecular typing to detect the gene encoding metronidazole resistance in these isolates. Subsequently, antibacterial activity of drugs was tested against the selected clinical isolates. A total of 53 clinical isolates involving 18 obligate and 35 facultative anaerobic bacteria were recovered from clinical samples of 67 patients who were suspected to have anaerobic infection. A disk diffusion method was employed to screen for metronidazole-resistance among these isolates. PCR assay was used to detect the metronidazole resistant gene (nim). Susceptibility studies in metronidazole resistant clinical isolates as well as positive controls were performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. According to disc diffusion method, of 53 isolates, 21 isolates (39.6%) were found to be metronidazole resistant. Further screening of these isolates with PCR revealed only 13 isolates (24.5%) carry nim gene. Out of which 7 were of B. fragilis, 3 were of Y. enterocolitica, 2 were of E. coli and 1 was of S. aureus. The highest number of metronidazole resistant isolates were found in abscess (7) followed by intra-abdominal infection (5) and bone and joint infection (1). When metronidazole resistant isolates were subjected to screen for the presence of nim gene, all isolates were found to carry nim gene. According to minimum inhibitory concentration (MIC) data, among the tested antibacterial agents, Mebatic emerged as the most active antibacterial against metronidazole resistant isolates of B. fragilis, E. coli, S. aureus and Y. enterocolitica with MIC values 0.125 to 1.0 µg mL −1 . Similarly, Antimicrobial Susceptibility Test (AST) data also revealed that Mebatic was most efficacious in the metronidazole resistant organisms. From the above results, it is evident that Mebatic has enhanced in vitro antibacterial activity compared to other drugs in metronidazole resistant isolates thus can be a potent antibacterial agent for the treatment of infections caused by metronidazole resistant organisms.

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Lessons Learned from the Anaerobe Survey: Historical Perspective and Review of the Most Recent Data (2005–2007)

Cited by 149 publications

References 20 publications

Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

A Novel Selective Medium for Isolation of Bacteroides fragilis from Clinical Specimens

Emerging Metronidazole Resistance in Anaerobes and Mapping Their Susceptibility Behaviour

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