Multidrug-Resistant<i>Bacteroides fragilis</i>Bacteremia in a US Resident: An Emerging Challenge

Merchan, Cristian; Parajuli, Sunita; Siegfried, Justin; Scipione, Marco R.; Dubrovskaya, Yanina; Rahimian, Joseph

doi:10.1155/2016/3607125

Cited by 16 publications

(13 citation statements)

References 11 publications

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“…Of the anaerobes, only one B. fragilis isolates showed low resistant to both imipenem and metronidazole 1(0.61%), while 3(1.83%) showed resistance to piperacillin/tazobactam. This outcome is in sharp contrast to previous study [52] but is in consistent with the observation made by Boyanova et al [53] in a study [2,9] and metronidazole [2].…”

Section: Discussionsupporting

confidence: 89%

Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

Abdu

Egbagba

Fente

2019

Trop J Pathol Microbiol

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Introduction: Infected wounds in particular, those associated with antimicrobial resistant microorganisms constitute a significant source of physical, psychological, and economic burden to patients in particular, and the society at large in terms of the huge resources spent in treating such wounds as well as time/days lost at workplaces leading to increased morbidity and mortality globally. The present study sought to investigate and identify the common bacteria associated with wound infections and their antibiotic sensitivity pattern. Material and Methods: A total of 130 wound samples were collected by doctors in ward using Sterile Swab Sticks over a period of 6 months from February-July 2019. Pathogenic bacteria were isolated, identified and their antibiotic susceptibility tests were performed. Results: Among 130 cases, 108 (83.08%) were culture positive for bacterial pathogens, while 22 (16.92%) were bacteriologically sterile (Negative). Rate of infection was high in males (56.15%) than females (43.85%). Of the 108-culture positive, 164 isolates were recovered of which 28 (17.07) were anaerobes, while 136 were aerobes of which 106 (64.64%) were Gram-negative species and 30 (18.29%) Gram-negative species. The predominant isolates among the facultative aerobes, were Pseudomonas aeruginosa 28 (17.07%), followed by E. coli 19 (11.58%), Klebsiella pneumonia 17 (10.37%) while the least were amongst Morganella morgani, Providencia rettgeri and Serretia marcescens with 2 (1.22%) individually. Among the Gram-positive, Staphylococcus aureus 10 (6.10%) were most common, followed by Enterococcus spp 4 (2.44%), Coagulase negative staphylococcus (CoNS) 4 (2.44%) while the least were amongst Streptococcus Group B, Streptococcus Group C, Streptococcus Group G with 2 (1.22%) separately. Amongst the anaerobes, Bacterioides fragilis 16 (9.75%) is the most common, followed by Peptostreptococcus spp., and Prevotella spp with 4 (2.44%) each, while Fusobacterium spp and Veillonella spp were the least, 2 (1.22%) each. Amikacin and nitrofurantoin are the most efficacious for managing wound infections, with all the isolates being susceptible to them. Resistance was moderate to Levofloxacin (49.39%). On the other hand, resistance were above average among Ciprofloxacin (96.34%), Cloxacillin (94.51%), Ceftriaxone (91.46%), Ceftazidine (91.46%), Cefotaxime (87.20%), Erythromycin (59.15%), Ofloxacin (58.54%) and Chloramphenicol (51.22%). The least resistance shown to Gentamicin (16.46%), Streptomycin (16.46%), Imipenem (7.93%), Metronidazole (7.93%), and Piperacillin-tazobactam (7.93%). Conclusion: Antibiotic susceptibility test is suggested prior to administration of antibiotics for successful treatment and intermittent monitoring is also encouraged to check emerging multidrug resistant trends as a guide to health authorities.

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Section: Discussionsupporting

confidence: 89%

Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

Abdu

Egbagba

Fente

2019

Trop J Pathol Microbiol

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“…However, antibiotics, even used for short periods may raise the issue of both toxicity and the emergence of bacterial antibiotic resistance. The number of reports of multidrug-resistant B. fragilis strains has increased in the past decade [53,54,55]. In particular, at NYU Langone Medical Center, resistance rates for 361 Bacteroides isolates were evaluated over a 5-year time period which demonstrated overall resistance rates of 5% (17/361) to metronidazole, 4% (13/361) to carbapenems, and 0.3% (1/361) to both carbapenems and metronidazole [56].…”

Section: Discussionmentioning

confidence: 99%

Zerumbone Suppresses Enterotoxigenic Bacteroides fragilis Infection-Induced Colonic Inflammation through Inhibition of NF-κΒ

Hwang

Hong

et al. 2019

IJMS

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Enterotoxigenic Bacteroides fragilis (ETBF) is human intestinal commensal bacterium and a potent initiator of colitis through secretion of the metalloprotease Bacteroides fragilis toxin (BFT). BFT induces cleavage of E-cadherin in colon cells, which subsequently leads to NF-κB activation. Zerumbone is a key component of the Zingiber zerumbet (L.) Smith plant and can exhibit anti-bacterial and anti-inflammatory effects. However, whether zerumbone has anti-inflammatory effects in ETBF-induced colitis remains unknown. The aim of this study was to determine the anti-inflammatory effect of orally administered zerumbone in a murine model of ETBF infection. Wild-type C57BL/6 mice were infected with ETBF and orally administered zerumbone (30 or 60 mg/kg) once a day for 7 days. Treatment of ETBF-infected mice with zerumbone prevented weight loss and splenomegaly and reduced colonic inflammation with decreased macrophage infiltration. Zerumbone treatment significantly decreased expression of IL-17A, TNF-α, KC, and inducible nitric oxide synthase (iNOS) in colonic tissues of ETBF-infected mice. In addition, serum levels of KC and nitrite was also diminished. Zerumbone-treated ETBF-infected mice also showed decreased NF-κB signaling in the colon. HT29/C1 colonic epithelial cells treated with zerumbone suppressed BFT-induced NF-κB signaling and IL-8 secretion. However, BFT-mediated E-cadherin cleavage was unaffected. Furthermore, zerumbone did not affect ETBF colonization in mice. In conclusion, zerumbone decreased ETBF-induced colitis through inhibition of NF-κB signaling.

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“…Additional virulence determinants of this species include the presence of various fimbriae and adhesions, which help the bacteria to adhere to matrix proteins of the host [ 50 ]. The most significant role of B. fragilis as an infectious agent is thought to be in anaerobic bacteraemia, where the associated mortality is estimated to be around 19% (60% if left untreated) [ 84 , 85 ].…”

Section: Examples Of Clinically Relevant Anaerobic Bacteriamentioning

confidence: 99%

“…But if we observe the data from the (inter)national surveillance reports from Europe ( Table 6 ) [ 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 ] and the United States ( Table 7 ) [ 95 , 135 , 144 , 145 , 146 , 147 ], the same trends can be discovered: steadily growing resistance to all classes of antimicrobial agents, with some of them rendered completely useless. Several publications report the emergence of multidrug resistant anaerobic Gram-negative bacteria (especially within the B. fragilis group isolates), harbouring multiple resistance genes or with a combination of intrinsic and acquired resistance mechanisms [ 80 , 85 , 147 , 148 , 149 , 150 , 151 ]. In these cases, the bacteria were usually termed multidrug resistant if they were resistant to 3–4 antibiotic classes besides metronidazole (due to nim nitroimidazole resistance genes) and the carbapenems (a metallo-β-lactamase encoded by cfiA / ccrA genes) [ 79 ].…”

Section: Antibiotic Resistance In Anaerobic Bacteria: the Importanmentioning

confidence: 99%

Identification and Antimicrobial Susceptibility Testing of Anaerobic Bacteria: Rubik’s Cube of Clinical Microbiology?

2017

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Anaerobic bacteria have pivotal roles in the microbiota of humans and they are significant infectious agents involved in many pathological processes, both in immunocompetent and immunocompromised individuals. Their isolation, cultivation and correct identification differs significantly from the workup of aerobic species, although the use of new technologies (e.g., matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, whole genome sequencing) changed anaerobic diagnostics dramatically. In the past, antimicrobial susceptibility of these microorganisms showed predictable patterns and empirical therapy could be safely administered but recently a steady and clear increase in the resistance for several important drugs (β-lactams, clindamycin) has been observed worldwide. For this reason, antimicrobial susceptibility testing of anaerobic isolates for surveillance purposes or otherwise is of paramount importance but the availability of these testing methods is usually limited. In this present review, our aim was to give an overview of the methods currently available for the identification (using phenotypic characteristics, biochemical testing, gas-liquid chromatography, MALDI-TOF MS and WGS) and antimicrobial susceptibility testing (agar dilution, broth microdilution, disk diffusion, gradient tests, automated systems, phenotypic and molecular resistance detection techniques) of anaerobes, when should these methods be used and what are the recent developments in resistance patterns of anaerobic bacteria.

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Multidrug-ResistantBacteroides fragilisBacteremia in a US Resident: An Emerging Challenge

Cited by 16 publications

References 11 publications

Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

Zerumbone Suppresses Enterotoxigenic Bacteroides fragilis Infection-Induced Colonic Inflammation through Inhibition of NF-κΒ

Identification and Antimicrobial Susceptibility Testing of Anaerobic Bacteria: Rubik’s Cube of Clinical Microbiology?

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