Susceptibilities of species of the Bacteroides fragilis group to 10 antimicrobial agents

Betriú, Carmen; Campos, Esther; Cabronero, C.; Rodríguez-Avial, Carmen; Picazo, Juan J.

doi:10.1128/aac.34.4.671

Cited by 33 publications

(17 citation statements)

References 23 publications

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“…The one isolate of Bacteroides fragilis with a metronidazole MIC of 8 mg/I was from Portugal and the two with metronidazole MICs of 4 mg/1 were from Germany and Austria. Only one isolate was resistant to chloramphenicol, in agreement with a report of rarity of such resistance from Spain (14).…”

Section: Discussionsupporting

confidence: 83%

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Antibiotic sensitivity of theBacteroides fragilis group in Europe

Phillips

King

Nord³

et al. 1992

Eur. J. Clin. Microbiol. Infect. Dis.

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Rates of resistance to 12 antibiotics were determined for 1,289 isolates of Bacteroides fragilis group submitted in 1988-1989 by 22 laboratories in 15 European countries. There was no resistance to metronidazole (breakpoint 8 mg/l) and only one isolate was resistant to chloramphenicol (breakpoint 8 mg/l). Resistance was uncommon for imipenem (0.3% at greater than 4 mg/l), amoxicillin/clavulanate (1% at greater than 8 mg/l), cefoxitin (3% at greater than 32 mg/l), mezlocillin (6% at greater than 64 mg/l) and clindamycin (9% at greater than 4 mg/l). Resistance was the rule for ampicillin (93% at greater than 4 mg/l), ciprofloxacin (56% at greater than 4 mg/l) and tetracycline (64% at greater than 4 mg/l). Bacteroides fragilis, the commonest species, was generally the most sensitive: resistance of this organism was uncommon for cefotetan (4% at greater than 32 mg/l) and ceftazidime (12% at greater than 32 mg/l) to which the other species were more often resistant. There were small but significant differences between laboratories and countries for many of the antibiotics. Regionally the most striking differences were for clindamycin where resistance in Bacteroides fragilis was most common in the South and for tetracycline where resistance in Bacteroides fragilis, Bacteroides thetaiotaomicron and Bacteroides uniformis was least common in the North.

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Section: Discussionsupporting

confidence: 83%

“…This is higher than the rate of 3 % reported from Spain (14). Although no results for mezlocillin were reported in the studies from the USA (7,15,16), on the basis of results for piperacillin it would seem that resistance was again more common in the USA (11-16 % with piperacillin MICs > 64 mg/1).…”

Section: Discussioncontrasting

confidence: 63%

Antibiotic sensitivity of theBacteroides fragilis group in Europe

Phillips

King

Nord³

et al. 1992

Eur. J. Clin. Microbiol. Infect. Dis.

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“…Mays and colleagues (72) (27,32,35,105) are considerably lower than our own values (see Table 1 (18,38,(41)(42)(43)(44)(45)95), Germany (49,55), Italy (16,90), Poland (65), Russia (13), Spain (12,67), Turkey (111), Switzerland (125), and the United Kingdom (50). A perusal of the articles with English abstracts was undertaken both to obtain data regarding antibiograms from foreign hospitals and to determine the kinds of techniques used in anaerobic susceptibility testing in other countries.…”

Section: Issues That Require Further Investigation Endpoint Definitionmentioning

confidence: 57%

Susceptibility testing of anaerobic bacteria: myth, magic, or method?

Wexler

1991

Clin Microbiol Rev

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The demand for susceptibility testing of anaerobes has increased, yet consensus as to procedure and interpretation in this area has not been achieved. While routine testing of anaerobic isolates is not needed, certain isolates in specific clinical settings should be tested. Also, laboratories may monitor their local antibiograms by doing periodic surveillance batch testing. The National Committee for Clinical Laboratory Standards has published a protocol of methods approved for susceptibility testing of anaerobic bacteria. Both agar and broth microdilution are included; however, the broth disk elution method is no longer approved by the National Committee for Clinical Laboratory Standards because of method-related interpretive errors. A number of newer methods are undergoing evaluation and seem promising. Clinicians and microbiologists reviewing susceptibility reports should be aware of sources of variability in the test results. Variables in susceptibility testing of anaerobes include the media and methods used, organisms chosen for testing, breakpoints chosen for interpretation, antibiotic, and determination of endpoint. Clustering of MICs around the breakpoint may lead to significant variability in test results. Adherence of testing laboratories to approved methods and careful descriptions of the method and the breakpoints used for interpretation would facilitate interlaboratory comparisons and allow problems of emerging resistance to be noted. A variety of resistance mechanisms occurs in anaerobic bacteria, including the production of beta-lactamase and other drug-inactivating enzymes, alteration of target proteins, and inability of the drug to penetrate the bacterial wall. Antimicrobial resistance patterns in the United States and abroad are described.

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“…Variations in proportions of species could not account for the outbreaks of resistance to clindamycin and to cefoxitin, since there was no significant difference in the proportions of the various species during the years 1979, 1982, 1985 and 1987. Until 1988, both imipenem and amoxicillinclavulanic acid were able to inhibit all strains of the Bacteroides fragilis group (17). In 1989 we detected the emergence of imipenem resistance in the Bacteroides fragilis group and such strains are still being isolated in 1991, so we believe that this observation is important.…”

mentioning

confidence: 77%

Changes in the susceptibility ofBacteroides fragilis group organisms to various antimicrobial agents 1979–1989

Betriú

Cabronero

Gómez

et al. 1992

Eur. J. Clin. Microbiol. Infect. Dis.

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The in vitro activity of metronidazole, chloramphenicol, clindamycin and 11 beta-lactam antibiotics against 135 clinical isolates of the Bacteroides fragilis group was compared. In addition, changes in the resistance patterns of members of the Bacteroides fragilis group isolated at the Hospital Universitario San Carlos in Madrid, Spain, between 1979 and 1989 were documented. The most active beta-lactam drugs were imipenem and beta-lactamase inhibitor combinations. In 1989, however, two strains were found to be resistant to imipenem and to all other beta-lactam agents tested. There was no emergence of resistance to metronidazole. Chloramphenicol was very effective: only one resistant strain was detected in 1979 and no chloramphenicol-resistant isolates were found during the rest of the study period. An outbreak of clindamycin resistance was noted in 1982, and the first cefoxitin resistant strains were recovered in 1985. The changing patterns of susceptibility of anaerobic bacteria to antimicrobial agents and the emergence of Bacteroides fragilis strains resistant to new beta-lactam agents suggest that periodic antimicrobial susceptibility tests should be performed in order to guide the selection of antimicrobial agents for therapy.

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Susceptibilities of species of the Bacteroides fragilis group to 10 antimicrobial agents

Cited by 33 publications

References 23 publications

Antibiotic sensitivity of theBacteroides fragilis group in Europe

Antibiotic sensitivity of theBacteroides fragilis group in Europe

Susceptibility testing of anaerobic bacteria: myth, magic, or method?

Changes in the susceptibility ofBacteroides fragilis group organisms to various antimicrobial agents 1979–1989

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