Third 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/dkl458

Cited by 70 publications

(65 citation statements)

References 5 publications

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“…The bacteria that accounted for the significantly increased proportion of resistance to amoxicillin and penicillin G in clinical samples were Gram-negative rods, susceptible to metronidazole. The results of Table II suggest that ß-lactamases from anaerobic Gram-negative bacteria are active on penicillins and cephalosporins, as also described by Wybo et al (2007) and Gaetti-Jardim Júnior et al (2007).…”

Section: Discussionsupporting

confidence: 75%

Antimicrobial Susceptibility to ß-lactams and Metronidazole of Microorganisms Isolated from Chronic and Aggressive Periodontitis

Júnior

Schweitzer

2013

Int. J. Odontostomat.

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susceptibility to ß-lactams and metronidazole of microorganisms isolated from chronic and aggressive periodontitis. Int. J. Odontostomat., 7(2):193-198, 2013. ABSTRACT:The objective of this study was to evaluate the microbial susceptibility to ß-lactams and metronidazole, and evaluate the production of ß-lactamases by microorganisms isolated from patients with chronic or aggressive periodontitis. The samples were obtained from 50 patients with periodontitis and microorganisms were isolated onto selective and nonselective culture media, identified by biochemical methods and tested for susceptibility to antimicrobial agents (amoxicillin, amoxicillin/clavulanate, cefoxitin, imipenem, metronidazole, penicillin G). The isolates were resistant to at least 1 mg/ml of any drug tested were evaluated to verify the production of ß-lactamases by the method of double layer (or biological) and chromogenic cephalosporin using nitrocefin. The results evidenced resistance to amoxicillin and penicillin G, while the susceptibility to association amoxicillin/clavulanate, imipenem and cefoxitin was widely disseminated among the organisms. Resistance to these drugs showed a clear correlation with the production of ß-lactamase in the majority of microbial groups.

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Section: Discussionsupporting

confidence: 75%

Antimicrobial Susceptibility to ß-lactams and Metronidazole of Microorganisms Isolated from Chronic and Aggressive Periodontitis

Júnior

Schweitzer

2013

Int. J. Odontostomat.

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“…Gram-positive anaerobic cocci are associated with malignancies (2, 7) and B. fragilis group members with a more severe clinical outcome (8,10). Importantly, B. fragilis group members are known to be more resistant to antibiotics than are other anaerobic organisms (8,11). The increased number of patients with severe immunosuppression and treatment for malignancies at our institution may explain the increase found for this group of anaerobes.…”

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confidence: 91%

Is the Incidence of Anaerobic Bacteremia Decreasing? Analysis of 114,000 Blood Cultures over a Ten-Year Period

et al. 2008

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Anaerobic organisms account for about 4% of bacteremias (range, 0.5% to 9%) depending on geographic location, hospital patient demographics, and patient age (5).From 1974 to 1988, the incidence of anaerobic bacteremia at the Mayo Clinic (Rochester, MN) decreased by 45% (3). Recently, a study from the same institution indicated the reemergence of anaerobic bacteremia from 1993 to 2004 (7). In contrast, a report from a U.S. community hospital provided no evidence for an increase (1). Therefore, we examined the occurrence of anaerobic and aerobic bacteremias at the University Hospital Basel (UHBS), Basel, Switzerland, and analyzed the proportions of six important groups of anaerobes in relation to 1,000 blood cultures as well as in relation to positive aerobic blood culture results over a 10-year period.The UHBS is a 680-bed tertiary care center in Switzerland with 27,000 inpatients and 167,000 outpatients per year. It provides all medical services for adults and is one of the major centers for hematopoietic stem cell transplants in Switzerland (9). We retrospectively analyzed blood culture data for a 10-year period between 1997 and 2006 at UHBS. During the entire study period, the same blood culture system (BacT/ ALERT; bioMérieux, Hazelwood, MO) and the same pair of aerobic/anaerobic bottles (BacT/ALERT FA/FN; bioMérieux) were used according to the manufacturer's instructions and incubated for 6 days. Since clinical data were not available for the entire study period, determination of sepsis versus contaminant was not possible for the isolates. Bacterial identification was performed according to the Wadsworth-KTL anaerobic bacteriology manual (6). Anaerobic organisms were categorized into six groups (Bacteroides fragilis group, Clostridium spp., gram-positive cocci, non-spore-forming gram-positive bacteria, Prevotella/Porphyromonas spp., other Bacteroides spp., and anaerobic gram-negative bacteria) as previously published (7). The rates of bacteremia during two time periods were compared using an incidence rate calculation (Stata 9.2; College Station, TX).A total of 114,338 blood cultures were submitted to the laboratory between 1997 and 2006. From those, 1,084 (0.95%) anaerobic organisms were isolated from blood cultures. The total number of blood cultures steadily increased over the 10

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“…In the [2003][2004][2005] Belgian multicenter survey (18), the prevalence of the cfiA resistance gene was 7.4% (10/135) (19), which is high compared with the prevalence of cfiA positivity (2 to 7%) in other countries (5,6,13,15,20). In the survey, 4% (6/135) of B. fragilis isolates were intermediate or resistant to meropenem according to CLSI breakpoints (18).…”

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confidence: 99%

“…The 135 B. fragilis clinical isolates from the survey mentioned above (18,19), originating from nine Belgian hospitals, as well as 113 B. fragilis isolates from routine cultures collected at our laboratory since 2005 were analyzed. Identification was performed by appropriate biochemical and enzymatic tests (11) and confirmed by MALDI-TOF MS. Meropenem susceptibility was determined by Etest methodology (bioMérieux, Marcy l'Etoile, France).…”

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confidence: 99%

Differentiation of cfiA -Negative and cfiA -Positive Bacteroides fragilis Isolates by Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry

et al. 2011

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Carbapenem resistance in Bacteroides fragilis is associated with cfiA-encoded class B metallo-beta-lactamase. cfiA-negative and cfiA-positive isolates belong to genotypically distinct groups. Of a total of 248 B. fragilis isolates included in this study, 214 were susceptible, 10 were intermediate, and 24 were resistant to meropenem. We show that matrix-assisted laser desorption ionization-time of flight mass spectrometry is able to differentiate between cfiA-negative and cfiA-positive isolates and predict carbapenem resistance in a routine laboratory setting.Bacteroides fragilis is a strictly anaerobic Gram-negative bacillus present in the human gut. It is recovered from various infection sites and frequently associated with abscess formation and sepsis. Carbapenem resistance in B. fragilis is emerging and associated with cfiA-encoded class B metallo-betalactamase, which is activated by insertion sequence (IS) elements. However, elevated MICs or resistance was also observed in strains that did not have activating IS elements in the upstream region of cfiA (17). In the 2003-2005 Belgian multicenter survey (18), the prevalence of the cfiA resistance gene was 7.4% (10/135) (19), which is high compared with the prevalence of cfiA positivity (2 to 7%) in other countries (5,6,13,15,20). In the survey, 4% (6/135) of B. fragilis isolates were intermediate or resistant to meropenem according to CLSI breakpoints (18).By using various molecular typing methods, such as arbitrarily primed PCR, ribotyping, multilocus enzyme electrophoresis, and sequencing of recA and glnA genes, cfiA-negative and cfiA-positive strains were shown to belong to two genotypically distinct groups (9, 10, 13). Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has the capacity to discriminate closely related species based on the spectrum of constantly expressed highly abundant proteins, such as ribosomal proteins. This technique was recently introduced as a rapid and accurate method for the identification of bacteria (2,7,14) and can also be applied in the identification of Bacteroides isolates (12). The aim of the present study was to examine the discriminatory power of MALDI-TOF MS to differentiate cfiA-positive from cfiA-negative B. fragilis strains in order to predict carbapenem susceptibility.The 135 B. fragilis clinical isolates from the survey mentioned above (18, 19), originating from nine Belgian hospitals, as well as 113 B. fragilis isolates from routine cultures collected at our laboratory since 2005 were analyzed. Identification was performed by appropriate biochemical and enzymatic tests (11) and confirmed by MALDI-TOF MS. Meropenem susceptibility was determined by Etest methodology (bioMérieux, Marcy l'Etoile, France). The CLSI breakpoints for susceptible and resistant strains are Յ4 mg/liter and Ն16 mg/liter, respectively (4). PCR analysis was performed to detect the presence of the cfiA gene. The annealing temperature of the cfiA gene detection method described by Sóki et al. (16) was increa...

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Third Belgian multicentre survey of antibiotic susceptibility of anaerobic bacteria

Cited by 70 publications

References 5 publications

Antimicrobial Susceptibility to ß-lactams and Metronidazole of Microorganisms Isolated from Chronic and Aggressive Periodontitis

Antimicrobial Susceptibility to ß-lactams and Metronidazole of Microorganisms Isolated from Chronic and Aggressive Periodontitis

Is the Incidence of Anaerobic Bacteremia Decreasing? Analysis of 114,000 Blood Cultures over a Ten-Year Period

Differentiation of cfiA -Negative and cfiA -Positive Bacteroides fragilis Isolates by Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry

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