Antimicrobial susceptibility of clinically isolated anaerobic bacteria in a University Hospital Center Split, Croatia in 2013.

Related Articles

Antimicrobial susceptibility of clinically isolated anaerobic bacteria in a University Hospital Center Split, Croatia in 2013.

Anaerobe. 2014 Dec 2;

Authors: Novak A, Rubic Z, Dogas V, Goic-Barisic I, Radic M, Tonkic M

Abstract
Anaerobic bacteria play a significant role in many endogenous polymicrobial infections. Since antimicrobial resistance among anaerobes has increased worldwide, it is useful to provide local susceptibility data to guide empirical therapy. The present study reports recent data on the susceptibility of clinically relevant anaerobes in a University Hospital Center (UHC) Split, Croatia. A total of 63 Gram-negative and 59 Gram-positive anaerobic clinical isolates from various body sites were consecutively collected from January to December 2013. Antimicrobial susceptibility testing was performed using standardized methods and interpreted using EUCAST criteria. Patient’s clinical and demographic data were recorded by clinical microbiologist. Among 35 isolates of Bacteroides spp., 97.1% were resistant to penicillin (PCN), 5.7% to amoxicillin/clavulanic acid (AMC), 8.6 % to piperacillin/tazobactam (TZP), 29.0% to clindamycin (CLI) and 2.9% to metronidazole (MZ). Percentages of susceptible strains to imipenem (IPM), meropenem (MEM) and ertapenem (ETP) were 94.3. Resistance of other Gram-negative bacilli was 76.0% to PCN, 8.0% to AMC, 12.0% to TZP, 28.0% to CLI and 8% to MZ. All other Gram-negative strains were fully susceptible to MEM and ETP, while 96.0% were susceptible to IPM. Clostridium spp. isolates were 100% susceptible to all tested antibiotics except to CLI (two of four tested isolates were resistant). Propionibacterium spp. showed resistance to CLI in 4.3%, while 100% were resistant to MZ. Among other Gram-positive bacilli, 18.2% were resistant to PCN, 9.1% to CLI and 54.5% to MZ, while 81.8% of isolates were susceptible to carbapenems. Gram-positive cocci were 100% susceptible to all tested antimicrobials except to MZ, where 28.6% of resistant strains were recorded. Abdomen was the most common source of isolates (82.5%). The most prevalent types of infection were abscess (22.1%), sepsis (14.8%), appendicitis (13.9%) and peritonitis (6.6%). Twenty four patients (19.7%) received empiric antimicrobial therapy. One hundred and one patients (82.8%) had polymicrobial aerobic/anaerobic isolates cultivated from the same specimens. Almost all aerobic bacteria were of endogenous origin and showed fully susceptible antimicrobial profile; only 8.7% (9/104) were multiresistant and considered as hospital acquired. Based on our findings, β-lactam/β-lactamase inhibitor combinations and metronidazole remain useful antimicrobials for empiric treatment of anaerobic infections, while carbapenems should be reserved for situations were multidrug resistant, aerobic or facultative Gram-negative bacteria are expected. However, a certain percentage of resistant isolates were observed for each of these agents. Therefore, periodic resistance surveillance in anaerobes is highly recommended in order to guide empirical therapy.

PMID: 25479237 [PubMed – as supplied by publisher]

Detection of carbapenemase activities of Bacteroides fragilis strains with Matrix-assisted laser desorption ionization -Time of flight Mass spectrometry (MALDI-TOF MS).

Related Articles

Detection of carbapenemase activities of Bacteroides fragilis strains with Matrix-assisted laser desorption ionization -Time of flight Mass spectrometry (MALDI-TOF MS).

Anaerobe. 2014 Jan 27;

Authors: Johansson A, Nagy E, Sóki J, ESGAI (ESCMID Study Group on Anaerobic Infections)

Abstract
Today resistance against carbapenems is considered an emerging problem in Bacteroides fragilis. Carbapenemase activities produced by aerobic bacteria have been detected by looking at hydrolysis of carbapenems with MALDI-TOF MS, but this technique was never used for anaerobic bacteria. We have developed a protocol for detection and verification of carbapenemase production in B. fragilis within 2.5 hours. Twenty-eight strains of B. fragilis were tested. Of the sixteen cfiA-positive strains all showed hydrolysis of ertapenem, whereas the twelve cfiA-negative strains showed no hydrolysis. Ertapenem hydrolysis could be inhibited with 2,6-Pyridinecarboxylic acid (DPA) in all cfiA-positive strains, verifying the presence of the metallo-beta-lactamase. Here we show a rapid way to detect carbapenemase activities of B. fragilis strains.

PMID: 24480431 [PubMed – as supplied by publisher]