Department of Microbiology and Instituto Biosanitario, Virgen de las Nieves University Hospita, Granada, Spain.
Department of Microbiology and Instituto Biosanitario, Virgen de las Nieves University Hospita, Granada, Spain.
Anaerobe. 2019 Oct;59:49-53. doi: 10.1016/j.anaerobe.2019.05.007. Epub 2019 May 16.
The objectives of this study were to report on the antimicrobial susceptibility of 276 clinically significant anaerobic bacteria belonging to the major genera isolated between May 2017 and November 2018 in a tertiary hospital in Granada (Spain) and to describe key clinical features of the patients. Species identification was performed by MALDI-TOF MS. Antimicrobial susceptibility tests were performed against penicillin, amoxicillin-clavulanic, imipenem, meropenem, moxifloxacin, clindamycin, metronidazole, vancomycin, and piperacillin-tazobactam using the gradient diffusion technique and EUCAST breakpoints (except for moxifloxacin). The most frequent anaerobes were Bacteroides (29.7%; n = 82), Clostridioides difficile (15.9%, n = 44), Prevotella (10.8%, n = 30), and Propionibacterium (10.7%, n = 25). Metronidazole was not universally active against all genera tested, and some isolates showed resistance to this drug. Almost all tested anaerobes were susceptible to carbapenems and amoxicillin-clavulanate except for Clostridioides difficile (resistance rate of 94%) and Bacteroides (19%), respectively. High overall resistance rates to clindamycin were observed, especially for genera Finegoldia (54%), Bacteroides (49%), and Prevotella (40%). Resistance rates to carbapenems and amoxicillin-clavulanate were very low for the majority of tested genera but were high for Clostridioides difficile and Bacteroides spp., respectively. Resistance to clindamycin was very high, especially for Bacteroides, Finegoldia magna, Prevotella and Peptoniphilus. Routine antimicrobial susceptibility testing for anaerobes contributes information on the global situation and allows empirical therapies to be selected in accordance with local data on resistant strains.
本研究的目的是报告 2017 年 5 月至 2018 年 11 月期间在西班牙格拉纳达的一家三级医院分离的主要属的 276 株临床重要厌氧菌的抗菌药物敏感性,并描述患者的主要临床特征。采用基质辅助激光解吸电离飞行时间质谱法(MALDI-TOF MS)进行菌种鉴定。采用梯度扩散技术和 EUCAST 折点(莫西沙星除外)进行药敏试验,检测青霉素、阿莫西林-克拉维酸、亚胺培南、美罗培南、莫西沙星、克林霉素、甲硝唑、万古霉素和哌拉西林-他唑巴坦对分离株的抗菌活性。最常见的厌氧菌为拟杆菌属(29.7%,n=82)、艰难梭菌(15.9%,n=44)、普雷沃菌属(10.8%,n=30)和丙酸杆菌属(10.7%,n=25)。甲硝唑对所有测试的菌属并非普遍有效,部分分离株对该药物耐药。除艰难梭菌(耐药率 94%)和拟杆菌属(19%)外,几乎所有测试的厌氧菌均对碳青霉烯类和阿莫西林-克拉维酸敏感。克林霉素总体耐药率较高,尤其是脆弱拟杆菌(54%)、拟杆菌属(49%)和普雷沃菌属(40%)。大多数测试菌属对碳青霉烯类和阿莫西林-克拉维酸的耐药率很低,但艰难梭菌和拟杆菌属的耐药率很高。克林霉素耐药率很高,尤其是拟杆菌属、巨大消化链球菌、普雷沃菌属和消化链球菌属。对厌氧菌进行常规药敏试验有助于了解全球情况,并根据当地耐药菌株的数据选择经验性治疗。