Bacteroides Fragilis: Current Susceptibilities, Mechanisms of Drug Resistance, and Principles of Antimicrobial Therapy

1986 ◽  
Vol 20 (7-8) ◽  
pp. 567-573 ◽  
Author(s):  
George J. Cuchural ◽  
Francis P. Tally

The Bacteroides fragilis group of organisms includes the most clinically important anaerobic bacteria. Optimal therapy of infections in which these organisms are involved includes adequate and timely surgical drainage of all collections, debridement of necrotic tissue, optimal nutritional support, and administration of appropriate empiric antibiotics to cover both the aerobic and anaerobic bacterial components of these mixed infections. Special attention must be paid to the B. fragilis group because of its high rate of resistance to many of the commonly used antibiotics. Of the currently available beta-lactam antibiotics, piperacillin has the lowest rate of resistance. Successful antimicrobial agents include clindamycin, chloramphenicol, and metronidazole plus an aminoglycoside. Piperacillin, cefoxitin, and moxalactam can be used with an aminoglycoside or alone if no resistant organisms are revealed on culture and susceptibility testing. Beta-lactam-based regimens are potentially less toxic and may be less costly than those that contain one or more non-beta-lactam antibiotics.

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 479
Author(s):  
Elisabeth König ◽  
Hans P. Ziegler ◽  
Julia Tribus ◽  
Andrea J. Grisold ◽  
Gebhard Feierl ◽  
...  

Anaerobic bacteria play an important role in human infections. Bacteroides spp. are some of the 15 most common pathogens causing nosocomial infections. We present antimicrobial susceptibility testing (AST) results of 114 Gram-positive anaerobic isolates and 110 Bacteroides-fragilis-group-isolates (BFGI). Resistance profiles were determined by MIC gradient testing. Furthermore, we performed disk diffusion testing of BFGI and compared the results of the two methods. Within Gram-positive anaerobes, the highest resistance rates were found for clindamycin and moxifloxacin (21.9% and 16.7%, respectively), and resistance for beta-lactams and metronidazole was low (<1%). For BFGI, the highest resistance rates were also detected for clindamycin and moxifloxacin (50.9% and 36.4%, respectively). Resistance rates for piperacillin/tazobactam and amoxicillin/clavulanic acid were 10% and 7.3%, respectively. Two B. fragilis isolates were classified as multi-drug-resistant (MDR), with resistance against all tested beta-lactam antibiotics. The comparative study of 109 BFGI resulted in 130 discrepancies in 763 readings (17%) with a high number of Very Major Errors (VME) and Major Errors (ME). In summary, resistance rates, with the exception of clindamycin and moxifloxacin, are still low, but we are facing increasing resistance rates for BFGI. Surveillance studies on a regular basis are still recommended.


2012 ◽  
Vol 6 (06) ◽  
pp. 489-494 ◽  
Author(s):  
Alaa Hani Al-Charrakh

Introduction: The presence of microorganisms in pharmaceuticals is undesirable because they may cause spoilage of the product and may present an infection hazard to the consumers or patients.  Methodology: A total of 102 samples of oral and topical non-sterile pharmaceutical products were collected at random from different drug houses and pharmacies in Iraq, to investigate the microbial contamination of these products. Bacterial isolates recovered from these medicaments were subjected to susceptibility testing against various antibiotics by disk diffusion method according to Clinical and Laboratory Standards (CLSI) guidelines. Results: The results revealed that the occurrence of Gram-positive bacteria was in oral and topical medicaments while Gram-negative bacteria were only detected in topical medicaments. More than 58% of Bacillus isolates were resistant to lincomycin and Bacillus mycoides isolates were resistant to beta-lactam antibiotics and trimethoprim-sulfamethoxazole. Staphylococcus spp. showed a relatively high resistance to ampicillin, amoxicillin, penicillin, tetracycline, and trimethoprim-sulfamethoxazole. S. epidermidis had the highest number of multi-resistant isolates. Furthermore, 87.5% of isolated Gram-negative rods showed high resistance to beta-lactam antibiotics and 75% of them were highly resistant to erythromycin. One isolate of Pseudomonas aeruginosa was the most resistant among all Gram-negative rod isolates. Conclusion: The high rate of resistance to antimicrobial agents of bacterial isolates recovered from oral and topical medicaments in this study may indicate a widespread antibiotic resistance among bacteria isolated from different sources, including those of anthropological and environmental origin. 


2011 ◽  
Vol 145 (5) ◽  
pp. 851-852 ◽  
Author(s):  
Itzhak Brook

This case study with chart review describes the aerobic and anaerobic microbiology of specimens obtained from 47 patients with Aspergillus spp fungus ball. Bacteria were recovered from 32 of the 47 (68%) patients. Eighty-six isolates, 29 aerobic and facultatives and 57 anaerobic, were recovered. Aerobic and facultatives only were recovered in 6 instances (19% of culture-positive specimens), anaerobes only in 11 (34%), and mixed aerobes and anaerobes in 15 (47%). The predominant aerobes were Staphylococcus aureus (6 isolates), α-hemolytic streptococci (5 isolates), Enterobacteriacae (4 isolates), and microaerophilic streptococci (4 isolates). The predominant anaerobes were Gram-negative bacilli (26), Peptostreptococcus spp (14), and Fusobacterium spp. (10). Twenty-two β-lactamase–producing bacteria were recovered from 15 patients. These included all 6 S aureus and 2 Bacteroides fragilis group isolates, 4 of 10 of Fusobacteria, and 7 of 19 Prevotella and Porphyromonas. This study demonstrates the recovery of polymicrobial aerobic-anaerobic flora in the sinuses of patients with fungus ball.


2011 ◽  
Vol 56 (3) ◽  
pp. 1247-1252 ◽  
Author(s):  
James A. Karlowsky ◽  
Andrew J. Walkty ◽  
Heather J. Adam ◽  
Melanie R. Baxter ◽  
Daryl J. Hoban ◽  
...  

ABSTRACTClinical isolates of theBacteroides fragilisgroup (n= 387) were collected from patients attending nine Canadian hospitals in 2010-2011 and tested for susceptibility to 10 antimicrobial agents using the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method.B. fragilis(59.9%),Bacteroides ovatus(16.3%), andBacteroides thetaiotaomicron(12.7%) accounted for ∼90% of isolates collected. Overall rates of percent susceptibility were as follows: 99.7%, metronidazole; 99.5%, piperacillin-tazobactam; 99.2%, imipenem; 97.7%, ertapenem; 92.0%, doripenem; 87.3%, amoxicillin-clavulanate; 80.9%, tigecycline; 65.9%, cefoxitin; 55.6%, moxifloxacin; and 52.2%, clindamycin. Percent susceptibility to cefoxitin, clindamycin, and moxifloxacin was lowest forB. thetaiotaomicron(n= 49, 24.5%),Parabacteroides distasonis/P. merdae(n= 11, 9.1%), andB. ovatus(n= 63, 31.8%), respectively. One isolate (B. thetaiotaomicron) was resistant to metronidazole, and two isolates (bothB. fragilis) were resistant to both piperacillin-tazobactam and imipenem. Since the last published surveillance study describing Canadian isolates ofB. fragilisgroup almost 20 years ago (A.-M. Bourgault et al., Antimicrob. Agents Chemother. 36:343–347, 1992), rates of resistance have increased for amoxicillin-clavulanate, from 0.8% (1992) to 6.2% (2010-2011), and for clindamycin, from 9% (1992) to 34.1% (2010-2011).


2020 ◽  
Vol 13 (3) ◽  
pp. 135-140
Author(s):  
HauwaYakubu ◽  
Mahmud Yerima Iliyasu ◽  
Asma’u Salisu ◽  
Abdulmumin Ibrahim Sulaiman ◽  
Fatima Tahir ◽  
...  

Carbapenemases are microbial enzymes that confer resistance to virtually all available beta-lactam antibiotics and the most frequent carbapenemases are the Klebsiella pneumoniae Carbapenamase (KPC). Detection of carbapenemases is a significant infection control strategy as the enzymes are often associated with extensive antimicrobial resistance, therapeutic failures and mortality associated with infectious diseases. A total of 400 clinical samples were collected from different groups of patients in Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria and 118 K. pneumoniae were isolated using standard microbiological techniques. The isolates were subjected to antibiotic susceptibility testing by Kirby-Bauer disc diffusion method, then screened for Carbapenamase production using modified Hodge test. The results indicated that the isolates were resistant to Ampicillin (61.9%), Ceftriaxone (50.8%) and Ceftazidime (50.8%), then Ciprofloxacin (54.2%), but predominantly sensitive to Imipenem (66.9%), Eterpenem (60.2%) and Meropenem (65.3%). It was found that 38 (32.2%) of the isolates phenotypically shows the presence of Carbapenamase, with highest frequency of (40.7%) among patients, mainly adult females with cases of Urinary Tract Infections (UTIs) and the least from wound (11.8%).This study revealed that the isolates produced other beta-lactamases than KPC or variants of Carbapenamase that cannot be detected by modified Hodge test, thus shows low resistance to carbapenems. Therefore further studies is needed to genotypically confirm the presence of KPC in these isolates.


2010 ◽  
Vol 54 (12) ◽  
pp. 5381-5386 ◽  
Author(s):  
Jong Hwa Yum ◽  
Sung Hak Choi ◽  
Dongeun Yong ◽  
Yunsop Chong ◽  
Weon Bin Im ◽  
...  

ABSTRACT Resistance of Gram-positive pathogens to first-line antimicrobial agents has been increasing in many parts of the world. We compared the in vitro activities of torezolid with those of other antimicrobial agents, including linezolid, against clinical isolates of major aerobic and anaerobic bacteria. Torezolid had an MIC90 of ≤0.5 μg/ml for the Gram-positive bacterial isolates tested and was more potent than either linezolid or vancomycin.


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