Wüst J, Hardegger U
Institut für Medizinische Mikrobiologie, Universität Zürich.
Schweiz Rundsch Med Prax. 1991 Dec 27;80(52):1474-80.
There have been numerous reports on resistance of anaerobic bacteria against antimicrobial agents. Therefore, to assess the situation in Zurich, 187 anaerobic strains of various bacterial genera, isolated from clinical specimens during winter 1990/91, were tested for their susceptibility to antimicrobial agents active against anaerobic bacteria. Besides the Bacteroides fragilis group, which is naturally resistant against penicillin, 30% of isolates of other Bacteroides species were also resistant against penicillin. In general, anaerobes have remained susceptible to cefoxitin, chloramphenicol, clindamycin, imipenem, the 5-nitroimidazoles (metronidazole, ornidazole) as well as combinations of beta-lactam antibiotics with beta-lactamase inhibitors (clavulanic acid, sulbactam and tazobactam). Because rare strains resistant against cefoxitin, clindamycin and beta-lactams plus beta-lactamase inhibitors can be found, at least isolates from specific clinical situations should be tested for antimicrobial susceptibility. These are strains isolated from patients with brain abscess, endocarditis, osteomyelitis, arthritis, infected implants and prosthesis as well as those from persisting or recurrent bacteremia. Because the agar diffusion test yields unreliable results, minimal inhibitory concentration should be determined. Maybe the new 'E test' or the spiral gradient procedure can be used after evaluation.
关于厌氧菌对抗菌药物的耐药性已有大量报道。因此，为评估苏黎世的情况，对1990/91年冬季从临床标本中分离出的187株不同细菌属的厌氧菌株进行了测试，以检测它们对厌氧活性抗菌药物的敏感性。除了对青霉素天然耐药的脆弱拟杆菌群外，其他拟杆菌属分离株中30%也对青霉素耐药。一般来说，厌氧菌对头孢西丁、氯霉素、克林霉素、亚胺培南、5-硝基咪唑类（甲硝唑、奥硝唑）以及β-内酰胺抗生素与β-内酰胺酶抑制剂（克拉维酸、舒巴坦和他唑巴坦）的组合仍敏感。由于可发现对头孢西丁、克林霉素以及β-内酰胺类加β-内酰胺酶抑制剂耐药的罕见菌株，至少应针对特定临床情况的分离株进行药敏试验。这些菌株是从脑脓肿、心内膜炎、骨髓炎、关节炎、感染的植入物和假体患者以及持续性或复发性菌血症患者中分离出的。由于琼脂扩散试验结果不可靠，应测定最低抑菌浓度。评估后或许可以使用新的“E试验”或螺旋梯度法。
