Marina M, Ivanova M, Kantardjiev T
Anaerobic Laboratory, Department of Microbiology, National Center of Infectious and Parasitic Diseases, 26 Yanko Sakazov Blvd. 1504 Sofia, Bulgaria.
Anaerobe. 2009 Aug;15(4):127-32. doi: 10.1016/j.anaerobe.2009.03.002. Epub 2009 Mar 16.
The antimicrobial susceptibility of anaerobic bacteria isolated from clinical specimens in the referent for Bulgaria anaerobic laboratory was studied in a period of 25 years (1983-2007).
NCCLS-recommended agar dilution methods were used. beta-lactamase activity was determined with nitrocefin discs.
The 29 antimicrobial agents included in the study were divided according to their in vitro activity against the anaerobic isolates into 4 main groups for guiding empirical treatment: 1st group of metronidazole, chloramphenicol, meropenem, imipenem and combinations of beta-lactam antibiotics with sulbactam--with high activity and drugs of choice for treatment; 2nd group--clindamycin, cefoxitin, carbenicillin/and azlocillin, piperacillin/--with a good activity and low percent of resistant strains; 3rd group--of tetracycline and erythromycin with higher percent of resistant strains including the new macrolides as josamycin, clarithromycin, roxithromycin and azithromycin; 4th group--penicillins/ampicillin, amoxicillin, penicillin/and cephalosporins/cefamandole, cefazolin, cefotaxime and cefoperazone/--not suitable for treatment of infections including Bacteroides fragilis group strains, with a very high percent of resistant strains, probably due to beta-lactamase activity in most of the strains.
A continued updating and a follow-up in the changes of antibiotic susceptibility are necessary in every country as resistance patterns vary not only between geographical regions but also even among medical centers and hospitals which may be connected with differences in antibiotic usage in man and animals.
对保加利亚厌氧实验室参考中心25年（1983 - 2007年）期间从临床标本中分离出的厌氧菌的抗菌药敏性进行研究。
采用美国国家临床实验室标准化委员会（NCCLS）推荐的琼脂稀释法。用硝噻吩纸片测定β-内酰胺酶活性。
研究中纳入的29种抗菌药物根据其对厌氧分离株的体外活性分为4个主要组，用于指导经验性治疗：第1组为甲硝唑、氯霉素、美罗培南、亚胺培南以及β-内酰胺抗生素与舒巴坦的组合，活性高，是治疗的首选药物；第2组为克林霉素、头孢西丁、羧苄西林/和阿洛西林、哌拉西林/，活性良好，耐药菌株百分比低；第3组为四环素和红霉素，耐药菌株百分比更高，包括新的大环内酯类药物如交沙霉素、克拉霉素、罗红霉素和阿奇霉素；第4组为青霉素/氨苄西林、阿莫西林、青霉素/和头孢菌素/头孢孟多、头孢唑林、头孢噻肟和头孢哌酮/，不适合治疗包括脆弱拟杆菌群菌株在内的感染，耐药菌株百分比非常高，可能是由于大多数菌株具有β-内酰胺酶活性。
每个国家都有必要持续更新并跟踪抗生素敏感性的变化，因为耐药模式不仅因地理区域而异，甚至在医疗中心和医院之间也存在差异，这可能与人和动物抗生素使用的差异有关。
