Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; UMR MIVEGEC IRD-CNRS-Université de Montpellier, IRD, Montpellier, France.
Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; UMR MIVEGEC IRD-CNRS-Université de Montpellier, IRD, Montpellier, France.
Anaerobe. 2020 Aug;64:102207. doi: 10.1016/j.anaerobe.2020.102207. Epub 2020 Apr 28.
Bacteremia implicating anaerobic bacteria (BIAB) represents 2-6% of all episodes of bacteremia and is associated with high mortality. In this retrospective study from June 2015 to December 2016, we compared BIAB frequency in two hospital centers in Montpellier (France): Montpellier university hospital (MUH) and a center specialized in cancer (ICM). Among the 2465 microbiologically relevant episodes of bacteremia, we identified 144 (5.8%) in which anaerobic bacteria were implicated. BIAB frequency was higher at ICM than MUH (10.4%, vs. 4.9%, p < 0.01). Poly-microbial bacteremia was more frequent among the BIAB episodes (31.9% vs. 11.0% for aerobic-only bacteremia, p < 0.01). Bacteroides and Clostridium were the most frequently identified genera of anaerobic bacteria (64 and 18 episodes, respectively), with the B. fragilis group (BFG) involved in 68/144 episodes. We could perform antibiotic susceptibility typing in 106 of the 144 anaerobic isolates, including 67 BFG isolates. All isolates but one were susceptible to metronidazole. In the BFG, sporadic resistant or intermediate results were found for amoxicillin-clavulanate (5/67), piperacillin-tazobactam (2/67) and imipenem (1/67). BFG isolates were susceptible also to cefoxitin (90.8%), rifampicin (97.0%) and tigecyclin (91.0%). Multidrug resistance in this group (7 isolates) was mostly due to acquired resistance to moxifloxacin, clindamycin and tigecyclin. This study shows that BIAB frequency can vary among hospitals and services. They should especially be taken into account in centers specialized in cancer treatment. However, the implicated bacteria remain frequently susceptible to the most used antibiotics used against anaerobic bacteria, although resistance does exist.
涉及厌氧菌的菌血症（BIAB）占所有菌血症病例的 2-6%，与高死亡率相关。在这项 2015 年 6 月至 2016 年 12 月的回顾性研究中，我们比较了法国蒙彼利埃的两家医院中心（蒙彼利埃大学医院（MUH）和一家专门治疗癌症的中心（ICM））的 BIAB 频率。在 2465 例微生物学相关菌血症病例中，我们确定了 144 例（5.8%）涉及厌氧菌。ICM 的 BIAB 频率高于 MUH（10.4%比 4.9%，p<0.01）。多微生物菌血症在 BIAB 病例中更为常见（31.9%比有氧菌血症的 11.0%，p<0.01）。拟杆菌属和梭菌属是最常鉴定出的厌氧菌属（分别为 64 例和 18 例），其中脆弱拟杆菌组（BFG）涉及 68/144 例。我们可以对 144 株厌氧分离株中的 106 株进行抗生素药敏性分型，其中包括 67 株 BFG 分离株。除一株外，所有分离株均对甲硝唑敏感。在 BFG 中，阿莫西林克拉维酸（5/67）、哌拉西林他唑巴坦（2/67）和亚胺培南（1/67）的耐药或中介结果偶有发现。BFG 分离株对头孢西丁（90.8%）、利福平（97.0%）和替加环素（91.0%）也敏感。该组（7 株）的多药耐药性主要是由于对莫西沙星、克林霉素和替加环素的获得性耐药。这项研究表明，BIAB 的频率在医院和科室之间可能有所不同。在专门治疗癌症的中心，尤其应该考虑到这一点。然而，所涉及的细菌对最常用于治疗厌氧菌的抗生素仍经常敏感，尽管确实存在耐药性。
