Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, Crete, Greece.
University of Crete Medical School, Heraklion, Crete, Greece.
Anaerobe. 2020 Aug;64:102245. doi: 10.1016/j.anaerobe.2020.102245. Epub 2020 Jul 22.
Antimicrobial resistance among anaerobic bacteria is increasingly recognized with geographic differences. In this study we analyzed the distribution and antimicrobial susceptibility profiles of 358 Gram-positive clinically significant anaerobes, isolated from 2017 to 2019, in a Greek tertiary-care hospital. The species identification was performed by Vitek 2 and conventional biochemical methods, and the antimicrobial susceptibility testing by the E-test method. The antimicrobial agents tested were penicillin, ampicillin, amoxicillin-clavulanic acid, piperacillin-tazobactam, cefoxitin, imipenem, meropenem, clindamycin, metronidazole, moxifloxacin, chloramphenicol, tigecycline and vancomycin. Clostridioides difficile isolates were also tested against tetracycline. The results were interpreted using the CLSI and the EUCAST breakpoints. Clostridium species accounted for 35.5% of the isolates, followed by Gram-positive cocci (GPAC) (33.2%) and non-spore-forming bacilli (31.3%). Beta-lactams, β-lactam/β-lactamase inhibitors, cefoxitin, carbapenems, chloramphenicol, tigecycline and vancomycin proved all effective against the GPAC tested. Clindamycin, moxifloxacin and metronidazole resistance varied among different species of GPAC. Clindamycin and moxifloxacin resistance observed was 10% and 5% for Cutibacterium acnes, 25% and 6.2% for Actinomyces odontolyticus and 40% and 5% for Clostridium perfringens. C. difficile isolates were fully susceptible to metronidazole, vancomycin, and tigecycline. Resistance rates to clindamycin, moxifloxacin and tetracycline were 62.9%, 30% and 24.3%, respectively. These data highlight the need for periodic surveillance to monitor changes in susceptibility profiles.
抗微生物药物耐药性在厌氧菌中日益受到关注，且具有地域差异。本研究分析了 2017 年至 2019 年期间，希腊一家三级保健医院分离的 358 株临床重要的革兰阳性厌氧菌的分布和抗微生物药物敏感性谱。通过 Vitek 2 和常规生化方法进行种属鉴定，E 试验法进行抗微生物药物敏感性试验。检测的抗微生物药物包括青霉素、氨苄西林、阿莫西林-克拉维酸、哌拉西林-他唑巴坦、头孢西丁、亚胺培南、美罗培南、克林霉素、甲硝唑、莫西沙星、氯霉素、替加环素和万古霉素。艰难梭菌分离株也测试了四环素的耐药性。结果根据 CLSI 和 EUCAST 折点进行解释。梭菌属占分离株的 35.5%，其次是革兰阳性球菌（GPAC）（33.2%）和无芽孢杆菌（31.3%）。β-内酰胺类、β-内酰胺/β-内酰胺酶抑制剂、头孢西丁、碳青霉烯类、氯霉素、替加环素和万古霉素对所测试的 GPAC 均有效。克林霉素、莫西沙星和甲硝唑的耐药性在不同的 GPAC 种属之间存在差异。发现痤疮丙酸杆菌的克林霉素和莫西沙星耐药率分别为 10%和 5%，伴放线放线杆菌为 25%和 6.2%，产气荚膜梭菌为 40%和 5%。艰难梭菌分离株对甲硝唑、万古霉素和替加环素完全敏感。克林霉素、莫西沙星和四环素的耐药率分别为 62.9%、30%和 24.3%。这些数据强调了需要定期进行监测，以监测敏感性谱的变化。
