Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Clinical Laboratory, Queen Astrid Military Hospital, Brussels, Belgium.
Anaerobe. 2021 Jun;69:102348. doi: 10.1016/j.anaerobe.2021.102348. Epub 2021 Feb 14.
Eggerthella lenta is a Gram-positive anaerobic bacillus that is an important cause of bloodstream infections. This study aims to test the susceptibility of Eggerthella lenta blood culture isolates to commonly used antibiotics for the empirical treatment of anaerobic infections.
In total, 49 positive blood cultures for Eggerthella lenta were retrospectively included from patients hospitalised at the Universitair Ziekenhuis Brussel, Belgium, between 2004 and 2018. Identification was done by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) system. Antimicrobial susceptibility testing was performed using the reference agar dilution method according to Clinical and Laboratory Standards Institute (CLSI) guidelines with Brucella agar supplemented with 5 μg/mL hemin, 1 μg/mL vitamin K1 and 5% laked sheep blood. The minimal inhibitory concentrations were interpreted using the EUCAST breakpoints. Clinical characteristics were collected by reviewing the patient's medical records.
All isolates were susceptible to amoxicillin-clavulanate, metronidazole and meropenem. Eighty-eight % of them were susceptible to clindamycin and 94% (20% S, 74% I) were susceptible to piperacillin-tazobactam. The mean age of the patients was 64 (±20) and they showed a 30-day mortality of 27%. The source of infection was in 65.3% of the cases abdominal, 20.4% were sacral pressure ulcers and 14.3% were unknown causes. While all isolates were fully susceptible at standard dosing regimen to amoxicillin-clavulanate, most were only susceptible at increased exposure or resistant to piperacillin-tazobactam.
Our results suggest to be careful with the use of piperacillin-tazobactam and clindamycin in the empirical treatment of Eggerthella lenta infections.
迟缓埃格特菌（Eggerthella lenta）是一种革兰阳性厌氧杆菌，是引起血流感染的重要原因。本研究旨在检测迟缓埃格特菌血培养分离株对常用于治疗厌氧感染的经验性抗生素的敏感性。
回顾性纳入了 2004 年至 2018 年期间在比利时布鲁塞尔大学医院住院的 49 例迟缓埃格特菌阳性血培养患者。通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）系统进行鉴定。药敏试验采用 Brucella 琼脂中添加 5μg/mL 血红素、1μg/mL 维生素 K1 和 5%去垢绵羊血的参考琼脂稀释法，根据临床和实验室标准协会（CLSI）指南进行，使用 EUCAST 折点解释最小抑菌浓度。通过查阅患者病历收集临床特征。
所有分离株均对阿莫西林-克拉维酸、甲硝唑和美罗培南敏感。88%的分离株对克林霉素敏感，94%（20% S，74% I）对哌拉西林-他唑巴坦敏感。患者的平均年龄为 64（±20）岁，30 天死亡率为 27%。感染源在 65.3%的病例中为腹部，20.4%为骶骨压疮，14.3%原因不明。虽然所有分离株在标准剂量方案下对阿莫西林-克拉维酸完全敏感，但大多数仅在增加暴露量或对哌拉西林-他唑巴坦敏感。
我们的结果表明，在治疗迟缓埃格特菌感染的经验性治疗中，应谨慎使用哌拉西林-他唑巴坦和克林霉素。
