Department of Laboratory Medicine and Pathobiology, University of Toronto, Medical Sciences Building Room 6231, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.
Department of Laboratory Medicine and Pathobiology, University of Toronto, Medical Sciences Building Room 6231, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada; Public Health Ontario, 661 University Avenue, Suite 1701, Toronto, Ontario, M5G 1M1, Canada.
Anaerobe. 2021 Aug;70:102386. doi: 10.1016/j.anaerobe.2021.102386. Epub 2021 May 25.
Anaerobic bacteria can cause severe and life threatening infections. Susceptibility data are relatively limited on anaerobic organisms despite the clinical importance in guiding empiric treatment of infections. To determine antimicrobial susceptibility profiles of clinically significant anaerobic bacteria, isolates obtained from sterile sites submitted to Public Health Ontario Laboratory (2012-2019) were included in this study (N = 5712). Cefoxitin, clindamycin, metronidazole, meropenem, penicillin and piperacillin-tazobactam were tested using the gradient strip method with MICs interpreted based on Clinical and Laboratory Standards Institute guidelines. Bacteroides spp. (N = 958; 16.7%), Clostridium spp. (N = 798; 14.0%), Cutibacterium spp. (N =659; 11.5%) and Actinomyces spp. (N = 551; 7.0%) were the most commonly isolated genera. Bacteroides fragilis isolates were susceptible to cefoxitin (88.4%), clindamycin (68.4%), metronidazole (96.0%), meropenem (99.0%) and piperacillin-tazobactam (98.4%). Other Bacteroides spp. showed reduced susceptibility to several antimicrobials. Clostridium spp. isolates were susceptible to penicillin (69.7%), clindamycin (69.7%) and cefoxitin (76.3%); C. perfringens and C. ramosum showed distinct susceptibility profiles. Susceptibility rates among anaerobes remained relatively unchanged over 8 years with a few exceptions: C. perfringens susceptibility to clindamycin decreased from 91.3% to 60% (p = 0.03); Clostridium spp. susceptibility to penicillin similarly decreased from 82.1% to 65.9% (p = 0.03); Eggerthella spp. susceptibility to piperacillin-tazobactam decreased from 100% to 24.3% (p < 0.001); B. fragilis group susceptibility to cefoxitin decreased from 70.4% to 48.2% (p = 0.05); and Parabacteroides spp. susceptibility to piperacillin-tazobactam decreased from 100% to 25% (p = 0.01). Our findings underscore the need for ongoing surveillance and periodic monitoring of antimicrobial resistance in order to guide empiric therapy.
厌氧细菌可导致严重且危及生命的感染。尽管在指导感染的经验性治疗方面具有重要的临床意义，但关于厌氧微生物的药敏数据相对有限。为了确定临床相关厌氧细菌的抗菌药物敏感性特征，本研究纳入了 2012 年至 2019 年从无菌部位送检至安大略省公共卫生实验室的分离株（N=5712）。使用梯度条法测试头孢西丁、克林霉素、甲硝唑、美罗培南、青霉素和哌拉西林-他唑巴坦，并根据临床和实验室标准协会的指南解释 MIC。拟杆菌属（N=958；16.7%）、梭菌属（N=798；14.0%）、小棒杆菌属（N=659；11.5%）和放线菌属（N=551；7.0%）是最常分离的菌属。脆弱拟杆菌分离株对头孢西丁（88.4%）、克林霉素（68.4%）、甲硝唑（96.0%）、美罗培南（99.0%）和哌拉西林-他唑巴坦（98.4%）敏感。其他拟杆菌属对几种抗菌药物的敏感性降低。梭菌属分离株对青霉素（69.7%）、克林霉素（69.7%）和头孢西丁（76.3%）敏感；产气荚膜梭菌和脆弱梭菌具有独特的药敏谱。8 年来，除少数例外，厌氧菌的药敏率相对保持不变：克林霉素对产气荚膜梭菌的敏感性从 91.3%降至 60%（p=0.03）；梭菌属对青霉素的敏感性也从 82.1%降至 65.9%（p=0.03）；埃格特菌属对哌拉西林-他唑巴坦的敏感性从 100%降至 24.3%（p<0.001）；脆弱拟杆菌组对头孢西丁的敏感性从 70.4%降至 48.2%（p=0.05）；副拟杆菌属对哌拉西林-他唑巴坦的敏感性从 100%降至 25%（p=0.01）。我们的研究结果强调了需要进行持续监测和定期监测抗菌药物耐药性，以指导经验性治疗。
