University of Lille, France.
Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, the Netherlands.
Anaerobe. 2021 Dec;72:102463. doi: 10.1016/j.anaerobe.2021.102463. Epub 2021 Sep 28.
In anaerobic infections, the relationship between clinical failure and antibiotic resistance is difficult to demonstrate, especially in mixed anaerobic-aerobic infections. Single isolates of anaerobes in cases of bacteraemia revealed that treatment failures were due to inappropriate therapy. We review here cases, where the empiric treatment was unsuccessful due to resistance of anaerobic bacteria to the administered agents and where the change of the antibiotic allowed the patients to be cured. Many therapeutic failures could be linked to the lack of timely detection of resistance, including heteroresistance of the anaerobes. Disk diffusion or Etest methodology may be suitable, at least for rapidly growing anaerobes, to detect both resistance and heteroresistance to antibiotics widely used for empirical therapy.
在厌氧感染中，临床失败与抗生素耐药性之间的关系很难证明，特别是在混合厌氧-需氧感染中。菌血症中单一厌氧菌的分离株表明，治疗失败是由于抗生素治疗不当。我们在此回顾了一些因被给予的药物对厌氧细菌的耐药性而导致经验性治疗无效的病例，以及抗生素的改变使患者得以治愈的病例。许多治疗失败可能与未能及时发现耐药性有关，包括厌氧菌的异质性耐药性。纸片扩散或 Etest 方法至少适用于快速生长的厌氧菌，可以检测广泛用于经验性治疗的抗生素的耐药性和异质性耐药性。
