Hashimoto Takehiro, Hashinaga Kazuhiko, Komiya Kosaku, Hiramatsu Kazufumi
Infection Control Center, Oita University Hospital, Japan.
Infection Control Center, Oita University Hospital, Japan.
J Infect Chemother. 2023 Mar;29(3):284-288. doi: 10.1016/j.jiac.2022.11.011. Epub 2022 Dec 5.
Bacteroides spp. are the most common anaerobic bacteria isolated from the human gastrointestinal tract. Several resistant genes are present in Bacteroides spp. However, most studies have focused on the prevalence of the cfiA gene in Bacteroides fragilis alone. We assessed the susceptibility to antimicrobial agents and the prevalence of cepA, cfiA, cfxA, ermF, nim, and tetQ genes in Bacteroides strains isolated from clinical specimens in our hospital.
We isolated 86 B. fragilis and 58 non-fragilis Bacteroides strains from human clinical specimens collected from January 2011 to November 2021. Resistance against piperacillin (PIPC), cefotaxime (CTX), cefepime (CFPM), meropenem (MEPM), clindamycin, and minocycline was determined.
The resistant rates of penicillins and cephalosporins in non-fragilis isolates were significantly higher than those in B. fragilis isolates. In B. fragilis isolates, the resistant rates of PIPC, CTX, and CFPM in cfxA-positive isolates were significantly higher than those in cfxA-negative isolates (71% vs. 16%, 77% vs. 19%, and 77% vs. 30%, respectively). Thirteen B. fragilis isolates harbored the cfiA gene, two of which were resistant to MEPM. Six of the 13 cfiA-positive B. fragilis isolates were heterogeneously resistant to MEPM.
It is important to evaluate the use of MEPM as empirical therapy for Bacteroides spp. infections, considering the emergence of carbapenem resistance during treatment, existence of MEPM-resistant strains, and heterogeneous resistance.
拟杆菌属是从人类胃肠道分离出的最常见的厌氧菌。拟杆菌属中存在几种耐药基因。然而,大多数研究仅关注脆弱拟杆菌中cfiA基因的流行情况。我们评估了我院从临床标本中分离出的拟杆菌菌株对抗菌药物的敏感性以及cepA、cfiA、cfxA、ermF、nim和tetQ基因的流行情况。
我们从2011年1月至2021年11月收集的人类临床标本中分离出86株脆弱拟杆菌和58株非脆弱拟杆菌菌株。测定了对哌拉西林(PIPC)、头孢噻肟(CTX)、头孢吡肟(CFPM)、美罗培南(MEPM)、克林霉素和米诺环素的耐药性。
非脆弱拟杆菌分离株中青霉素和头孢菌素的耐药率显著高于脆弱拟杆菌分离株。在脆弱拟杆菌分离株中,cfxA阳性分离株中PIPC、CTX和CFPM的耐药率显著高于cfxA阴性分离株(分别为71%对16%、77%对19%和77%对30%)。13株脆弱拟杆菌分离株携带cfiA基因,其中2株对MEPM耐药。13株cfiA阳性脆弱拟杆菌分离株中有6株对MEPM呈异质性耐药。
考虑到治疗期间碳青霉烯耐药性的出现、MEPM耐药菌株的存在以及异质性耐药,评估将MEPM用作拟杆菌属感染的经验性治疗方法非常重要。