Reissier Sophie, Penven Malo, Guérin François, Cattoir Vincent
Rennes University Hospital, Department of Clinical Microbiology, F-35033 Rennes, France.
UMR_S1230 BRM, Inserm, University of Rennes, F-35043 Rennes, France.
Microorganisms. 2023 Jun 1;11(6):1474. doi: 10.3390/microorganisms11061474.
Anaerobic bacteria are normal inhabitants of the human commensal microbiota and play an important role in various human infections. Tedious and time-consuming, antibiotic susceptibility testing is not routinely performed in all clinical microbiology laboratories, despite the increase in antibiotic resistance among clinically relevant anaerobes since the 1990s. β-lactam and metronidazole are the key molecules in the management of anaerobic infections, to the detriment of clindamycin. β-lactam resistance is usually mediated by the production of β-lactamases. Metronidazole resistance remains uncommon, complex, and not fully elucidated, while metronidazole inactivation appears to be a key mechanism. The use of clindamycin, a broad-spectrum anti-anaerobic agent, is becoming problematic due to the increase in resistance rate in all anaerobic bacteria, mainly mediated by Erm-type rRNA methylases. Second-line anti-anaerobes are fluoroquinolones, tetracyclines, chloramphenicol, and linezolid. This review aims to describe the up-to-date evolution of antibiotic resistance, give an overview, and understand the main mechanisms of resistance in a wide range of anaerobes.
厌氧菌是人类共生微生物群的正常组成部分，在各种人类感染中发挥重要作用。尽管自20世纪90年代以来临床相关厌氧菌的抗生素耐药性有所增加，但抗生素敏感性测试繁琐且耗时，并非在所有临床微生物实验室都常规进行。β-内酰胺类和甲硝唑是治疗厌氧菌感染的关键药物，而克林霉素的使用则受到影响。β-内酰胺耐药通常由β-内酰胺酶的产生介导。甲硝唑耐药仍然不常见、情况复杂且尚未完全阐明，而甲硝唑失活似乎是一个关键机制。由于所有厌氧菌的耐药率上升，主要由Erm型rRNA甲基化酶介导，广谱抗厌氧菌药物克林霉素的使用正变得成问题。二线抗厌氧菌药物有氟喹诺酮类、四环素类、氯霉素和利奈唑胺。本综述旨在描述抗生素耐药性的最新演变，进行概述，并了解多种厌氧菌耐药的主要机制。
