荷兰 8 家实验室分离的临床相关拟杆菌、海洋杆菌、副拟杆菌和普雷沃菌属物种的抗菌药敏谱。
Antimicrobial susceptibility profile of clinically relevant Bacteroides, Phocaeicola, Parabacteroides and Prevotella species, isolated by eight laboratories in the Netherlands.
机构信息
University Medical Center Groningen, Department of Medical Microbiology and Infection Prevention, University of Groningen, Groningen, The Netherlands.
Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
出版信息
J Antimicrob Chemother. 2024 Apr 2;79(4):868-874. doi: 10.1093/jac/dkae043.
OBJECTIVES
Recently, reports on antimicrobial-resistant Bacteroides and Prevotella isolates have increased in the Netherlands. This urged the need for a surveillance study on the antimicrobial susceptibility profile of Bacteroides, Phocaeicola, Parabacteroides and Prevotella isolates consecutively isolated from human clinical specimens at eight different Dutch laboratories.
METHODS
Each laboratory collected 20-25 Bacteroides (including Phocaeicola and Parabacteroides) and 10-15 Prevotella isolates for 3 months. At the national reference laboratory, the MICs of amoxicillin, amoxicillin/clavulanic acid, piperacillin/tazobactam, meropenem, imipenem, metronidazole, clindamycin, tetracycline and moxifloxacin were determined using agar dilution. Isolates with a high MIC of metronidazole or a carbapenem, or harbouring cfiA, were subjected to WGS.
RESULTS
Bacteroides thetaiotaomicron/faecis isolates had the highest MIC90 values, whereas Bacteroides fragilis had the lowest MIC90 values for amoxicillin/clavulanic acid, piperacillin/tazobactam, meropenem, imipenem and moxifloxacin. The antimicrobial profiles of the different Prevotella species were similar, except for amoxicillin, for which the MIC50 ranged from 0.125 to 16 mg/L for Prevotella bivia and Prevotella buccae, respectively. Three isolates with high metronidazole MICs were sequenced, of which one Bacteroides thetaiotaomicron isolate harboured a plasmid-located nimE gene and a Prevotella melaninogenica isolate harboured a nimA gene chromosomally.Five Bacteroides isolates harboured a cfiA gene and three had an IS element upstream, resulting in high MICs of carbapenems. The other two isolates harboured no IS element upstream of the cfiA gene and had low MICs of carbapenems.
CONCLUSIONS
Variations in resistance between species were observed. To combat emerging resistance in anaerobes, monitoring resistance and conducting surveillance are essential.
目的
最近，荷兰有关耐抗菌药物的拟杆菌属和普雷沃氏菌属分离株的报告有所增加。这促使我们有必要对从荷兰 8 家不同实验室的人体临床标本中连续分离的拟杆菌属、Phocaeicola、Parabacteroides 和普雷沃氏菌属分离株的抗菌药物敏感性概况进行监测研究。
方法
每家实验室收集 20-25 株拟杆菌（包括 Phocaeicola 和 Parabacteroides）和 10-15 株普雷沃氏菌，持续 3 个月。在国家参考实验室，采用琼脂稀释法测定阿莫西林、阿莫西林/克拉维酸、哌拉西林/他唑巴坦、美罗培南、亚胺培南、甲硝唑、克林霉素、四环素和莫西沙星的 MIC 值。对甲硝唑或碳青霉烯类药物 MIC 值较高，或携带 cfiA 的菌株进行 WGS 检测。
结果
Bacteroides thetaiotaomicron/faecis 分离株的 MIC90 值最高，而 Bacteroides fragilis 对阿莫西林/克拉维酸、哌拉西林/他唑巴坦、美罗培南、亚胺培南和莫西沙星的 MIC90 值最低。不同普雷沃氏菌种的抗菌药物谱相似，除了阿莫西林，其中 Prevotella bivia 和 Prevotella buccae 的 MIC50 分别为 0.125 至 16mg/L。3 株甲硝唑 MIC 值较高的分离株进行了测序，其中 1 株 Bacteroides thetaiotaomicron 分离株携带位于质粒上的 nimE 基因，1 株 Prevotella melaninogenica 分离株携带染色体上的 nimA 基因。5 株拟杆菌分离株携带 cfiA 基因，3 株携带位于 cfiA 基因上游的 IS 元件，导致碳青霉烯类药物 MIC 值较高。另外 2 株分离株 cfiA 基因上游没有 IS 元件，碳青霉烯类药物 MIC 值较低。
结论
观察到不同种属之间存在耐药性差异。为了对抗厌氧菌的新出现的耐药性，监测耐药性和进行监测至关重要。
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