Hanshu Fang , Xin Li , Mei-Kum Yan , Man-Ki Tong , Kin-Hung Chow , Vincent Chi-Chung Cheng , Pak-Leung Ho
{"title":"香港脆弱拟杆菌群生物的耐药性，2020-2021年。","authors":"Hanshu Fang , Xin Li , Mei-Kum Yan , Man-Ki Tong , Kin-Hung Chow , Vincent Chi-Chung Cheng , Pak-Leung Ho","doi":"10.1016/j.anaerobe.2023.102756","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>This retrospective study analyzed the susceptibility levels of <span><em>Bacteroides fragilis</em></span><span><span> group (BFG) in a hospital-based laboratory where disk diffusion test (DDT) was routinely performed. Isolates non-susceptible to </span>imipenem<span> and metronidazole by DDT were further investigated using a gradient method.</span></span></p></div><div><h3>Methods</h3><p>The DDT and MIC susceptibility data of clindamycin<span><span>, metronidazole, moxifloxacin and imipenem obtained on </span>Brucella<span> blood agar for 1264 non-duplicated isolates during 2020–2021 were analyzed. Species identification was obtained by matrix-assisted laser desorption ionization time-of-flight mass spectrometry and 16S rRNA<span> sequencing. Interpretative agreement of DDT results using the 2015 EUCAST tentative and 2021 CA-SFM breakpoints was compared against MIC as the reference.</span></span></span></p></div><div><h3>Results</h3><p>The dataset included 604 <em>B. fragilis</em> (483 division I, 121 division II isolates), 415 non-<em>fragilis Bacteroides</em>, 177 <em>Phocaeicola</em> and 68 <span><em>Parabacteroides</em></span><span>. Susceptibility rates for clindamycin (22.1–62.1%) and moxifloxacin (59.9–80.9%) were low and many had no inhibition zones. At the EUCAST and CA-SFM breakpoints, 83.0 and 89.4% were imipenem-susceptible, and 89.6% and 97.4 were metronidazole-susceptible. MIC testing confirmed 11.4% and 2.8% isolates as imipenem-non-susceptible and metronidazole-resistant, respectively. Significant numbers of false-susceptibility and/or false-resistance results were observed at the CA-SFM breakpoint but not the EUCAST breakpoint. Higher rates of imipenem and/or metronidazole resistance were detected in </span><em>B. fragilis</em> division II, <em>B. caccae, B. ovatus, B. salyersiae, B. stercoris</em> and <em>Parabacteroides</em>. Co-resistance to imipenem and metronidazole was detected in 3 <em>B. fragilis</em> division II isolates.</p></div><div><h3>Conclusions</h3><p>The data demonstrated emerging BFG resistance to several important anti-anaerobic antibiotics and highlights the importance of anaerobic susceptibility testing in clinical laboratories to guide therapy.</p></div>","PeriodicalId":8050,"journal":{"name":"Anaerobe","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Antimicrobial susceptibility of Bacteroides fragilis group organisms in Hong Kong, 2020–2021\",\"authors\":\"Hanshu Fang , Xin Li , Mei-Kum Yan , Man-Ki Tong , Kin-Hung Chow , Vincent Chi-Chung Cheng , Pak-Leung Ho\",\"doi\":\"10.1016/j.anaerobe.2023.102756\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>This retrospective study analyzed the susceptibility levels of <span><em>Bacteroides fragilis</em></span><span><span> group (BFG) in a hospital-based laboratory where disk diffusion test (DDT) was routinely performed. Isolates non-susceptible to </span>imipenem<span> and metronidazole by DDT were further investigated using a gradient method.</span></span></p></div><div><h3>Methods</h3><p>The DDT and MIC susceptibility data of clindamycin<span><span>, metronidazole, moxifloxacin and imipenem obtained on </span>Brucella<span> blood agar for 1264 non-duplicated isolates during 2020–2021 were analyzed. Species identification was obtained by matrix-assisted laser desorption ionization time-of-flight mass spectrometry and 16S rRNA<span> sequencing. Interpretative agreement of DDT results using the 2015 EUCAST tentative and 2021 CA-SFM breakpoints was compared against MIC as the reference.</span></span></span></p></div><div><h3>Results</h3><p>The dataset included 604 <em>B. fragilis</em> (483 division I, 121 division II isolates), 415 non-<em>fragilis Bacteroides</em>, 177 <em>Phocaeicola</em> and 68 <span><em>Parabacteroides</em></span><span>. Susceptibility rates for clindamycin (22.1–62.1%) and moxifloxacin (59.9–80.9%) were low and many had no inhibition zones. At the EUCAST and CA-SFM breakpoints, 83.0 and 89.4% were imipenem-susceptible, and 89.6% and 97.4 were metronidazole-susceptible. MIC testing confirmed 11.4% and 2.8% isolates as imipenem-non-susceptible and metronidazole-resistant, respectively. Significant numbers of false-susceptibility and/or false-resistance results were observed at the CA-SFM breakpoint but not the EUCAST breakpoint. Higher rates of imipenem and/or metronidazole resistance were detected in </span><em>B. fragilis</em> division II, <em>B. caccae, B. ovatus, B. salyersiae, B. stercoris</em> and <em>Parabacteroides</em>. Co-resistance to imipenem and metronidazole was detected in 3 <em>B. fragilis</em> division II isolates.</p></div><div><h3>Conclusions</h3><p>The data demonstrated emerging BFG resistance to several important anti-anaerobic antibiotics and highlights the importance of anaerobic susceptibility testing in clinical laboratories to guide therapy.</p></div>\",\"PeriodicalId\":8050,\"journal\":{\"name\":\"Anaerobe\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anaerobe\",\"FirstCategoryId\":\"99\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1075996423000653\",\"RegionNum\":3,\"RegionCategory\":\"生物学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaerobe","FirstCategoryId":"99","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1075996423000653","RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
Antimicrobial susceptibility of Bacteroides fragilis group organisms in Hong Kong, 2020–2021
Objectives
This retrospective study analyzed the susceptibility levels of Bacteroides fragilis group (BFG) in a hospital-based laboratory where disk diffusion test (DDT) was routinely performed. Isolates non-susceptible to imipenem and metronidazole by DDT were further investigated using a gradient method.
Methods
The DDT and MIC susceptibility data of clindamycin, metronidazole, moxifloxacin and imipenem obtained on Brucella blood agar for 1264 non-duplicated isolates during 2020–2021 were analyzed. Species identification was obtained by matrix-assisted laser desorption ionization time-of-flight mass spectrometry and 16S rRNA sequencing. Interpretative agreement of DDT results using the 2015 EUCAST tentative and 2021 CA-SFM breakpoints was compared against MIC as the reference.
Results
The dataset included 604 B. fragilis (483 division I, 121 division II isolates), 415 non-fragilis Bacteroides, 177 Phocaeicola and 68 Parabacteroides. Susceptibility rates for clindamycin (22.1–62.1%) and moxifloxacin (59.9–80.9%) were low and many had no inhibition zones. At the EUCAST and CA-SFM breakpoints, 83.0 and 89.4% were imipenem-susceptible, and 89.6% and 97.4 were metronidazole-susceptible. MIC testing confirmed 11.4% and 2.8% isolates as imipenem-non-susceptible and metronidazole-resistant, respectively. Significant numbers of false-susceptibility and/or false-resistance results were observed at the CA-SFM breakpoint but not the EUCAST breakpoint. Higher rates of imipenem and/or metronidazole resistance were detected in B. fragilis division II, B. caccae, B. ovatus, B. salyersiae, B. stercoris and Parabacteroides. Co-resistance to imipenem and metronidazole was detected in 3 B. fragilis division II isolates.
Conclusions
The data demonstrated emerging BFG resistance to several important anti-anaerobic antibiotics and highlights the importance of anaerobic susceptibility testing in clinical laboratories to guide therapy.
期刊介绍：
Anaerobe is essential reading for those who wish to remain at the forefront of discoveries relating to life processes of strictly anaerobes. The journal is multi-disciplinary, and provides a unique forum for those investigating anaerobic organisms that cause infections in humans and animals, as well as anaerobes that play roles in microbiomes or environmental processes.
Anaerobe publishes reviews, mini reviews, original research articles, notes and case reports. Relevant topics fall into the broad categories of anaerobes in human and animal diseases, anaerobes in the microbiome, anaerobes in the environment, diagnosis of anaerobes in clinical microbiology laboratories, molecular biology, genetics, pathogenesis, toxins and antibiotic susceptibility of anaerobic bacteria.
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