Lessons learned from the anaerobe survey historical perspective and review of the most recent data (2005-2007)

David R. Snydman, Nilda V. Jacobus, Laura A. McDermott, Yoav Golan, David W. Hecht, Ellie J.C. Goldstein, Lizzie Harrell, Stephen Jenkins, Duane Newton, Carl Pierson, John D. Rihs, Victor L. Yu, Richard Venezia, Sydney M. Finegold, Jon E. Rosenblatt, Sherwood L. Gorbach

Research output: Contribution to journalArticlepeer-review

120 Scopus citations

Abstract

The rationale and lessons learned through the evolution of the National Survey for the Susceptibility of Bacteroides fragilis Group from its initiation in 1981 through 2007 are reviewed here. The survey was conceived in 1980 to track emerging antimicrobial resistance in Bacteroides species. Methods. Data from the last 11 years of the survey (1997-2007), including 6574 isolates from 13 medical centers, were analyzed for in vitro antimicrobial resistance to both frequently used and newly developed antianaerobic agents. The minimum inhibitory concentrations of the antibiotics were determined using agar dilution in accordance with Clinical and Laboratory Standards Institute recommendations. Results. The analyses revealed that the carbapenems (imipenem, meropenem, ertapenem, and doripenem) and piperacillin-tazobactam were the most active agents against these pathogens, with resistance rates of 0.9%-2.3%. In the most recent 3 years of the survey (2005-2007), resistance to some agents was shown to depend on the species, such as ampicillin-sulbactam against Bacteroides distasonis (20.6%) and tigecycline against Bacteroides uniformis and Bacteroides eggerthii (∼7%). Very high resistance rates (>50%) were noted for moxifioxacin and trovafloxacin, particularly against Bacteroides vulgatus. During that period of study, non-B. fragilis Bacteroides species had >40% resistance to clindamycin. Metronidazole-resistant Bacteroides strains were also first reported during that period. Conclusions. In summary, resistance to antibiotics was greater among non-B. fragilis Bacteroides species than among B. fragilis and was especially greater among species with a low frequency of isolation, such as Bacteroides caccae and B. uniformis. The emergence of resistance among the non-B. fragilis Bacteroides species underscores the need for speciation of B. fragilis group isolates and for clinicians to be aware of associations between species and drug resistance.

Original languageEnglish
Pages (from-to)S26-S33
JournalClinical Infectious Diseases
Volume50
Issue numberSUPP.1
DOIs
StatePublished - 1 Jan 2010
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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