Clinical characteristics and antimicrobial susceptibilities of anaerobic bacteremia in an acute care hospital

Tan, Thean Yen; Ng, Lily Siew Yong; Kwang, Lee Ling; Rao, S. Girish; Eng, Li Ching

doi:10.1016/j.anaerobe.2016.11.009

Cited by 33 publications

(35 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, a low rate of resistance to metronidazole and imipenem was observed (3.2% each one). Of course, resistance to penicillin was observed in 98.3% of the isolates tested, similar to the rate published in other studies [10][11][12]. In these studies, and in others [13,14], the resistance rate of Bacteroides to clindamycin is high and similar to our study.…”

Section: Discussionsupporting

confidence: 92%

“…However, a report (n = 13) showed the highest resistance was to clindamycin in previous years (61.5%) [15]. Regarding moxifloxacin, all mentioned studies showed less resistance of Bacteroides to this drug [10][11][12][13], except two studies that showed a similar rate [14,15]. Overall, resistance of Bacteroides to metronidazole remains rare [10,12,13], although in two studies some cases of metronidazole resistance could be observed, as in our case [11,12].…”

Section: Discussionmentioning

confidence: 50%

See 1 more Smart Citation

Clinical Findings and Antimicrobial Susceptibility of Anaerobic Bacteria Isolated in Bloodstream Infections

et al. 2020

View full text Add to dashboard Cite

The objectives of this study were to report on the antimicrobial susceptibility of 141 clinically significant anaerobic bacteria isolated from bloodstream infections between January 2016 and April 2020 in a tertiary-care hospital in Granada (Spain) and to describe the main clinical features of the patients. Species identification was performed by MALDI-TOF MS (Bruker Daltonics, Billerica, MA, USA). Antimicrobial susceptibility tests were performed against penicillin, amoxicillin-clavulanic acid, imipenem, moxifloxacin, clindamycin, metronidazole, and piperacillin-tazobactam using the gradient diffusion technique and EUCAST breakpoints, except for moxifloxacin (CLSI breakpoints). The most frequent anaerobes were Bacteroides (43.9%, n = 62), Clostridium (24.1%, n = 34) and Gram-positive anaerobic cocci (GPACs) (15.6%, n = 22). Almost all tested anaerobes were susceptible to imipenem and amoxicillin-clavulanic acid, except for Bacteroides. High overall resistance rates to clindamycin were observed, especially for Gram-positive anaerobic cocci (GPACs) (54.5%) and for Bacteroides spp. (45.1%). Overall, low resistance rates to almost all antibiotics were observed for Clostridium. High resistance rates to penicillin were also observed for Gram-positive anaerobic bacilli (GPABs) (44.4%), as well as to metronidazole (22.2%), although only nine isolates were included. Antimicrobial susceptibility testing for anaerobes should always be performed in severe infections, such as those localized in the bloodstream. The information obtained contributes to selecting empirical treatments according with local data on resistance.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 50%

Clinical Findings and Antimicrobial Susceptibility of Anaerobic Bacteria Isolated in Bloodstream Infections

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Anaerobic bacteria have been reported to be isolated from up to 4.1% of positive blood culture samples (25). Members of the Bacteroides fragilis group are the most prevalent anaerobic pathogens recovered with 45% (25) and are associated with a high mortality rate up to 25% (26). Anaerobic incubation and growth rates usually prolong time to identification by conventional methods, with 45.13 h for the three isolates in this study compared to a median time to identification of 31.07 h (IQR ϭ 28.82 to 46.55 h).…”

Section: (S)mentioning

confidence: 78%

Evaluation of the Accelerate Pheno System for Fast Identification and Antimicrobial Susceptibility Testing from Positive Blood Cultures in Bloodstream Infections Caused by Gram-Negative Pathogens

et al. 2017

View full text Add to dashboard Cite

Bloodstream infections (BSI) are an important cause of morbidity and mortality. Increasing rates of antimicrobial-resistant pathogens limit treatment options, prompting an empirical use of broad-range antibiotics. Fast and reliable diagnostic tools are needed to provide adequate therapy in a timely manner and to enable a de-escalation of treatment. The Accelerate Pheno system (Accelerate Diagnostics, USA) is a fully automated test system that performs both identification and antimicrobial susceptibility testing (AST) directly from positive blood cultures within approximately 7 h. In total, 115 episodes of BSI with Gram-negative bacteria were included in our study and compared to conventional culture-based methods. The Accelerate Pheno system correctly identified 88.7% (102 of 115) of all BSI episodes and 97.1% (102 of 105) of isolates that are covered by the system's identification panel. The Accelerate Pheno system generated an AST result for 91.3% (95 of 104) samples in which the Accelerate Pheno system identified a Gram-negative pathogen. The overall category agreement between the Accelerate Pheno system and culture-based AST was 96.4%, the rates for minor discrepancies 1.4%, major discrepancies 2.3%, and very major discrepancies 1.0%. Of note, ceftriaxone, piperacillintazobactam, and carbapenem resistance was correctly detected in blood culture specimens with extended-spectrum beta-lactamase-producing Escherichia coli (n ϭ 7) and multidrug-resistant Pseudomonas aeruginosa (n ϭ 3) strains. The utilization of the Accelerate Pheno system reduced the time to result for identification by 27.49 h (P Ͻ 0.0001) and for AST by 40.39 h (P Ͻ 0.0001) compared to culture-based methods in our laboratory setting. In conclusion, the Accelerate Pheno system provided fast, reliable results while significantly improving turnaround time in blood culture diagnostics of Gramnegative BSI.KEYWORDS antimicrobial susceptibility testing, bloodstream infections, rapid tests B loodstream infections (BSI) are an important cause of morbidity and mortality, associated with prolonged hospital stays, as well as high costs for health care systems (1-3). Increasing rates of antimicrobial-resistant pathogens, in particular Gramnegative bacteria, limit treatment options, often prompting the empirical use of broad-range antibiotics. Therefore, we need fast and reliable diagnostic tools to speed up both identification (ID) and antimicrobial susceptibility testing (AST) from blood cultures in order to provide adequate therapy in a timely manner and to enable effective antibiotic stewardship interventions (4).

show abstract

“…The significance of the abovementioned tendencies is further underlined by the fact, that treatment failure has been described in empirical treatment in cases of anaerobic bacteraemia, as result of a multidrug resistant B. fragilis infection [ 9 , 84 , 152 , 153 , 154 , 155 ]. What makes this problem even more insidious is the fact that the correlation between the presence of multidrug resistant anaerobic bacterial strains and clinical failure is hard to prove.…”

Section: Antibiotic Resistance In Anaerobic Bacteria: the Importanmentioning

confidence: 99%

Identification and Antimicrobial Susceptibility Testing of Anaerobic Bacteria: Rubik’s Cube of Clinical Microbiology?

2017

View full text Add to dashboard Cite

Anaerobic bacteria have pivotal roles in the microbiota of humans and they are significant infectious agents involved in many pathological processes, both in immunocompetent and immunocompromised individuals. Their isolation, cultivation and correct identification differs significantly from the workup of aerobic species, although the use of new technologies (e.g., matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, whole genome sequencing) changed anaerobic diagnostics dramatically. In the past, antimicrobial susceptibility of these microorganisms showed predictable patterns and empirical therapy could be safely administered but recently a steady and clear increase in the resistance for several important drugs (β-lactams, clindamycin) has been observed worldwide. For this reason, antimicrobial susceptibility testing of anaerobic isolates for surveillance purposes or otherwise is of paramount importance but the availability of these testing methods is usually limited. In this present review, our aim was to give an overview of the methods currently available for the identification (using phenotypic characteristics, biochemical testing, gas-liquid chromatography, MALDI-TOF MS and WGS) and antimicrobial susceptibility testing (agar dilution, broth microdilution, disk diffusion, gradient tests, automated systems, phenotypic and molecular resistance detection techniques) of anaerobes, when should these methods be used and what are the recent developments in resistance patterns of anaerobic bacteria.

show abstract

Clinical characteristics and antimicrobial susceptibilities of anaerobic bacteremia in an acute care hospital

Cited by 33 publications

References 17 publications

Clinical Findings and Antimicrobial Susceptibility of Anaerobic Bacteria Isolated in Bloodstream Infections

Clinical Findings and Antimicrobial Susceptibility of Anaerobic Bacteria Isolated in Bloodstream Infections

Evaluation of the Accelerate Pheno System for Fast Identification and Antimicrobial Susceptibility Testing from Positive Blood Cultures in Bloodstream Infections Caused by Gram-Negative Pathogens

Identification and Antimicrobial Susceptibility Testing of Anaerobic Bacteria: Rubik’s Cube of Clinical Microbiology?

Contact Info

Product

Resources

About