Emergence of carbapenem resistance in Bacteroides fragilis in China

Gao, Qiong; Shi, Wei; Xu, Teng; Zhao, Xilin; Huang, Haihui; Hu, Fupin

doi:10.1016/j.ijantimicag.2019.02.017

Cited by 34 publications

(31 citation statements)

References 18 publications

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“…The resistance rate of B. fragilis to metronidazole in this study was 7.5%, which is obviously higher than previous reports [5,6,7,9,21,22], and no metronidazole resistant non-B. fragilis isolate was detected.…”

Section: Antibiotic Susceptibility Test Resultscontrasting

confidence: 83%

“…strains was firstly reported over 3 decades ago [11]. As reported in present studies, the primary mechanism of carbapenem resistance of B. fragilis was production of metallo-β-lactamase encoded by the cfiA gene [12] and specific upstream insertion sequence (IS) element is required for its expression, which was confirmed by some subsequent investigations [7,13]. However, owing to lack of popularization of anaerobes culture among Chinese hospitals, less is known about the actual resistance tendency and resistance mechanism of Bacteroides spp.…”

Section: Introductionsupporting

confidence: 68%

“…is a kind of common anaerobes inhabiting the intestines of humans and is the most common anaerobes recovered from various infections, such as intra-abdominal infection, foot ulcer and bloodstream infection [1,2,3]. In recent years, multi-drug resistant Bacteroides fragilis emerged in several areas around the world [4,5,6], but resistance features varied greatly among different areas [7].…”

Section: Introductionmentioning

confidence: 99%

“…Macrolide-Lincosamide-Streptogramin B resistant determinants, erm genes are widely distributed among Bacteroides spp. isolates and ermF gene is responsible for B. fragilis resistance to clindamycin [7,10]. The existence of imipenem-resistant Bacteroides spp.…”

Section: Introductionmentioning

confidence: 99%

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Higher prevalence of multi-antimicrobial resistant Bacteroides spp. strains isolated at a tertiary teaching hospital, China

Wang¹,

Han²,

Shen³

et al. 2019

Preprint

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Background: The antimicrobial resistance of Bacteroides spp. isolates is reported to be increasing among different districts around the world, and few reports found that multi-antimicrobial resistant strains emerged. However, less is known about the prevalence of multi-antimicrobial resistant isolates in China, especially for carbapenem resistance. Methods: Bacteroides spp. clinical strains were isolated from inpatients at a 3000 bed tertiary teaching hospital , and were identified by MALDI-TOF MS and VITEK-2 anaerobes and corynebacterium (ANC) card. Broth microdilution method was employed to detect the antimicrobial sensitivities of Bacteroides spp. isolates and PCR method was used to detect the resistance genes, including cfxA, cepA, cfiA, ermF and nim. The upstream insertion sequence (IS) element of cfiA gene was further detected and verified. Results: Among 115 Bacteroides spp. strains enrolled in this study, 80 isolates were Bacteroides fragilis and 35 isolates were non-Bacteroides fragilis. The total resistance rates of 115 Bacteroides spp. isolates to ampicillin/sulbactam, amoxicillin/clavulanic, cefoxitin, piperacillin, piperacillin/tazobactam, moxifloxacin, clindamycin, metronidazole, imipenem and meropenem were 22.6%, 19.6%, 3.5%, 27.8%, 8.7%, 16.5%, 80.0%, 5.2%, 13.9% and 13.9% , respectively. Except cefoxitin and moxifloxacin, the resistance rates of B. fragilis isolates to the above antibiotics were all higher than those of non-B. fragilis isolates. The positive rates of carbapenem resistance gene cfiA were 38.9% and 8.6% for B. fragilis and non-B. fragilis isolates, respectively. For 15 carbapenem resistant B. fragilis isolates, the co-carrying rates of carbapenem resistance gene cfiA and its upstream IS element were 86.7% (13/15). Conclusions: The overall resistance rates of Bacteroides spp. isolates toward multiple antibiotics were at a higher level, especially for B. fragilis. CfiA gene carrying rate among B. fragilis isolates was high up to 38.9% and its mediated carbapenem resistance was a major resistance mechanism for B. fragilis. The findings of this study imply that the actual resistance tendency of Bacteroides spp. may be underestimated and need to be given more attention to.

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Section: Antibiotic Susceptibility Test Resultscontrasting

confidence: 83%

Section: Introductionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Higher prevalence of multi-antimicrobial resistant Bacteroides spp. strains isolated at a tertiary teaching hospital, China

Wang¹,

Han²,

Shen³

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…At the same time, it can increase the secretion of chloride ions and inhibit the absorption of sodium ions, thereby weakening the intestinal mucosal barrier and resulting in Bacteria translocation (40,41). In recent years, Bacteroides fragilis has developed resistance to a variety of commonly used antibiotics, especially imipenem and metronidazole (42,43). Our study has observed that the abundance of Bacteroides fragilis in neutropenic with childhood acute leukemia is signi cantly higher than that in children with non-neutropenia.…”

Section: Discussionmentioning

confidence: 63%

Characteristics of Gut Microbiome and Prediction of Infection in Neutropenic Children with Acute Leukemia

Wang

et al. 2020

Preprint

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Background: Neutropenia in children with acute leukemia have a high incidence of infection and mortality. To identify and classify the potentially infected pathogens, this study compared the structural characteristics of gut microbiome in neutropenic and non-neutropenic children with acute leukemia. Results: The results showed that 6033 OUTs were observed in total, and the sequence coverage index was more than 0.97. In the analysis of alpha diversity, the colony richness index (Chao1 index) of Group A1 was significantly lower than that of Group A0 (P = 0.035). The fecal bacterial communities were dominated by the phylum Firmicutes, Proteobacteria, and Bacteroidetes in both groups, with no significant difference. Higher relative abundance of genera Enterococcus (P = 0.0076), Streptococcus (P = 0.014) and species Bacteroides fragilis (P = 0.034) were observed in Group A1, but class Clostridia (P = 0.038), genera Blautia (P = 0.021) and Roseburia (P = 0.011) were more prevalent in Group A0. The relatively high abundance of Bacteroides fragilis in neutropenia with childhood acute leukemia was an independent risk factor for infection (P=0.028, 95% CI 1.024-1.241).Conclusions: The increase of Enterococcus, Streptococcus and Bacteroides fragilis, and the decrease of Clostridium, Blautia, and Roseburia may be the characteristics of intestinal flora in patients with acute leukemia. The relatively high abundance of Bacteroides fragilis in neutropenia with childhood acute leukemia may predict the occurrence of infection.

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Phenotypic and genotypic identification of carbapenem resistance in Bacteroides fragilis clinical strains

Kierzkowska

Majewska

Karlowicz

et al. 2023

Med Microbiol Immunol

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Bacteroides fragilis is an important etiological agent of serious infections in humans. Rapid methods, readily adaptable to use in medical laboratories, are needed to detect antibiotic resistance and decrease the likelihood of therapy failure. The aim of this study was to determine the prevalence of B. fragilis cfiA-positive isolates. The second purpose was to investigate the carbapenemase activity in B. fragilis strains by Carba NP test. In the study, 5.2% of B. fragilis isolates are phenotypically resistant to meropenem. The cfiA gene was identified in 6.1% of B. fragilis isolates. The MICs of meropenem were significantly higher in cfiA-positive strains. The presence of the cfiA gene along with the IS1186 was detected in one B. fragilis strain which was resistant to meropenem (MIC 1.5 mg/L). The Carba NP test results were positive for all the cfiA-positive strains, including those susceptible to carbapenems based on their MIC values. A review of the literature revealed that the rate of B. fragilis with the cfiA gene varies from 7.6 to 38.9% worldwide. Presented results are in line with the other European studies. Phenotypic testing with the Carba NP test, it seems to be a viable alternative for the cfiA gene detection in B. fragilis isolates. The positive result obtained is of greater clinical importance than the detection of the gene cfiA.

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Emergence of carbapenem resistance in Bacteroides fragilis in China

Cited by 34 publications

References 18 publications

Higher prevalence of multi-antimicrobial resistant Bacteroides spp. strains isolated at a tertiary teaching hospital, China

Higher prevalence of multi-antimicrobial resistant Bacteroides spp. strains isolated at a tertiary teaching hospital, China

Characteristics of Gut Microbiome and Prediction of Infection in Neutropenic Children with Acute Leukemia

Phenotypic and genotypic identification of carbapenem resistance in Bacteroides fragilis clinical strains

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