First Hungarian case of an infection caused by multidrug-resistant Bacteroides fragilis strain

The clinically important anaerobic, human pathogenic Bacteroides species and their antibiotic resistance levels in Central and Southeast Europe

“…A jelen tanulmány által tárgyalt régióban is leírtak már ilyen eseteket. Először görögországi szerzők írtak le két kóresetet [24], majd Magyarországról jelent meg egy [25]. Előbbi tanulmányban egy gyulladásos bélszindrómában és gyomorlimfómában szenvedő 71 éves férfi és egy gyomordaganatban szenvedő 75 éves férfi kórtörténetét írták le.…”

“…A kitenyészett B. fragilis rezisztensnek bizonyult penicillin G-re, amoxicillin-klavulánsavra, ampicillinszulbaktámra, cefoxitinre, imipenemre, meropenemre, eritromicinre, klindamicinre és tetraciklinre, illetve érzékeny volt moxifloxacinra, metronidazolra, kloramfenikolra és tigeciklinre, valamint hordozta a cfiA és nimD géneket. A beteg lokális célzott antibiotikumterápia után gyógyult [25]. Összefoglalásul elmondhatjuk, hogy (i) a Bacteroides és Parabacteroides törzsek fontos opportunista patogének speciális biológiai háttérrel, (ii) antibiotikumrezisztenciájuk hasonló számokat mutat a közép-és délkelet-európai régióban a más régiókban extenzívebben követett adatokhoz képest, és (iii) itt is megjelentek, habár kis számban, multidrogrezisztens törzsek, amelyek esetén az antibiotikumérzékenységi vizsgálat kritikus faktor lehet.…”

Molecular characterisation of multidrug-resistant Bacteroides isolates from Hungarian clinical samples

“…Although the Bacteroides species are members of the normal human gut microbiota, these bacteria are significant opportunistic pathogens as well and are responsible for significant mortality, especially in the case of bacteremia [1,2]. B. fragilis can cause intraabdominal, skin and soft tissue infections and diarrhoea caused by enterotoxin producing B. fragilis isolates, particularly in young children under the age of five years [1,3]. The most important antibiotics against anaerobes are cephamycins, β-lactam/ β-lactamase inhibitors, carbapenems, metronidazole, clindamycin and fourth generation fluoroquinolones [1].…”

Epidemiological- and antibiotic susceptibility investigation of Hungarian Bacteroides fragilis group clinical isolates

“…The molecular background of the resistance pattern of the MDR isolates differ from strain to strain. In Hungary, only one MDR B. fragilis isolate has been published so far, which was resistant to penicillin, amoxicillin/clavulanic acid, piperacillin/tazobactam, cefoxitin, meropenem, clindamycin and tetracycline, harboured cepA, cfiA, erm, nimA, tetQ genes and IS1187 element [85]. In the upstream region of the cfxA gene, special genetic elements (IS614B, Tn4555 and Tn4351) can be usually detected, (which were described earlier by Garcia et al and Sóki et al [86,112] able to identify a strain called B. fragilis SZ54 that harboured the cfiA and bft genes simultaneously, which is a rare finding, and only one similar strain was described earlier by Soki et al [123].…”

“…collection of the first 100 nonrepeating isolates from each centres, agardilution method) and with so high number of isolates.The comparison of our data and the previous Hungarian studies is quite hard, because of the difference of breakpoints and the antibiotic susceptibility methods. Some publications report the emergence of MDR resistant isolates (especially within the B. fragilis isolates), harbouring multiple resistance genes or with a combination of intrinsic and acquired resistance mechanisms[79][80][81][82][83][84][85][86]. In these cases, the bacteria were usually termed MDR if they were resistant to threefour antibiotic classes besides metronidazole (due to nim 5-nitroimidazole resistance genes) and the carbapenems (a metallo-β-lactamase encoded by cfiA or ccrA genes)[79][80][81][82][83][84][85][86].…”