Multi-drug resistant Bacteroides fragilis recovered from blood and severe leg wounds caused by an improvised explosive device (IED) in Afghanistan

Sherwood, Jeffrey E.; Fraser, Susan; Citron, Diane M.; Wexler, Hana; Blakely, Garry W.; Jobling, Kelly; Patrick, Sheila

doi:10.1016/j.anaerobe.2011.02.007

Cited by 71 publications

(36 citation statements)

References 13 publications

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“…The antibiograms of anaerobic bacteria have become increasingly unpredictable, and multiresistant clinical isolates are appearing, confounding the concept of foolproof anaerobic therapy (21,23,147). Resistance to even the most active drugs, such as imipenem, piperacillin-tazobactam, ampicillin-sulbactam, and metronidazole, has been reported (23,25,26).…”

Section: Susceptibilty Testing Of Anaerobic Bacteriamentioning

confidence: 99%

“…There is evidence that suboptimal therapy can actually select for antibiotic resistance and even induce transfer of resistance determinants. Also, more strains exhibiting multidrug resistance (MDR) have been found (21,23).…”

Section: Susceptibilty Testing Of Anaerobic Bacteriamentioning

confidence: 99%

“…The most commonly isolated antibiotic-resistant anaerobes are species within the Bacteroides fragilis group (18). Resistance to several antimicrobial agents by B. fragilis group species and other anaerobic Gram-negative bacilli (AGNB) has increased over the past decade (15)(16)(17)(19)(20)(21)(22). Resistance has also increased among other anaerobes, such as Clostridium spp., that were previously very susceptible.…”

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confidence: 99%

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Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

2013

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SUMMARY Susceptibility testing of anaerobic bacteria recovered from selected cases can influence the choice of antimicrobial therapy. The Clinical and Laboratory Standards Institute (CLSI) has standardized many laboratory procedures, including anaerobic susceptibility testing (AST), and has published documents for AST. The standardization of testing methods by the CLSI allows comparisons of resistance trends among various laboratories. Susceptibility testing should be performed on organisms recovered from sterile body sites, those that are isolated in pure culture, or those that are clinically important and have variable or unique susceptibility patterns. Organisms that should be considered for individual isolate testing include highly virulent pathogens for which susceptibility cannot be predicted, such as Bacteroides , Prevotella , Fusobacterium , and Clostridium spp.; Bilophila wadsworthia ; and Sutterella wadsworthensis . This review describes the current methods for AST in research and reference laboratories. These methods include the use of agar dilution, broth microdilution, Etest, and the spiral gradient endpoint system. The antimicrobials potentially effective against anaerobic bacteria include beta-lactams, combinations of beta-lactams and beta-lactamase inhibitors, metronidazole, chloramphenicol, clindamycin, macrolides, tetracyclines, and fluoroquinolones. The spectrum of efficacy, antimicrobial resistance mechanisms, and resistance patterns against these agents are described.

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Section: Susceptibilty Testing Of Anaerobic Bacteriamentioning

confidence: 99%

Section: Susceptibilty Testing Of Anaerobic Bacteriamentioning

confidence: 99%

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Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

2013

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“…Antimicrobial resistance or reduced susceptibility has for a long time been considered rare in B. fragilis, but the reported numbers of resistant strains are growing (Nagy et al, 2011b). Multidrug resistant (MDR) B. fragilis has been reported (Sherwood et al, 2011;Kalapila et al, 2013), and a study from Justesen et al (2013) showed that 10.2 % of B. fragilis strains in blood cultures from several Danish hospitals carried the cfiA gene, which encodes a carbapenemase. Since antimicrobial testing of anaerobes is more time-consuming and often more expensive, a rapid and accurate method to detect carbapenemase production in these strains is of great importance.…”

Section: Introductionmentioning

confidence: 99%

Instant screening and verification of carbapenemase activity in Bacteroides fragilis in positive blood culture, using matrix-assisted laser desorption ionization–time of flight mass spectrometry

Johansson

Nagy

Sóki

2014

Journal of Medical Microbiology

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Rapid identification of isolates in positive blood cultures are of great importance to secure correct treatment of septicaemic patients. As antimicrobial resistance is increasing, rapid detection of resistance is crucial. Carbapenem resistance in Bacteroides fragilis associated with cfiA-encoded class B metallo-beta-lactamase is emerging. In our study we spiked blood culture bottles with 26 B. fragilis strains with various cfiA-status and ertapenem MICs. By using main spectra specific for cfiA-positive and cfiA-negative B. fragilis strains, isolates could be screened for resistance. To verify strains that were positive in the screening, a carbapenemase assay was performed where the specific peaks of intact and hydrolysed ertapenem were analysed with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). We show here that it is possible to correctly identify B. fragilis and to screen for enzymic carbapenem resistance directly from the pellet of positive blood cultures. The carbapenemase assay to verify the presence of the enzyme was successfully performed on the pellet from the direct identification despite the presence of blood components. The result of the procedure was achieved in 3 h. Also the Bruker mass spectrometric b-lactamase assay (MSBL assay) prototype software was proven not only to be based on an algorithm that correlated with the manual inspection of the spectra, but also to improve the interpretation by showing the variation in the dataset.

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“…Bu bakteriler karbapenemler, beta-laktam/beta-laktamaz inhibitörleri ve nitroimidazol gibi sınırlı sayıda antibiyotiklere duyarlıdırlar 2 . Ancak son zamanlarda bazı ülkelerde nadiren de olsa nitroimidazollere dirençli kökenler rapor edilmiştir [2][3][4][5] .…”

Section: Introductionunclassified

The First Metronidazole-Resistant Bacteroides Species Isolated at Marmara University Hospital: Bacteroides thetaiotaomicron

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Sayın²,

Soyad³

et al. 2013

Mikrobiyol Bul

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* Bu çalışma, XXXV. Türk Mikrobiyoloji Kongresi (3-7 Kasım 2012, Kuşadası, Aydın)'nde sunulmuş veThe American Society for Microbiology en iyi poster ödülüne layık görülmüştür. ÖZETİnsan bağırsak mikrobiyotasının önemli bir kısmını oluşturan Bacteroides türleri, ağır batın içi enfeksiyonları, cerrahi yara enfeksiyonları ve bakteriyemiye neden olabilirler. Ayrıca bu bakteriler, diğer anaerop bakterilere göre antibiyotiklere daha fazla dirençlidirler. Karbapenemler, beta-laktam/beta-laktamaz inhibitörleri ve nitroimidazol gibi sınırlı sayıda antibiyotikler Bacteroides türlerinin eliminasyonunda etkilidirler. Ancak son zamanlarda bazı ülkelerde nadiren de olsa nitroimidazollere dirençli Bacteroides kökenleri bildirilmiştir. Metronidazole direnç mekanizmasının çoğunda nim genleri (nim A-G) suçlanmaktadır. Bu raporda, kan kültüründen izole edilen metronidazole dirençli bir Bacteroides thetaiotaomicron kökeni bildirilmektedir. Pankreas başı adenokarsinomu tanısı alan 62 yaşındaki erkek hastanın cerrahi girişim sonrası 5. günde, kan kültüründen gram-negatif zorunlu anaerop bir çomak izole edilmiştir. Geleneksel testler ve ticari biyokimyasal kitler kullanılarak köken, B.thetaiotaomicron olarak tanımlanmıştır. İzolatın antimikrobiyal duyarlılık paterni agar dilüsyon yöntemiyle belirlenmiştir. Direnç genleri, nim genine özgül primer çiftleri kullanılarak polimeraz zincir reaksiyonu (PCR) ile araştırılmıştır. Saflaştırılan PCR ürünü dizilenmiş ve GenBank'da bulunan dizilerle karşılaştırılarak analizi yapılmıştır. Metronidazolün MİK değeri 16 mg/L olarak tespit edilmiştir. Köken CLSI kriterlerine göre ara değerde (intermediate) olmakla beraber, EUCAST kriterlerine göre dirençli (> 4 mg/L) bulunmuştur. Bakteride nim geni saptanmış; yapılan dizi analizinde, PCR ürününün nimE geni (emb|AM042593.1|) ile %100 benzer olduğu görülmüştür. DiğerGeliş Tarihi

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Multi-drug resistant Bacteroides fragilis recovered from blood and severe leg wounds caused by an improvised explosive device (IED) in Afghanistan

Cited by 71 publications

References 13 publications

Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

Instant screening and verification of carbapenemase activity in Bacteroides fragilis in positive blood culture, using matrix-assisted laser desorption ionization–time of flight mass spectrometry

The First Metronidazole-Resistant Bacteroides Species Isolated at Marmara University Hospital: Bacteroides thetaiotaomicron

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