Ann Lab Med.  2015 Jan;35(1):94-98. 10.3343/alm.2015.35.1.94.

Antimicrobial Susceptibility of Clinical Isolates of Bacteroides fragilis Group Organisms Recovered from 2009 to 2012 in a Korean Hospital

• Yim J
• Lee Y
• Kim M
• Seo YH
• Kim WH
• Yong D
• Jeong SH
• Lee K
• Chong Y

• KMID: 2363154
• DOI: http://doi.org/10.3343/alm.2015.35.1.94

Abstract

BACKGROUND
Periodic monitoring of antimicrobial resistance trends of clinically important anaerobic bacteria such as Bacteroides fragilis group organisms is required. We determined the antimicrobial susceptibilities of clinical isolates of B. fragilis group organisms recovered from 2009 to 2012 in a tertiary-care hospital in Korea.
METHODS
A total of 180 nonduplicate clinical isolates of B. fragilis group organisms were collected in a tertiary care hospital. The species were identified by conventional methods: the ATB 32A rapid identification system (bioMerieux, France) and the Vitek MS matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (bioMerieux). Antimicrobial susceptibility was determined by the CLSI agar dilution method.
RESULTS
Imipenem and meropenem resistance rates were 0-6% for B. fragilis group isolates. The rate of resistance to piperacillin-tazobactam was 2% for B. fragilis and 0% for other Bacteroides species, but 17% for B. thetaiotaomicron isolates. High resistance rates to piperacillin (72% and 69%), cefotetan (89% and 58%), and clindamycin (83% and 69%) were observed for B. thetaiotaomicron and other Bacteroides spp. The moxifloxacin resistance rate was 27% for other Bacteroides spp. The MIC50 and MIC90 of tigecycline were 2-4 microg/mL and 8-16 microg/mL, respectively. No isolates were resistant to chloramphenicol or metronidazole.
CONCLUSIONS
Imipenem, meropenem, chloramphenicol, and metronidazole remain active against B. fragilis group isolates. Moxifloxacin and tigecycline resistance rates are 2-27% and 8-15% for B. fragilis group isolates, respectively.

Keyword

Bacteroides fragilis group; Antimicrobial resistance; Tigecycline; Moxifloxacin

MeSH Terms

Anti-Infective Agents/*pharmacology
Bacteroides Infections/*microbiology/pathology
Bacteroides fragilis/*drug effects/isolation & purification
Drug Resistance, Multiple, Bacterial
Humans
Imipenem/pharmacology
Inhibitory Concentration 50
Microbial Sensitivity Tests
Penicillanic Acid/analogs & derivatives/pharmacology
Piperacillin/pharmacology
Republic of Korea
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Tertiary Care Centers
Thienamycins/pharmacology
Anti-Infective Agents
Thienamycins
Imipenem
Penicillanic Acid
Piperacillin

Reference

1. Treviño M, Areses P, Peñalver MD, Cortizo S, Pardo F, del Molino ML, et al. Susceptibility trends of Bacteroides fragilis group and characterisation of carbapenemase-producing strains by automated REP-PCR and MALDI TOF. Anaerobe. 2012; 18:37–43. PMID: 22261518.

2. Karlowsky JA, Walkty AJ, Adam HJ, Baxter MR, Hoban DJ, Zhanel GG. Prevalence of antimicrobial resistance among clinical isolates of Bacteroides fragilis group in Canada in 2010-2011: CANWARD surveillance study. Antimicrob Agents Chemother. 2012; 56:1247–1252. PMID: 22203594.

3. Nagy E, Urbán E, Nord CE. Antimicrobial susceptibility of Bacteroides fragilis group isolates in Europe: 20 years of experience. Clin Microbiol Infect. 2011; 17:371–379. PMID: 20456453.

4. Fille M, Mango M, Lechner M, Schaumann R. Bacteroides fragilis group: trends in resistance. Curr Microbiol. 2006; 52:153–157. PMID: 16450067.

5. Snydman DR, Jacobus NV, McDermott LA, Ruthazer R, Golan Y, Goldstein EJ, et al. National survey on the susceptibility of Bacteroides fragilis group: report and analysis of trends in the United States from 1997 to 2004. Antimicrob Agents Chemother. 2007; 51:1649–1655. PMID: 17283189.

6. Roh K, Kim S, Kim CK, Yum JH, Kim MS, Yong D, et al. Resistance trends of Bacteroides fragilis group over an 8-year period, 1997-2004, in Korea. Korean J Lab Med. 2009; 29:293–298. PMID: 19726890.

7. Fernández-Canigia L, Litterio M, Legaria MC, Castello L, Predari SC, Di Martino A, et al. First national survey of antibiotic susceptibility of the Bacteroides fragilis group: emerging resistance to carbapenems in Argentina. Antimicrob Agents Chemother. 2012; 56:1309–1314. PMID: 22232282.

8. Lee Y, Park Y, Kim MS, Yong D, Jeong SH, Lee K, et al. Antimicrobial susceptibility patterns for recent clinical isolates of anaerobic bacteria in South Korea. Antimicrob Agents Chemother. 2010; 54:3993–3997. PMID: 20585132.

9. CLSI. Methods for Antimicrobial susceptibility testing of anaerobic bacteria; Approved standard, 8^th ed. CLSI document M11-A8. Wayne, PA: Clinical and Laboratory Standards Institute;2012.

10. Seifert H, Dalhoff A. German multicentre survey of the antibiotic susceptibility of Bacteroides fragilis group and Prevotella species isolated from intra-abdominal infections: results from the PRISMA study. J Antimicrob Chemother. 2010; 65:2405–2410. PMID: 20851813.

11. Brook I, Wexler HM, Goldstein EJ. Antianaerobic antimicrobials: spectrum and susceptibility testing. Clin Microbiol Rev. 2013; 26:526–546. PMID: 23824372.

12. The US Food and Drug Administration. FDA Approved Drug Products Label for TYGACIL, NDA no. 021821 (approved on 23/05/2013). http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021821s037lbl.pdf.

13. European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 3.1, 2013. http://www.eucast.org/clinical_breakpoints/.

14. Snydman DR, Jacobus NV, McDermott LA, Golan Y, Hecht DW, Goldstein EJ, et al. Lessons learned from the anaerobe survey: historical perspective and review of the most recent data (2005-2007). Clin Infect Dis. 2010; 50(Sl):S26–S33. PMID: 20067390.

15. Goldstein EJC. Resistance trends in antimicrobial susceptibility of anaerobic bacteria, part II. Clinical Microbiology Newsletter. 2011; 33:9–15.

16. Betriu C, Rodríguez-Avial I, Gómez M, Culebras E, Picazo JJ. Changing patterns of fluoroquinolone resistance among Bacteroides fragilis group organisms over a 6-year period (1997-2002). Diagn Microbiol Infect Dis. 2005; 53:221–223. PMID: 16243476.

17. Cho S, Chung HS, Lee Y, Kim M, Yong D, Jeong SH, et al. In vitro activities of ceftriaxone-sulbactam against major aerobic and anaerobic bacteria from clinical samples. Lab Med Online. 2011; 1:209–220.

18. Wybo I, Van den Bossche D, Soetens O, Vekens E, Vandoorslaer K, Claeys G, et al. Fourth Belgian multicentre survey of antibiotic susceptibility of anaerobic bacteria. J Antimicrob Chemother. 2014; 69:155–161. PMID: 24008826.

19. Brazier JS, Stubbs SL, Duerden BI. Metronidazole resistance among clinical isolates belonging to the Bacteroides fragilis group: time to be concerned. J Antimicrob Chemother. 1999; 44:580–581. PMID: 10588328.

20. Lee K, Shin HB, Chong Y. Antimicrobial resistance patterns of Bacteroides fragilis group organisms in Korea. Yonsei Med J. 1998; 39:578–586. PMID: 10097686.