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Antimicrobial Agents and Chemotherapy, April 2001, p. 1238-1243, Vol. 45, No. 4
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.4.1238-1243.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Multicenter Survey of the Changing In Vitro Antimicrobial Susceptibilities of Clinical Isolates of Bacteroides fragilis Group, Prevotella, Fusobacterium, Porphyromonas, and Peptostreptococcus Species

Kenneth E. Aldridge,1,* Deborah Ashcraft,1 Karl Cambre,2 Carl L. Pierson,3 Stephen G. Jenkins,4,dagger and Jon E. Rosenblatt5

Departments of Medicine (Infectious Diseases)1 and Computer Services,2 Louisiana State University Health Sciences Center, New Orleans, Louisiana; Department of Pathology, The University of Michigan Hospitals, Ann Arbor, Michigan3; Department of Pathology, Carolinas Medical Center, Charlotte, North Carolina4; and Clinical Microbiology, Mayo Clinic, Rochester, Minnesota5

Received 15 September 2000/Returned for modification 1 November 2000/Accepted 24 January 2001

In vitro surveys of antimicrobial resistance among clinically important anaerobes are an important source of information that can be used for clinical decisions in the choice of empiric antimicrobial therapy. This study surveyed the susceptibilities of 556 clinical anaerobic isolates from four large medical centers using a broth microdilution method. Piperacillin-tazobactam was the only antimicrobial agent to which all the isolates were susceptible. Similarly, imipenem, meropenem, and metronidazole were highly active (resistance, <0.5%), whereas the lowest susceptibility rates were noted for penicillin G, ciprofloxacin, and clindamycin. For most antibiotics, blood isolates were less susceptible than isolates from intra-abdominal, obstetric-gynecologic, and other sources. All isolates of the Bacteroides fragilis group were susceptible to piperacillin-tazobactam and metronidazole, while resistance to imipenem and meropenem was low (<2%). For these same isolates, resistance rates (intermediate and resistant MICs) to ampicillin-sulbactam, cefoxitin, trovafloxacin, and clindamycin were 11, 8, 7, and 29%, respectively. Among the individual species of the B. fragilis group, the highest resistance rates were noted among the following organism-drug combinations: for clindamycin, Bacteroides distasonis and Bacteroides ovatus; for cefoxitin, Bacteroides thetaiotaomicron, B. distasonis, and Bacteroides uniformis; for ampicillin-sulbactam, B. distasonis, B. ovatus, and B. uniformis; and for trovafloxacin, Bacteroides vulgatus. For the carbapenens, imipenem resistance was noted among B. fragilis and meropenem resistance was seen among B. fragilis, B. vulgatus, and B. uniformis. With few exceptions all antimicrobial agents were highly active against isolates of Prevotella, Fusobacterium, Porphyromonas, and Peptostreptococcus. These data further establish and confirm that clinically important anaerobes can vary widely in their antimicrobial susceptibilities. Fortunately most antimicrobial agents were active against the test isolates. However, concern is warranted for what appears to be a significant increases in resistance to ampicillin-sulbactam and clindamycin.

* Corresponding author. Mailing address: Department of Medicine, LSU Health Sciences Center, 1542 Tulane Ave., New Orleans, LA 70112. Phone: (504) 568-5031. Fax: (504) 568-2127. E-mail: kaldri{at}lsuhsc.edu.

dagger Present address: Mt. Sinai Medical Center, New York, NY 10029.

Antimicrobial Agents and Chemotherapy, April 2001, p. 1238-1243, Vol. 45, No. 4
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.4.1238-1243.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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