Analysis of trends in antimicrobial resistance patterns among clinical isolates of Bacteroides fragilis group species from 1990 to 1994

被引:36
作者
Snydman, DR
McDermott, L
Cuchural, GJ
Hecht, DW
Iannini, PB
Harrell, LJ
Jenkins, SG
OKeefe, JP
Pierson, CL
Rihs, JD
Yu, VL
Finegold, SM
Gorbach, SL
机构
[1] TUFTS UNIV,NEW ENGLAND MED CTR,SCH MED,DEPT PATHOL,BOSTON,MA 02111
[2] TUFTS UNIV,NEW ENGLAND MED CTR,SCH MED,DEPT COMMUNITY HLTH,BOSTON,MA 02111
[3] DANBURY HOSP,DANBURY,CT
[4] DUKE UNIV,MED CTR,DURHAM,NC
[5] UNIV FLORIDA,JACKSONVILLE,FL
[6] LOYOLA UNIV,MED CTR,MAYWOOD,IL 60153
[7] UNIV MICHIGAN,MED CTR,ANN ARBOR,MI
[8] VET ADM MED CTR,PITTSBURGH,PA
[9] VET ADM WADSWORTH HOSP CTR,CTR ULCER RES & EDUC,MED SERV,LOS ANGELES,CA 90073
关键词
D O I
10.1093/clinids/23.Supplement_1.S54
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Antimicrobial resistance, including plasmid-mediated resistance, among Bacteroides fragilis group species is well documented. A 5-year (1990-1994) prospective, eight-center survey of 3,177 clinical isolates of Bacteroides species was undertaken to review trends in resistance, using the breakpoints for full and intermediate susceptibility established by the National Committee for Clinical Laboratory Standards. No documented resistance to either metronidazole or chloramphenicol was found in this survey. Among B. fragilis isolates virtually no resistance was seen to imipenem, meropenem, ampicillin/sulbactam, piperacillin/tazobactam, or ticarcillin/clavulanate. Significant increases in resistance among B. fragilis isolates to cefotetan, ceftizoxime, and clindamycin (P <.01) were noted. Resistance to cefoxitin remained unchanged. Among the non-fragilis species of the B. fragilis group, there was virtually no resistance to imipenem, meropenem, chloramphenicol, or metronidazole. The three beta-lactamase inhibitors had increasing levels of resistance, although 95%-98% of strains were susceptible (P <.05). There was a significant decline in cefoxitin, cefotetan, cefmetazole, and clindamycin activity over time against these strains (P <.01). There was a significant (P <.001) increase in geometric mean minimum inhibitory concentration for most drugs and species tested from 1990 to 1994. Clusters in the eight institutions could not account for this rise in resistance. This survey demonstrates that rates of resistance of B. fragilis and non-fragilis species of the B. fragilis group are increasing.
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页码:S54 / S65
页数:12
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