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Trends in antimicrobial resistance of the Bacteroides fragilis, group over an 11-year period



Trends in antimicrobial resistance of the Bacteroides fragilis, group over an 11-year period



Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 41: 112



Background: Geographic variations and increasing resistance of Bacteroides fragilis group organisms to antimicrobials have been reported. Methods: The evolution of the susceptibility patterns of the B. fragilis group was studied by comparing the results of previous surveys performed in our hospital from 1989 to 2000. A total of 1618 strains were included in the study. Susceptibility testing was performed by the NCCLS reference agar dilution method. Drugs evaluated included metronidazole, chloramphenicol, clindamycin, and 6 beta-lactam agents. Trovafloxacin and moxifloxacin have been tested since 1997. Results: Metronidazole continues to be highly active and no resistance was detected. Chloramphenicol also remained very active; only one resistant strain was found. Rates of resistance to clindamycin remained stable at around 20% in the 1989-1992 period, and increased to 29.6% in 1994 (P<0.05) and to 42.5% in 1999. Susceptibility to trovafloxacin did not change significantly over the 4 years of testing, although the MIC90 increased from 1 mug/ml in 1997 to 4 mug/ml in 2000. There was also a shift to higher MIC90s for moxifloxacin over time. Resistance to cefoxitin remained stable in the 6-9% range until 1994, increased to 19.5% in 1995 (P<0.0001), and since 1997 fell to 4.3% during the last study period. Resistance to imipenem was first detected in our hospital in 1989. Since then, the incidence of such resistance has remained low (0-1.5%). Piperacillin-tazobactam was the most active of the beta-lactamase inhibitor combinations evaluated. There was a slight increase over the last 4 years in resistance to ampicillin-sulbactam and amoxicillin-clavulanate. Conclusion: The increasing resistance to several beta-lactam agents as well as to clindamycin, observed in this study, emphasizes the need to monitor the antibiotic susceptibility patterns of B. fragilis group organisms.

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