title: Antimicrobial susceptibility of Bacteroides fragilis group isolates in Europe: 20 years of experience.
abstract: The susceptibilities of 824 Bacteroides fragilis group isolates against nine antibiotics were evaluated in a Europe-wide study involving 13 countries. Species determination, by different methods, was carried out on all but one isolate. Resistance rates were evaluated according to species and geographical areas via CLSI and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints. The present data were compared with those obtained 10 and 20 years ago at a European level. High-level resistance (MIC ≥ 64 mg/L) to ampicillin was observed in 44.5% of the strains, which is a significant increase relative to 20 years ago (16%). Piperacillin/tazobactam was more active than amoxicillin/clavulanic acid (3.1% and 10.4% resistance, respectively), again with a resistance increase relative to earlier studies. Dramatic increases in resistance were observed for cefoxitin, clindamycin and moxifloxacin, with rates of 17.2%, 32.4% and 13.6%, respectively. The lowest resistances were found for imipenem, metronidazole and tigecycline (1.2%, <1% and 1.7%). Nonsusceptible strains to imipenem and metronidazole were more resistant to other anti-anaerobic drugs. Differences were detected between geographical areas, with higher resistance rates for moxifloxacin in Scandinavian countries (21.4%) than in Mediterranean countries (5.4%), whereas, for clindamycin, the resistance rates were higher in Mediterranean (41.8%) and lower in Scandinavian countries (22.5%). Piperacillin/tazobactam resistance was also higher in Scandinavian countries.
authors.affiliation: Institute of Clinical Microbiology, Albert Szent-Györgyi Medical Centre, University of Szeged, Hungary. agye@mlab.szote.u-szeged.hu
authors.forename: E
authors.initials: E
authors.lastname: Nagy
authors.forename: E
authors.initials: E
authors.lastname: Urbán
authors.forename: Carl Erik
authors.initials: CE
authors.lastname: Nord
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001442:Bacteroides Infections / Q000453:epidemiology / Q000382:microbiology*; D001441:Bacteroides fragilis / Q000187:drug effects* / Q000302:isolation & purification; D024881:Drug Resistance, Bacterial; D005060:Europe / Q000453:epidemiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D058974:Phylogeography
chemical_list: D000900:Anti-Bacterial Agents