title: Resistance of Bacteroides isolates recovered among clinical samples from a major Costa Rican hospital between 2000 and 2008 to ß-lactams, clindamycin, metronidazole, and chloramphenicol.
abstract: OBJECTIVE
  To assess the susceptibility of 100 isolates of Bacteroides spp. recovered in a major Costa Rican hospital between 2000 and 2008 to several ß-lactams, chloramphenicol, clindamycin and metronidazole.
  
  
  METHODS
  Susceptibility to amoxicillin, amoxicillin with clavulanic acid, piperacillin, piperacillin with tazobactam, ticarcillin, ticarcillin with clavulanic acid, cefoxitin, cefotetan, imipenem, chloramphenicol, clindamycin, and metronidazole was determined with the ATB ANA® system. In addition, minimum inhibitory concentrations (MIC) of clindamycin and metronidazole were determined with the broth microdilution method because these drugs are the treatment of choice for anaerobic infections in Costa Rica. Reference strains ATCC® 25285 and ATCC® 29741 were employed as indicated.
  
  
  RESULTS
  According to the ATB ANA® system, 93 isolates were resistant to at least one antibiotic. Resistance to ß-lactams was common. By contrast, resistance to ß-lactams supplemented with ß-lactamase inhibitors was rare. All of the strains were inhibited by imipenem and chloramphenicol. By a broth microdilución test, resistance to clindamycin was 20%, with MIC ranging from 64 mg/L to 256 mg/L; all of the strains were susceptible to metronidazole.
  
  
  CONCLUSIONS
  The high MIC for clindamycin obtained for the majority of the resistant strains is highly suggestive of the presence of mechanisms of acquired resistance among the isolates, therefore surveillance studies are required to determine its efficacy. The low resistance to metronidazole observed underlines its value as a first-line drug. On the other hand, imipenem could be used to treat infections that do not respond well to metronidazole or clindamycin.
authors.affiliation: Laboratorio de Investigación en Bacteriología Anaerobia (LIBA), Centro de Investigación en Enfermedades Tropicales (CIET) and Facultad de Microbiología, Universidad de Costa Rica, Ciudad Universitaria Rodrigo Facio, San José, Costa Rica.
authors.forename: E
authors.initials: E
authors.lastname: Cordero-Laurent
authors.forename: C
authors.initials: C
authors.lastname: Rodríguez
authors.forename: E
authors.initials: E
authors.lastname: Rodríguez-Cavallini
authors.forename: M M
authors.initials: MM
authors.lastname: Gamboa-Coronado
authors.forename: C
authors.initials: C
authors.lastname: Quesada-Gómez
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001439:Bacteroides / Q000187:drug effects* / Q000302:isolation & purification; D001442:Bacteroides Infections / Q000453:epidemiology / Q000382:microbiology*; D002701:Chloramphenicol / Q000494:pharmacology; D002981:Clindamycin / Q000494:pharmacology; D003364:Costa Rica / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D008795:Metronidazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D018440:beta-Lactam Resistance; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D008795:Metronidazole; D002981:Clindamycin; D002701:Chloramphenicol