title: Antibiotic resistance in Prevotella species isolated from patients with cystic fibrosis.
abstract: OBJECTIVE
  To compare the antimicrobial susceptibility of Prevotella spp. isolated from cystic fibrosis (CF) and non-CF patients and analyse the impact of antibiotic prescribing in the preceding year on resistance amongst CF isolates.
  
  
  METHODS
  The susceptibility of 80 CF Prevotella isolates to 12 antibiotics was compared with that of 50 Prevotella isolates from invasive infections in people who did not have CF and 27 Prevotella isolates from healthy controls.
  
  
  RESULTS
  All isolates were susceptible to chloramphenicol, meropenem and piperacillin/tazobactam, with only four isolates resistant to metronidazole. However, resistance to amoxicillin, ceftazidime and tetracycline was apparent in all groups. Significant differences in clindamycin resistance (UK CF, 56%; UK invasive, 10%) and co-amoxiclav non-susceptibility (UK CF, 32%; UK invasive, 12%) were observed between UK CF and UK invasive isolates. The likelihood of non-susceptibility to clindamycin and co-amoxiclav in UK CF isolates was 5.5-fold and 2.5-fold higher relative to that in UK invasive isolates, respectively. Azithromycin MICs were also significantly higher for CF isolates (P < 0.001), which was associated with current prescription of azithromycin. More than 50% of clinical isolates tested in this study were β-lactamase positive.
  
  
  CONCLUSIONS
  This study profiles antibiotic susceptibility in Prevotella spp. in CF and demonstrates that meropenem, piperacillin/tazobactam, chloramphenicol and metronidazole are likely to be the most effective antibiotics if treatment is indicated.
authors.affiliation: CF & Airways Microbiology Group, Queen's University Belfast, Belfast, UK.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Sherrard
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Graham
authors.forename: Stef J
authors.initials: SJ
authors.lastname: McGrath
authors.forename: Leanne
authors.initials: L
authors.lastname: McIlreavey
authors.forename: Joseph
authors.initials: J
authors.lastname: Hatch
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Muhlebach
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Wolfgang
authors.forename: Deirdre F
authors.initials: DF
authors.lastname: Gilpin
authors.forename: J Stuart
authors.initials: JS
authors.lastname: Elborn
authors.forename: Thamarai
authors.initials: T
authors.lastname: Schneiders
authors.forename: Michael M
authors.initials: MM
authors.lastname: Tunney
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016866:Bacteroidaceae Infections / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018720:Prevotella / Q000187:drug effects* / Q000302:isolation & purification; D006113:United Kingdom; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
keywords: anaerobic bacteria; antimicrobial susceptibility; β-lactamase production