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JAC Advance Access originally published online on October 17, 2006
Journal of Antimicrobial Chemotherapy 2006 58(6):1160-1167; doi:10.1093/jac/dkl420
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Clindamycin-induced enrichment and long-term persistence of resistant Bacteroides spp. and resistance genes

Sonja Löfmark1, Cecilia Jernberg1,2, Janet K. Jansson3 and Charlotta Edlund1,4,*

1 Department of Laboratory Medicine, Karolinska Institute SE-141 86 Stockholm, Sweden 2 Section for Natural Sciences, Södertörn University College SE-141 89 Huddinge, Sweden 3 Department of Microbiology, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden 4 Medical Products Agency SE-751 03 Uppsala, Sweden

Received 30 March 2006; returned 29 April 2006; revised 25 August 2006; accepted 22 September 2006

*Corresponding author. Tel: +46-18-17-48-39; Fax: +46-87-11-39-18; E-mail: charlotta.edlund{at}mpa.se

Objectives: The aim was to study the long-term consequences of 1 week clindamycin administration regarding selection and persistence of resistance, resistance determinants and diversity of the Bacteroides spp. in the intestinal microflora.

Methods: A total of 1306 Bacteroides isolates were collected from constitutively cultured faecal samples during a 2 year period from eight healthy volunteers. The strains were identified by biochemical and genotyping methods. MIC values were determined by the agar dilution method and presence of resistance genes was screened by real-time PCR.

Results: Ecological changes in the intestinal microflora persisting up to 24 months were recorded after a 7 day clindamycin administration to four healthy volunteers. Compared to a control group, not exposed to clindamycin, an enrichment and stabilization of resistant Bacteroides strains and resistance determinants were discovered up to 2 years after clindamycin exposure.

Conclusions: The results indicate that even a short-term antibiotic administration can cause long-term alterations in the commensal microbiota of individual subjects, detectable 2 years after dosing. The recorded selection and persistence of resistant strains and resistance genes, illustrates the importance of increasing our knowledge of the role of the abundant intestinal microbial community as a reservoir for spread of resistance.

Keywords: antimicrobial resistance , intestinal microflora , clindamycin


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