JAC Advance Access originally published online on November 9, 2006
Journal of Antimicrobial Chemotherapy 2007 59(1):132-139; doi:10.1093/jac/dkl458
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Third Belgian multicentre survey of antibiotic susceptibility of anaerobic bacteria
1 Academisch Ziekenhuis Vrije Universiteit Brussel, 1090 Brussels Belgium 2 Universitair Medisch Centrum Sint-Pieter 1000 Brussels, Belgium 3 Universitair Ziekenhuis Gent 9000 Ghent, Belgium 4 Cliniques Universitaires Saint-Luc 1200 Brussels, Belgium 5 Cliniques Universitaires de Mont-Godinne 5530 Yvoir, Belgium 6 Algemeen Ziekenhuis Sint-Jan 8000 Bruges, Belgium 7 Universitair Ziekenhuis Antwerpen 2650 Edegem, Belgium 8 Cliniques Universitaires de Liège 4000 Liège, Belgium 9 Hôpital Universitaire Erasme 1070 Brussels, Belgium 10 Universitair Ziekenhuis Leuven 3000 Leuven, Belgium
Received 4 July 2006; returned 7 August 2006; revised 11 September 2006; accepted 14 October 2006
*Correspondence address. Department of Microbiology and Hospital Infection Control, Academisch Ziekenhuis Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium. Tel: +32-24775000; Fax: +32-24775015; E-mail: ingrid.wybo{at}az.vub.ac.be
Objectives: To collect recent data on the susceptibility of anaerobes and to compare them with results from previous studies.
Methods: Four hundred and forty-three anaerobic clinical isolates from various body sites were prospectively collected from October 2003 to February 2005 in nine Belgian hospitals. MICs were determined for nine anti-anaerobic and three recently developed antibiotics.
Results: Most Gram-negative bacilli except Fusobacterium spp. were resistant to penicillin. Piperacillin/tazobactam, metronidazole, chloramphenicol, meropenem and amoxicillin/clavulanic acid were very active against all groups, but only 86% of Bacteroides fragilis group strains were susceptible to the latter. Cefoxitin, cefotetan and clindamycin were less active. In particular, only 62%, 52% and 48% of B. fragilis group strains were susceptible, respectively. Clindamycin shows a continuing decrease in activity, as 83% were still susceptible in 1987 and 66% in 1993–94. Anti-anaerobic activity of the new antibiotics is interesting, with MIC50 and MIC90 of 1 and >32 mg/L for moxifloxacin, 2 and 4 mg/L for linezolid and 0.5 and 8 mg/L for tigecycline.
Conclusions: The susceptibility of anaerobic bacteria remains stable in Belgium, except for clindamycin, which shows a continuous decrease in activity. However, for each of the tested antibiotics, at least a few resistant organisms were detected. Consequently, for severe infections involving anaerobic bacteria, it could be advisable to perform microbiological testing instead of relying on known susceptibility profiles. Periodically monitoring background susceptibility remains necessary to guide empirical therapy.
Keywords: anaerobes , Etest , surveillance , empirical therapy
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