JAC Advance Access published online on July 15, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg320
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Geographic Medicine and
Infectious Diseases, Tufts--New England Medical Center,
Boston, MA
* Corresponding author. E-mail: YGolan{at}tufts-nemc.org.
Received 27 January 2003
; revised 29 April 2003
; accepted 7 May 2003
Background: Several newer generation
fluoroquinolones have demonstrated good in vitro activity
against Bacteroides species; particularly when
first introduced. However, resistance of Bacteroides to
quinolones appears to be increasing. Materials and methods: From 1994 to 2001, consecutive
non-duplicated Bacteroides isolates from clinical specimens
in 12 US hospitals were sent to the Tufts anaerobe laboratory for
identification and susceptibility testing. NCCLS recommended methodology
for testing was employed. Breakpoints of 8 mg/L for trovafloxacin
and 4 mg/L for moxifloxacin were used to examine susceptibility
trends. Results: In total, 4434 isolates were analysed.
The geometric mean MIC increased significantly for clinafloxacin,
trovafloxacin and moxifloxacin. Resistance to trovafloxacin (breakpoint
of 8 mg/L) and moxifloxacin (breakpoint of 4 mg/L) increased from
8% to 25% and from 30% to 43%,
respectively. Increased resistance was observed for all Bacteroides species,
for all sites of isolation, and in 11 of 12 participating hospitals. Bacteroides vulgatus and isolates from decubitus
ulcers were associated with increased resistance. During 2001, trovafloxacin
and moxifloxacin resistance among blood isolates was 27% and
52%, respectively. The association between increased resistance
and year of isolation remained significant after adjustment for hospital,
species and site of isolation. Conclusions: Fluoroquinolone resistance among Bacteroides isolated in the US has markedly increased during
the years 1994 to 2001. High rates of resistance among blood isolates
are of particular concern.
Keywords: antibiotic resistance, anaerobes
Emergence of fluoroquinolone resistance among Bacteroides species
2 R. M. Alden Research Laboratories,
UCLA Medical Center, Santa Monica, CA
3 Microbiology, Wadsworth Veteran
Administration Hospital, Los Angeles, CA
4 Microbiology, Duke University Medical Center, Durham,
NC
5 Microbiology, Loyola
University Medical Center, Maywood, IL
6 Microbiology, Carolinas Medical Center, Charlotte,
NC
7 Microbiology, Danbury
Hospital, Danbury, CT
8 Microbiology,
Albany Medical Center, Albany, NY
9 Microbiology, University of Michigan Medical Center,
Ann Arbor, MI
10 Microbiology,
Pittsburgh Veterans Administration Medical Center, Pittsburgh, PA,
USA
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