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JAC Advance Access published online on October 17, 2006
Journal of Antimicrobial Chemotherapy, 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
Received March 30, 2006
Revised August 25, 2006
Accepted September 22, 2006

Original article

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

Sonja Löfmark 1, Cecilia Jernberg 2, Janet K. Jansson 3, and Charlotta Edlund 4 *

1 Department of Laboratory Medicine, Karolinska Institute, SE-141 86 Stockholm, Sweden
2 Department of Laboratory Medicine, Karolinska Institute, SE-141 86 Stockholm, Sweden; 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 Department of Laboratory Medicine, Karolinska Institute, SE-141 86 Stockholm, Sweden; Medical Products Agency, SE-751 03 Uppsala, Sweden

* To whom correspondence should be addressed.
Charlotta Edlund, E-mail: charlotta.edlund{at}mpa.se


  Abstract

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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