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Title: [Analysis on the distribution and drug resistance features of anaerobes isolated from clinical infectious specimens].
Author: Wang YY, Han YQ, Guo SF, Fu Q, Wang JR.
Journal: Zhonghua Yi Xue Za Zhi; 2018 Sep 25; 98(36):2894-2898. PubMed ID: 30293345.
Abstract:
Objective: To clarify distribution and drug resistance characteristics of anaerobes isolated from clinical infectious samples, and to provide experimental data for guiding on treatment of infections caused by anaerobes. Methods: The anaerobes, isolated from 1 057 different clinical specimens from inpatients admitted to the Affiliated Hospital of Inner Mongolia Medical University from March 2016 to November 2017, were identified by VITEK-2 anaerobes and corynebacterium (ANC) card and bacteroides fragilis isolates were further verified by 16S-rRNA sequencing. Meanwhile, broth dilution method was employed to detect the drug sensititities of bacteroides fragilis and PCR method was used to detect the carbapenem resistance gene cfiA. Results: Totally 303 strains of anaerobic bacteria were isolated, among which 199 strains were gram-negative bacteria, accounted for 65.68%. Among the gram negative anaerobes, bacteroides species were the most common, accounted for 35.64%, followed by prevotella spp., which accounted for 19.14%. B. fragilis were the most common among Bacteroides spp., accounted for 21.54%, followed by Prevotella bivia, accounted for 5.94%. The coincidence rate of 16S-rRNA sequencing results of Bacteroides fragilis and that of ANC card identification results was 100% (65/65). The drug resistance of B. fragilis to penicillin, clidamycin, ampicillin/sulbactam, amoxicillin/clavulanic, were 100%, 90.77%, 56.92% and 66.67%, respectively. The resitance rate of B. fragilis to chloramphenicol was the lowest, which was 1.54%.Moreover, the resistance rate of B. fragilis to imipenem and metronidazole were both higher, which were 38.46%(25/65) and 23.08%(15/65), respectively, and the positive rate of beta lactamase was 100% (65/65). The carrying rate of carbapenems resistance gene cfiA for 65 strains of Bacteroides fragilis was 52.3% (34/65), and 72.00%(18/25)for imipenem resistant strains. Conclusions: The obligate anaerobic bacteria are widely distributed in clinical specimens, and the great majority are gram negative anaerobic bacteria, and the most frequently isolated one is Bacteroides fragilis. Bacteroides fragilis isolates are found to be resistant to several kinds of common antibiotics, especially for imipenem and metronidazole, which should be given more attention to. 目的：分析临床感染标本中专性厌氧菌分布特征及其耐药性，为指导厌氧菌感染治疗提供实验数据。 方法： 采用VITEK-2厌氧菌及棒状杆菌(ANC)鉴定卡对2016年3月至2017年11月内蒙古医科大学附属医院1 057份不同类型临床感染标本分离专性厌氧菌进行细菌学鉴定，采用16S-rRNA基因测序技术对65株脆弱拟杆菌进行验证，同步采用微量肉汤稀释法对脆弱拟杆菌进行药敏试验，进一步采用PCR方法对碳青霉烯酶编码基因cfiA进行检测。 结果： 各类临床感染标本中，共分离303株专性厌氧菌，其中革兰阴性厌氧菌199株(65.68%)，革兰阳性厌氧菌104株(34.32%)。革兰阴性厌氧菌以拟杆菌属为主(35.64%)，其次为普雷沃菌属(19.14%)。拟杆菌属中以脆弱拟杆菌为主(21.54%)，普雷沃菌属中以二路普雷沃菌为主(5.94%)。脆弱拟杆菌16S-rRNA基因测序结果与ANC卡鉴定结果符合率为100%(65/65)。药敏试验结果显示，脆弱拟杆菌对青霉素、克林霉素、氨苄西林/舒巴坦、阿莫西林/克拉维酸耐药率分别为100%、90.77%、56.92%和66.67%；对氯霉素耐药率最低，为1.54%。此外，脆弱拟杆菌对甲硝唑和亚胺培南耐药率分别达到38.46%(25/65)和23.08%(15/65)，β内酰胺酶阳性率为100%(65/65)。65株脆弱拟杆菌cfiA携带率为52.3%(34/65)，25株亚胺培南耐药株cfiA基因携带率为72.00%(18/25)。 结论： 专性厌氧菌在临床标本中分布广泛，以革兰阴性厌氧菌为主，特别是脆弱拟杆菌，其对多种临床常用抗生素产生耐药性，特别是对亚胺培南和甲硝唑，应引起广泛重视。.

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