Agarda Dilüsyon ve Deneme Aşamasındaki EUCAST Disk Difüzyon Yöntemi ile Saptanan Bacteroides fragilis Grubu İzolatlarına Ait Antimikrobiyal Duyarlılık Sonuçlarının Karşılaştırılması

Abstract

Objective: In this study it was aimed to determine the antimicrobial susceptibility of Bacteroides fragilis group (BFG) bacteria using recently developed European Committee on Antimicrobial Susceptibility Testing (EUCAST) disc diffusion method and agar dilution method recommended by Clinical Laboratory Standart Institude (CLSI) for anaerobes and to investigate the agreement of the results of two tests. Method: The antimicrobial susceptibilities of a total of 56 BFG strains isolated from clinical samples and identified by MALDI-TOF MS analysis between January 2017 and December 2018, were tested to ampicillin, ampicillin/sulbactam, cefoxitin, imipenem, clindamycin, tigecycline, moxifloxacin and metronidazole MICs were determined by agar dilution method using sheep blood supplemented Brucella agar and disk diffusion test using host blood supplemented Fastidius Anaerobic Agar (FAA). Results: Six different BFG species consisting mostly strains of Bacteroides fragilis (n=34, 61%) and Bacteroides thetaiotaomicron (n=11, 20%) isolated from various clinical samples such as intraabdominal abscess (n= 24), blood (n=10) and tissue biopsy samples (n=11).were identified. Imipenem and metronidazole were the most effective antimicrobials with 98.2% susceptibility rates, followed by tigecycline, ampicillin/sulbactam, moxifloxacin and clindamycin with susceptibility rates of 89.3%, 66.1%, 57.1% and 46.4%, respectively. Most concordant results were obtained with metronidazole (100%), imipenem (89.8%) and tigecycline (89.8%). Acceptable compliance rates were not found for other antimicrobials. Conclusion: We can say that disc diffusion method is a fast, easy-to-apply, and reliable method used in clinical microbiology laboratories to determine the susceptibility of BFG bacteria to metronidazole, imipenem and tigecycline. However, to evolve a standard method especially for other antimicrobials, the experimental conditions should be optimized with studies dome with greater number of isolates.