Abstract
Local antimicrobial susceptibility surveys are crucial for optimal empirical therapy guidelines and for aiding in antibiotic stewardship and treatment decisions. For many laboratories, a comprehensive overview of local antimicrobial susceptibility patterns of anaerobic bacteria is still lacking due to the long incubation time and effort involved. The present study investigates the antimicrobial susceptibility patterns and related clinical and demographic data of 2856 clinical isolates of anaerobic bacteria that were submitted for analysis to the Institute for Medical Microbiology and Hygiene of the Freiburg University Medical Center (a tertiary university medical center in Southern Germany) between 2015 and 2019. Antimicrobial susceptibility testing has been carried out according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guideline. Minimum inhibitory concentration (MIC)50 and MIC90 for penicillin, metronidazole, moxifloxacin, and clindamycin were established for Gram-positive anaerobes and for ampicillin-sulbactam, meropenem, metronidazole, moxifloxacin, and clindamycin for Gram-negative anaerobes. The distribution of MIC-values for various antibiotics against anaerobic bacteria was also established, especially for those having no specific breakpoints according to EUCAST guidelines. Most clinically relevant anaerobic bacteria originated from general surgery, neurological, and orthopedic wards. A high proportion of isolates were resistant to moxifloxacin and clindamycin indicating the importance of their susceptibility testing before administration. Based on our study metronidazole and other β-lactam/β-lactamase inhibitor combinations such as ampicillin-sulbactam remain suitable for empirical treatment of infections with anaerobic bacteria.
Highlights
Anaerobic bacteria constitute an important part of the human microbiome, and they play a substantial role in various human infections, such as central nervous system (CNS), intra-abdominal, and foreign body infections [1,2], especially those of a polymicrobial nature [3]
In this study we aim to document the trends within the groups of anaerobic bacteria in a university hospital in Southern Germany over the last 5 years, to understand how antibiotic susceptibility and clinical characteristics vary across different species
From January 2015 to December 2019, a total of 2856 isolates of anaerobic bacteria were included in this retrospective study
Summary
Anaerobic bacteria constitute an important part of the human microbiome, and they play a substantial role in various human infections, such as central nervous system (CNS), intra-abdominal, and foreign body infections [1,2], especially those of a polymicrobial nature [3]. Many anaerobic bacteria cannot be cultured at all in standard conditions, and many new species of anaerobic organisms are being discovered through culture-independent approaches such as next-generation sequencing at the present [9,10]. These new approaches have helped us better understand the role played by these organisms in many diseases, and especially their opportunistic nature when taking advantage of host-barrier defects
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