Original Article

Distribution of anaerobic bacteria and their sensitivity pattern to several antibiotics at the clinical microbiology laboratory of school of medicine, universitas Indonesia, Jakarta in 2019-2020

Abstract

Background and Objectives: Anaerobic bacteria are a common cause of endogenous infections, some of which can be life threatening. These bacteria are not easily cultured and isolated and often cannot even found from infected sites. Delayed or inappropriate treatment of these microorganisms can lead to failure in eradicating these infections. The purpose of this study was to determine the diversity of anaerobic bacteria at present and their pattern of sensitivity to several antibiotics.
Materials and Methods: A retrospective study was conducted over a period of two years on various specimens. Specimens derived from body fluids are inoculated on a BacT/Alert (bioMérieux). Anaerobic isolates were identified by Gram staining and continued identification using Vitek 2® automated system. Antibiotic sensitivity examination was carried out using ATBTM ANA (bioMérieux).
Results: A total of 440 specimens were received in microbiology laboratory for anaerobic culture from patients with multiple infections from 13 hospitals in Jakarta. Our research was able to identify 18 species on anaerobic bacteria, consisting 52.5% Gram positive and 47.5% Gram negative bacteria. The most common bacteria found were Clostridium perfringens (15%) from Gram positive and Provetella bivia (10%) from Gram negative. The sensitivity pattern shows that antibiotic piperacilline-tazobactam is 100% effective against anaerobic bacteria, while metronidazole as the drug of choice is only 75% effective. Against Gram positive, several antibiotics such as piperacilline-tazobactam, ticarcilin-clavunic acid, cefoxitin, cefotetan, imipenem and chloramphenicol were 100% effective, however metronidazole occupied the lowest position (61.9%). Meanwhile against Gram negative antibiotics piperacilline-tazobactam is 100% effective and chloramphenicol in the second position (94.75%).
Conclusion: Clostridium perfringens and Provetella bivia are the most common bacteria found. The antibiotics piperacilline-tazobactam is 100% effective against both Gram positive and negative. The accuracy of specimen management, isolation, identification and sensitivity examination will determine the successful microbiological investigations.

1. Leber AL (2016). Clinical microbiology procedures handbook. 4th ed. ASM press. Washington DC.
2. Begum S, Roy S, Yusuf MA. Anaerobic bacteria: infection and management. IOSR J Dent Med Sci 2015; 14: 69-72.
3. Shenoy PA, Vishwanath S, Gawda A, Shetty S, Anegundi R, Varma M, et al. Anaerobic bacteria in clinical specimens - frequent, but a neglected lot: a five year experience at a tertiary care hospital. J Clin Diagn Res 2017; 11: DC44-DC48.
4. Brook I (2007). Anaerobic infections: diagnosis and management (infectious disease and therapy). 1st ed. CRC Press. United States.
5. Brook I. Spectrum and treatment of anaerobic infections. J Infect Chemother 2016; 22: 1-13.
6. Nagy E. Anaerobic infections: update on treatment considerations. Drugs 2010; 70: 841-858.
7. Seiler JS, Herold RW. The use of systemic antibiotics in the treatment of aggressive periodontal disease. Gen Dent 2005; 53: 155-159; quiz 160, 145-146.
8. Gajdács M, Spengler G, Urbán E. Identification and antimicrobial susceptibility testing of anaerobic bacteria: Rubik’s cube of clinical microbiology? Antibiotics (Basel) 2017; 6: 25.
9. Schaumann R, Petzold S, Fille M, Rodloff AC. Inducible metronidazole resistance in nim-positive and nim-negative Bacteroides fragilis group strains after several passages metronidazole containing columbia agar plates. Infection 2005; 33: 368-372.
10. Jenkins SG. Infections due to anaerobic bacteria and the role of antimicrobial susceptibility testing of anaerobes. Rev Res Med Microbiol 2001; 12: 1-12.
11. Schuetz AN. Antimicrobial resistance and susceptibility testing of anaerobic bacteria. Clin Infect Dis 2014; 59: 698-705.
12. Brook I, Wexler HM, Goldstein EJ. Antianaerobic antimicrobials: spectrum and susceptibility testing. Clin Microbiol Rev 2013; 26: 526–546.
13. Liu CY, Huang YT, Liao CH, Yen LC, Lin HY, Hsueh PR. Increasing trends in antimicrobial resistance among clinically important anaerobes and Bacteroides fragilis isolates causing nosocomial infections: emerging resistance to carbapenems. Antimicrob Agents Chemother 2008; 52: 3161-3168.
14. Katsandri A, Papaparaskevas J, Pantazatou A, Petrikkos GL, Thomopoulos G, Houhoula DP, et al. Two cases of infections due to multidrug-resistant Bacteroides fragilis group strains. J Clin Microbiol 2006; 44: 3465-3467.
15. Gal M, Brazier JS. Metronidazole resistance in Bacteroides spp. carrying nim genes and the selection of slow-growing metronidazole-resistant mutants. J Antimicrob Chemother 2004; 54: 109-116.
16. Li Z, Liu S, Chen H, Zhang X, Ling Y, Zhang N, et al. Comparative evaluation of BACTEC FX, BacT/ALERT 3D, and BacT/ALERT VIRTUO-automated blood culture systems using simulated blood cultures. Acta Clin Belg 2022;77:71-78.
17. Löfmark S, Edlund C, Nord CE. Metronidazole is still the drug of choice for treatment of anaerobic infections. Clin Infect Dis 2010; 50 Suppl 1: S16-23.
18. Microbiology with confidence VITEK 2 results you can trust. Available from: www.biomerieux-usa.com
19. Microbiology with confidence ATB ANA. Available from: www.biomerieux.com
20. Cherkaoui A, Fischer A, Azam N, Riat A, Schrenzel J. A comparison of sensititreTM anaerobe MIC plate with ATB ANA® test for the routine susceptibility testing of common anaerobe pathogens. Eur J clin Microbiol Infect Dis 2018; 37: 2279-2284.
21. Jamal W, Al Hashem G, Rotimi VO. Antimicrobial resistance among anaerobes isolated from clinical specimens in Kuwait hospitals: comparative analysis of 11-year data. Anaerobe 2015; 31: 25-30.
22. De A, Gogate A. Prevalence of gram negative anaerobic bacilli in routine clinical specimens. Indian J Pathol Microbiol 2001; 44: 435-438.
23. Garg R, Kaistha N, Gupta V, Chander J. Isolation, identification and antimicrobial susceptibility of anaerobic bacteria: a study re-emphasizing its role. J Clin Diagn Res 2014; 8: DL01-2.
24. Akhi MT, Ghotaslou R, Beheshtirouy S, Asgharzadeh M, Pirzadeh T, Asghari B, et al. Antibiotic susceptibility pattern of aerobic and anaerobic bacteria isolated from surgical site infection of hospitalized patients. Jundishapur J Microbiol 2015; 8(7): e20309.
25. Ananth-Shenoy P, Vishwanath S, Targain R, Shetty S, Sunil-Rodrigues G, Mukhopadhyay C, et al. Anaerobic infections in surgical wards: a two year study. Iran J Microbiol 2016; 8: 181-186.
26. Aldridge KE, Ashcraft D, Cambre K, Pierson CL, Jenkins SG, Rosenblatt JE. Multicenter survey of the changing in vitro antimicrobial susceptibilities of clinical isolates of Bacteroides fragilis group, Prevotella, Fusobacterium, Porphyromonas, and Peptostreptococcus species. Antimicrob Agents Chemother 2001; 45: 1238-1243.
27. Brook I. The role of anaerobic bacteria in bacteremia. Anaerobe 2010; 16: 183-189.
28. Nguyen MH, Yu VL, Morris AJ, McDermott L, Wagener MW, Harrell L, et al. Antimicrobial resistance and clinical outcome of Bacteroides bacteremia: findings of a multicenter prospective observational trial. Clin Infect Dis 2000; 30: 870-876.
29. Lepivert JC, Guinet V, Auquit-Auckbur I. Necrotizing fasciitis of the hand and wrist due to Prevotella bivia. J Hand Surg Eur Vol 2015; 40: 757-758.
30. Knoester M, Lashley LE, Wessels E, Oepkes D, Kuijper EJ. First report of Atopobium vaginae bacteremia with fetal loss after chorionic villus sampling. J Clin Microbiol 2011; 49: 1684-1686.
31. Valéria Dos Santos K, Diniz CG, Coutinho SC, Apolônio ACM, Geralda de Sousa-Gaia L, Nicoli JR, et al. In vitro activity of piperacillin/tazobactam and ertapenem against Bacteroides fragilis and Escherichia coli in pure and mixed cultures. J Med Microbiol 2007; 56: 798-802.
32. Brook I. Microbiology and management of joint and bone infections due to anaerobic bacteria. J Orthop Sci 2008; 13: 160-169.
33. Keating GM, Perry CM. Ertapenem: a review of its use in the treatment of bacterial infections. Drugs 2005; 65: 2151-2178.
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IssueVol 14 No 1 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijm.v14i1.8797
Keywords
Anaerobic bacteria; Gram negative; Gram positive; Antibiotic sensitivity; Jakarta

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1.
Tjampakasari C, Prasetyo D, Ningsih I, Kiranasari A. Distribution of anaerobic bacteria and their sensitivity pattern to several antibiotics at the clinical microbiology laboratory of school of medicine, universitas Indonesia, Jakarta in 2019-2020. Iran J Microbiol. 2022;14(1):24-30.