Infections caused by anaerobic bacteria are common, and may be serious and life-threatening. Anaerobes predominant in the bacterial flora of normal human skin and mucous membranes, and are a common cause of bacterial infections of endogenous origin. Infections due to anaerobes can evolve all body systems and sites. The predominate ones include: abdominal, pelvic, respiratory, and skin and soft tissues infections. Because of their fastidious nature, they are difficult to isolate and are often overlooked. Failure to direct therapy against these organisms often leads to clinical failures. Their isolation requires appropriate methods of collection, transportation and cultivation of specimens. Treatment of anaerobic bacterial infection is complicated by the slow growth of these organisms, which makes diagnosis in the laboratory only possible after several days, by their often polymicrobial nature and by the growing resistance of anaerobic bacteria to antimicrobial agents.

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Thursday, June 20, 2019

Increased Antimicrobial Resistance against metronidazole and carbapenem in clinical anaerobic isolates from Pakistan.


Increased Antimicrobial Resistance against metronidazole and carbapenem in clinical anaerobic isolates from Pakistan was recently reported by reported by Shafquat and colleagues  from , Aga Khan University Hospital,in Karachi, Pakistan.

 Of the 223 clinically significant isolates collected between 2014 and 2017, 39 (17.5%) were metronidazole resistant. Imipenem resistance was determined in 29 metronidazole resistant isolates and of these 7 (24.1%) were found to be resistant. Proportion of metronidazole resistant strains was highest amongst Bacteroides species. A significant increase in metronidazole resistance from 12.3% in 2010-2011 to 17.5% in the current study was found. Carbapenem resistance also emerged in the period 2014-2017.
Isolates from malignancy and transplant patients showed lower odds of developing metronidazole resistance. Prolonged hospital stay was not associated with metronidazole resistance.

The worldwide rising trend of metronidazole resistance and emergence of carbapenem resistance in anaerobic bacteria is alarming. Continued surveillance with strengthening of laboratory capacity regarding anaerobic susceptibility testing is urgently needed.





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