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. 2013 Oct;68(10):2369-74.
doi: 10.1093/jac/dkt191. Epub 2013 May 21.

Antibiotic resistance in Prevotella species isolated from patients with cystic fibrosis

Laura J Sherrard  1 , Kathryn A Graham, Stef J McGrath, Leanne McIlreavey, Joseph Hatch, Marianne S Muhlebach, Matthew C Wolfgang, Deirdre F Gilpin, J Stuart Elborn, Thamarai Schneiders, Michael M Tunney
Affiliations

Antibiotic resistance in Prevotella species isolated from patients with cystic fibrosis

Laura J Sherrard et al. J Antimicrob Chemother. 2013 Oct.

Abstract

Objectives: To compare the antimicrobial susceptibility of Prevotella spp. isolated from cystic fibrosis (CF) and non-CF patients and analyse the impact of antibiotic prescribing in the preceding year on resistance amongst CF isolates.

Methods: The susceptibility of 80 CF Prevotella isolates to 12 antibiotics was compared with that of 50 Prevotella isolates from invasive infections in people who did not have CF and 27 Prevotella isolates from healthy controls.

Results: All isolates were susceptible to chloramphenicol, meropenem and piperacillin/tazobactam, with only four isolates resistant to metronidazole. However, resistance to amoxicillin, ceftazidime and tetracycline was apparent in all groups. Significant differences in clindamycin resistance (UK CF, 56%; UK invasive, 10%) and co-amoxiclav non-susceptibility (UK CF, 32%; UK invasive, 12%) were observed between UK CF and UK invasive isolates. The likelihood of non-susceptibility to clindamycin and co-amoxiclav in UK CF isolates was 5.5-fold and 2.5-fold higher relative to that in UK invasive isolates, respectively. Azithromycin MICs were also significantly higher for CF isolates (P < 0.001), which was associated with current prescription of azithromycin. More than 50% of clinical isolates tested in this study were β-lactamase positive.

Conclusions: This study profiles antibiotic susceptibility in Prevotella spp. in CF and demonstrates that meropenem, piperacillin/tazobactam, chloramphenicol and metronidazole are likely to be the most effective antibiotics if treatment is indicated.

Keywords: anaerobic bacteria; antimicrobial susceptibility; β-lactamase production.

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Figures

Figure 1.
Figure 1.
Relationship between azithromycin prescription and MICs for Prevotella isolates from CF patients [current prescription (n = 30) versus no current prescription (n = 32)] and comparison with MICs for UK healthy control isolates (n = 17). Any isolates recorded as having an MIC >256 mg/L are shown on the graph as an MIC of 512 mg/L.
See this image and copyright information in PMC

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