American Journal of Infectious Diseases and Microbiology
ISSN (Print): 2328-4056 ISSN (Online): 2328-4064 Website: Editor-in-chief: Maysaa El Sayed Zaki
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American Journal of Infectious Diseases and Microbiology. 2017, 5(2), 87-93
DOI: 10.12691/ajidm-5-2-3
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Emergence of Antimicrobial Resistance among Anaerobic Bacteria

B. G. Viswanath1, , G. Jyothi Lakshmi1, K. Nagamani1, N. V. N. Reddy2, G. Prakash Rao3, S. S. S. Srinivas3, Abhijeet M. Dashetwar4 and Manjula5

1Department of Microbiology, Gandhi Medical College & Hospital, Secunderabad, Telangana, India

2Department of General Surgery, Gandhi Medical College & Hospital, Secunderabad, Telangana, India

3Department of Neurosurgery, Gandhi Medical College & Hospital, Secunderabad, Telangana, India

4Department of Cardiothoracic Surgery, Gandhi Medical College & Hospital, Secunderabad, Telangana, India

5Department of Dental Surgery, Gandhi Medical College & Hospital, Secunderabad, Telangana, India

Pub. Date: May 16, 2017

Cite this paper:
B. G. Viswanath, G. Jyothi Lakshmi, K. Nagamani, N. V. N. Reddy, G. Prakash Rao, S. S. S. Srinivas, Abhijeet M. Dashetwar and Manjula. Emergence of Antimicrobial Resistance among Anaerobic Bacteria. American Journal of Infectious Diseases and Microbiology. 2017; 5(2):87-93. doi: 10.12691/ajidm-5-2-3


Polymicrobial infections are predominated by anaerobes accompanied by facultative anaerobes and aerobes. Failure in providing appropriate antibiotic coverage for anaerobes in mixed aerobic, anaerobic infections and increasing resistance to antimicrobial agents among anaerobic bacteria lead to increased morbidity and mortality. Antibiotic resistance among clinically important obligate anaerobic bacteria is going unnoticed because of inadequate isolation, identification, and susceptibility testing. The increasing resistance among several species emphasizes the need to survey the susceptibility patterns of anaerobic organisms. The aims of this study were, firstly, to determine the most common anaerobic bacteria originating from several abscesses and, secondly, to analyze their susceptibility patterns. This prospective study included 50 samples, either pus aspirates or tissue sections from patients with deep visceral abscesses, attending surgical and medical departments over a period of one year. Both aerobic and anaerobic cultures were done, and all isolates were subjected to antibiotic sensitivity using Kirby-Bauer disc diffusion method. A total of 33 samples showed the presence of obligate anaerobes with a rate of isolation of 66%.The obligate anaerobes isolated were Bacteroides, Prevotella, Fusobacterium, Porphyromonas, Peptococcus, Peptostreptococcus and Bifidobacterium species. Bacteroides showed resistance to penicillin G (76.9%), ciprofloxacin (61.5%), erythromycin (61.5%), metronidazole (46.1%), amoxicillin & clavulanic acid (46.1%) and clindamycin (38.4%). Prevotella showed resistance to penicillin G (69.2%), erythromycin (30.7%), metronidazole (15.3%) and clindamycin (7.6%). Porphyromonas, Peptostreptococcus, and Bifidobacterium showed susceptibility to all the drugs tested. Fusobacterium showed resistance to penicillin G (63.6%), metronidazole (54.5%), ciprofloxacin (36.3%) and erythromycin (27.2%). Peptococcus showed resistance only to ciprofloxacin (33.3%). As the anaerobic bacteria play a significant role in critical infections, all the preliminary laboratory measures are to be taken for their isolation such as proper sample collection, using appropriate media for their growth, and system for anaerobiosis. Their sensitivity pattern has to be studied as there are several reports of the emergence of resistance to various antibiotics. This antibiogram pattern helps the clinician to treat these infections with appropriate & effective therapy resulting in excellent clinical outcomes.

abscess obligate anaerobes antibiotic susceptibility testing antimicrobial resistanc

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[1]  Anuradha De, Gogate A.Prevalence of Gram Negative Bacilli in Routine Clinical Specimen. IJPM. 2001; 44(4): 435-438.
[2]  Rosenblatt JE, Ann F, Finegold SM. Comparison of methods for isolation of anaerobic bacteria from clinical specimens. App Microbiol. 1974; 25(1): 77-85.
[3]  Colayco CAS, Mendoza MT, Alejandria MM, Ang CF. Microbiological and clinical profile of diabetic foot infection. Phil J Microbial Infect Dis 2002; 31(4): 151-161.
[4]  Nagy E, Justesen U, Eitel Z, Urbán E. Development of EUCAST disk diffusion method for susceptibility testing of the Bacteroides fragilis group isolates. Anaerobe. 2014; 31: 65-71.
[5]  Somer H, Summanen P. Wadsworth-KTL anaerobic bacteriology manual. 6th ed. Korea: Star Publishing Company. 2002; 23-74.
[6]  Brook I. Anaerobic bacteria. In: Cohen J, Powderly WG, Steven M (eds). Infectious Diseases. 3rd edn Armstrong: Mosby, 2010; pp.226-83.
[7]  Brook I, Hunter V, Walker R. Synergistic effect of Bacteroides, Clostridium, Fusobacterium anaerobic cocci & aerobic bacteria on mortality & induction of subcutaneous abscess in Mice. Clin Inf Dis.1984; 149(6): 924-928.
[8]  Park Y, Young CJ, Yong D, Lee K, Kim KM.Clinical features & Prognostic Factors of Anaerobic Infection: A 7 Year Study.KJIM 2009; 24(1): 13-18.
[9]  Ajitha M, Smitha J, Walimbe S.Anaerobic Infections in Surgical Patients. Usha Gupta’s. Anaerobic Infections in Man.New Delhi. Everyman’s Press. 1981: 19-23.
[10]  Benett JE, Dolin R, Blaser J. Principles & Practice of Infectious diseases. 8th ed. United States of America: Elsevier Inc; 2015.
[11]  Brook I. Encapsulate anaerobic bacteria in Synergistic infection. Clin Microbiol Rev. 1986; 50: 452-457.
[12]  Mandell LG, Benett JE, Dolin R. Principles & Practice of Infectious diseases. 6th ed. United States of America: Elsevier Inc; 2005.
[13]  V. Lakshmi, P. Umabala, et al. Microbiological Spectrum of Brain Abscess at a Tertiary Care Hospital in South India: 24-Year Data and Review.
[14]  Collins MD, Lawson PA, Willems A.The phylogeny of the genus Clostridium- proposal of 5 new genera &111 new species combinations. Int J Syst Bacteriol.1994; 44: 812-826.
[15]  Zhang Y, Xiao G, Qin X, et al. Anaerobic infection and its rapid detection in surgical patients. Zhonghua Wai Ke Za Zhi 1999 Dec; 37(12): 765-7.
[16]  Gill DM.Bacterial toxins –a table of lethal amounts. Clin Microbiol Rev. 1982; 46: 86-9.
[17]  Ingham HR, Selkon JB, Roxby CM. Bacteriological study of otogenic cerebral, abscesses: the chemotherapeutic role of metronidazole. Brit Med Journal.197; 2: 991-993.
[18]  Sarala Menon, Renu Bharadwaj, Abhay Chowdhary, D. V. Kaundinya and D. A. Palande. Current epidemiology of intracranial abscesses: a prospective five-year study. Journal of Medical Microbiology (2008), 57, 1259-1268.
[19]  S. J. Eykyn and R. H. Grace. The relevance of microbiology in the management of anorectal sepsis. Ann R Coll Surg Engl. 1986 September; 68(5): 237-239.
[20]  S. Saini, N. Gupta, Aparna, G. Batra, DR. Arora. The role of anaerobes in acute pelvic inflammatory disease. Indian Journal Of Medical Microbiology, (2003) 21 (3): 189-192.
[21]  Jurg West.Susceptibility of anaerobic bacteria to Metronidazole, Ornidazole and Tinidazole and Routine Susceptibility Testing by Standardized methods. Antimicrob Chemother.77; 2(4): 631-637.
[22]  David W. Hecht. Prevalence of Antibiotic Resistance in Anaerobic Bacteria: Worrisome Developments. Clinical Infectious Diseases 2004; 39:92-7.
[23]  Ronit Cohen – Poradosu, Dennis L. Kasper. Anaerobic Infections: General concepts. In: Mandell L, Bennett E, Dolin (editors). Principles and Practice of Infectious Diseases. Philadelphia: Elsevier; 2010, p. 3083-3089.
[24]  David W. Hecht. Prevalence of Antibiotic Resistance in Anaerobic Bacteria: Worrisome Developments. Clinical Infectious Diseases 2004; 39: 92-7.
[25]  F. Baquero, M. Reig. The resistance of anaerobic bacteria to antimicrobial agents in Spain. European Journal of Clinical Microbiology and Infectious Diseases November 1992, Volume 11, Issue 11, pp 1016-1020.
[26]  Susan Nyfors, Eija Könönen, Ritva Syrjänen, Erkki Komulainen and Hannele Jousimies-Somer. The emergence of penicillin resistance among Fusobacterium nucleatum populations of commensal oral flora during early childhood. Journal of Antimicrobial Chemotherapy (2003) 51, 107-112.
[27]  Sutter VL, Citron VL, Finegold SM. Wadsworth Anaerobic Bacteriology Manual. 3rd ed USA: CV Mosby company. 1980.