TABLE 2.
Comparison of in vitro susceptibility rates of blood isolates of the B. fragilis group
| Antimicrobial agent | No. of isolates tested | MIC (μg/ml)
|
All isolates (%S)a | Cfx-I&Rb
|
Clin-I&Rc
|
|||||
|---|---|---|---|---|---|---|---|---|---|---|
| Range | Mode | MIC50 | MIC90 | %S | %SΔd | %S | %SΔ | |||
| Penicillin G | 160 | 0.06-128 | 8 | 8 | 128 | 0 | 0 | 0 | 0 | 0 |
| Piperacillin | 384 | 0.12-256 | 2 | 8 | 128 | 77 | 46 | −31 | 60 | −17 |
| Ticarcillin | 137 | 0.12-256 | 16 | 32 | 128 | 63 | 21 | −42 | 39 | −24 |
| Piperacillin-tazobactam | 142 | 0.06-64 | 2 | 1 | 8 | 99.3 | 96 | −3.3 | 96.1 | −3.2 |
| Ticarcillin-clavulanate | 191 | 0.25-256 | 1 | 0.5 | 8 | 96 | 83 | −13 | 86 | −10 |
| Ampicillin-sulbactam | 382 | 0.03-128 | 1 | 1 | 8 | 93 | 81 | −12 | 80 | −13 |
| Cefotaxime | 384 | 0.06-256 | 4 | 8 | 64 | 62 | 32 | −30 | 34 | −28 |
| Ceftriaxone | 138 | 1-128 | 2 | 32 | 128 | 49 | 7 | −42 | 7 | −42 |
| Cefoxitin | 515 | 0.12-128 | 8 | 8 | 32 | 84 | 0 | 73 | −11 | |
| Cefotetan | 473 | 0.06-256 | 8 | 8 | 64 | 64 | 8 | −56 | 26 | −38 |
| Cefmetazole | 84 | 0.25-128 | 8 | 16 | 64 | 61 | 0 | −61 | 35 | −26 |
| Ceftizoxime | 358 | 0.06-256 | 4 | 4 | 64 | 78 | 67 | −11 | 65 | −13 |
| Imipenem | 378 | 0.015-32 | 0.03 | 0.12 | 1 | 99.5 | 97 | −2.5 | 98 | −1.5 |
| Meropenem | 127 | 0.015-32 | 0.12 | 0.5 | 0.5 | 98 | 94 | −4 | 94 | −4 |
| Ertapenem | 92 | 0.06-32 | 0.25 | 0.25 | 2 | 94 | 64 | −30 | 86 | −8 |
| Trovafloxacin | 156 | 0.03-16 | 0.25 | 0.25 | 2 | 96 | 86 | −10 | 88 | −8 |
| Clindamycin | 542 | 0.015-64 | 0.25 | 0.5 | 16 | 78 | 63 | −15 | 0 | |
| Metronidazole | 542 | 0.06-8 | 1 | 1 | 2 | 100 | 100 | 0 | 100 | 0 |
The following MIC values (μg/ml) were used as susceptibility breakpoints as recommended by the NCCLS (14): penicillin G, ≤0.5; piperacillin, ≤32; ticarcillin, ≤32; piperacillin-tazobactam, ≤32; ticarcillin-clavulanate, ≤32; ampicillin-sulbactam, ≤8; cefotaxime, ≤16; ceftriaxone, ≤16; cefoxitin, ≤16; cefotetan, ≤16; cefmetazole, ≤16; ceftizoxime, ≤16; imipenem, ≤4; meropenem, ≤4; trovafloxacin, ≤2; clindamycin, ≤2; and metronidazole, ≤8. Ertapenem susceptibility was ≤4 μg/ml, as recommended by the manufacturer. Test isolates with higher than stated susceptible MICs were considered “not susceptible” and were comprised of isolates with MICs interpreted as intermediate or fully resistant.
Contains isolates with cefoxitin (Cfx) MICs of ≥32 μg/ml.
Contains isolates with clindamycin (Clin) MICs of ≥4 μg/ml.
Indicates the decrease in the percentage of isolates susceptible to isolates “not-susceptible” to cefoxitin or clindamycin.