Skip to main content
NCBI home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1993 Aug;37(8):1665–1669. doi: 10.1128/aac.37.8.1665

Antimicrobial resistance in human oral and intestinal anaerobic microfloras.

C A Stark 1, C Edlund 1, S Sjöstedt 1, G Kristensen 1, C E Nord 1
PMCID: PMC188038  PMID: 8215280

Abstract

In the present study we determined the resistance patterns of anaerobic bacteria from human saliva and stool specimens and investigated whether there were significant differences in resistance between outpatients and hospitalized patients, regardless of whether they had received antimicrobial agents. No bacterial strains resistant to ampicillin, piperacillin, cefoxitin, cefuroxime, imipenem, clindamycin, doxycycline, chloramphenicol, or metronidazole were isolated from the saliva samples. However, resistance to ampicillin, cefoxitin, and cefuroxime was found in strains from 70% of the fecal samples (mainly Bacteroides thetaiotaomicron, Clostridium innocuum, and Bacteroides ovatus). Resistance to both ampicillin and cefuroxime was frequently found in 19% of the isolated strains (mainly B. thetaiotaomicron, B. ovatus, and Bacteroides vulgatus). No strains that were resistant to imipenem, chloramphenicol, or metronidazole were found. Hospitalization and/or intake of antimicrobial agents was associated with an increase in the relative number of resistant anaerobic intestinal bacteria. The percentage of resistant anaerobic strains encountered, compared with the total number of anaerobic bacteria in the normal fecal microflora, was between 5.2 and 14.8%, with the lower value associated with the outpatient group. Two-thirds of the resistant strains from this group had a relative frequency of less than 1% of the total anaerobic flora, while one-third of the strains were present at a level of greater than 1%; for the hospitalized patients, two-thirds of the strains were present at a level of greater than 1%, and one-third of the strains were present at a level of less than 1% (P < 0.001). Patients who had received antimicrobial agents for 6 days or more (n=20) had an average of 1.6 resistant anaerobic strains each, while patients treated for 3 to 5 days (n = 30) had a mean number of 0.87 resistant strains each ( P < 0.05).

Full text

PDF
1665

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andåker L., Kling P. A., Burman L. G. Antibiotic consumption and faecal bacterial susceptibility in surgical in-patients. Acta Chir Scand. 1987 Jul-Aug;153(7-8):411–416. [PubMed] [Google Scholar]
  2. Bourgault A. M., Lamothe F., Hoban D. J., Dalton M. T., Kibsey P. C., Harding G., Smith J. A., Low D. E., Gilbert H. Survey of Bacteroides fragilis group susceptibility patterns in Canada. Antimicrob Agents Chemother. 1992 Feb;36(2):343–347. doi: 10.1128/aac.36.2.343. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brook I. Anaerobic bacterial bacteremia: 12-year experience in two military hospitals. J Infect Dis. 1989 Dec;160(6):1071–1075. doi: 10.1093/infdis/160.6.1071. [DOI] [PubMed] [Google Scholar]
  4. Crook D. W., Cuchural G. J., Jr, Jacobus N. V., Tally F. P. Antimicrobial resistance in oral and colonic bacteroides. Scand J Infect Dis Suppl. 1988;57:55–64. [PubMed] [Google Scholar]
  5. Cuchural G. J., Jr, Malamy M. H., Tally F. P. Beta-lactamase-mediated imipenem resistance in Bacteroides fragilis. Antimicrob Agents Chemother. 1986 Nov;30(5):645–648. doi: 10.1128/aac.30.5.645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Ellner P. D., Fink D. J., Neu H. C., Parry M. F. Epidemiologic factors affecting antimicrobial resistance of common bacterial isolates. J Clin Microbiol. 1987 Sep;25(9):1668–1674. doi: 10.1128/jcm.25.9.1668-1674.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Finegold S. M. Clinical relevance of antimicrobial susceptibility testing. Eur J Clin Microbiol Infect Dis. 1992 Nov;11(11):1021–1024. doi: 10.1007/BF01967793. [DOI] [PubMed] [Google Scholar]
  8. Hedberg M., Edlund C., Lindqvist L., Rylander M., Nord C. E. Purification and characterization of an imipenem hydrolysing metallo-beta-lactamase from Bacteroides fragilis. J Antimicrob Chemother. 1992 Feb;29(2):105–113. doi: 10.1093/jac/29.2.105. [DOI] [PubMed] [Google Scholar]
  9. Heimdahl A., Nord C. E. Effect of phenoxymethylpenicillin and clindamycin on the oral, throat and faecal microflora of man. Scand J Infect Dis. 1979;11(3):233–242. doi: 10.3109/inf.1979.11.issue-3.11. [DOI] [PubMed] [Google Scholar]
  10. Heimdahl A., von Konow L., Nord C. E. Beta-lactamase-producing Bacteroides species in the oral cavity in relation to penicillin therapy. J Antimicrob Chemother. 1981 Sep;8(3):225–229. doi: 10.1093/jac/8.3.225. [DOI] [PubMed] [Google Scholar]
  11. Kling P. A., Ostensson R., Granström S., Burman L. G. A 7-year survey of drug resistance in aerobic and anaerobic fecal bacteria of surgical inpatients: clinical relevance and relation to local antibiotic consumption. Scand J Infect Dis. 1989;21(6):589–596. doi: 10.3109/00365548909021685. [DOI] [PubMed] [Google Scholar]
  12. Levy S. B., Marshall B., Schluederberg S., Rowse D., Davis J. High frequency of antimicrobial resistance in human fecal flora. Antimicrob Agents Chemother. 1988 Dec;32(12):1801–1806. doi: 10.1128/aac.32.12.1801. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Piddock L. J., Wise R. Cefoxitin resistance in Bacteroides species: evidence indicating two mechanisms causing decreased susceptibility. J Antimicrob Chemother. 1987 Feb;19(2):161–170. doi: 10.1093/jac/19.2.161. [DOI] [PubMed] [Google Scholar]
  14. Shaw E. J., Datta N., Jones G., Marr F. M., Froud W. J. Effect of stay in hospital and oral chemotherapy on the antibiotic sensitivity of bowel coliforms. J Hyg (Lond) 1973 Sep;71(3):529–534. doi: 10.1017/s0022172400046519. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Sjöstedt S., Levin P., Kager L., Malmborg A. S., Bergman U. Hospital and catchment area antibiotic utilization and bacterial sensitivity in primary infections following gastric surgery in Huddinge, Sweden. Eur J Clin Pharmacol. 1990;39(3):211–216. doi: 10.1007/BF00315098. [DOI] [PubMed] [Google Scholar]
  16. Wexler H. M. Susceptibility testing of anaerobic bacteria: myth, magic, or method? Clin Microbiol Rev. 1991 Oct;4(4):470–484. doi: 10.1128/cmr.4.4.470. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES