ABSTRACT
Introduction:Clostridium perfringens and other gas gangrene-forming clostridia are commensals of the human gut and vaginal microbiota, but can cause serious or even fatal infections. As there are relatively few published studies on antibiotic susceptibility of these bacteria, we decided to perform a 10-year retrospective study in a South-Eastern Hungarian clinical centre.Methods: A total of 372 gas gangrene-forming Clostridium spp. were isolated from clinically relevant samples and identified with rapid ID 32A (bioMérieux, France) and MALDI-TOF MS (Bruker Daltinics, Germany) methods. Antibiotic susceptibility was determined with E-tests.Results: We identified 313 C. perfringens, 20 C. septicum, 10 C. sordellii, 10 C. sporogenes, 9 C. tertium, 6 C. bifermentans, 4 C. histolyticum isolates. In C. perfringens isolates, the rate of penicillin resistance was 2.6% and the rate of clindamycin resistance 3.8%. Penicillin resistance was found in 6.8% and clindamycin resistance in 8.5% of the non-perfringens Clostridium spp. isolates.Conclusion: The antibiotic susceptibility of C. perfringens isolates was in good agreement with previous publications. The rates of resistance to penicillin and clindamycin were very low. The resistance rates of non-perfringens Clostridium spp. isolates were higher than those of C. perfringens strains, but lower than those published in the literature.
Subject(s)
Anti-Bacterial Agents/pharmacology , Clindamycin/pharmacology , Clostridium/drug effects , Gas Gangrene/microbiology , Penicillins/pharmacology , Adolescent , Adult , Aged , Aged, 80 and over , Amoxicillin-Potassium Clavulanate Combination/pharmacology , Cefoxitin/pharmacology , Child , Child, Preschool , Clostridium/isolation & purification , Clostridium bifermentans/drug effects , Clostridium bifermentans/isolation & purification , Clostridium histolyticum/drug effects , Clostridium histolyticum/isolation & purification , Clostridium perfringens/drug effects , Clostridium perfringens/isolation & purification , Clostridium septicum/drug effects , Clostridium septicum/isolation & purification , Clostridium sordellii/drug effects , Clostridium sordellii/isolation & purification , Clostridium tertium/drug effects , Clostridium tertium/isolation & purification , Drug Resistance, Bacterial , Female , Gas Gangrene/drug therapy , Humans , Hungary , Imipenem/pharmacology , Infant , Inhibitory Concentration 50 , Male , Meropenem/pharmacology , Microbial Sensitivity Tests , Middle Aged , Retrospective Studies , Tigecycline/pharmacology , Young AdultSubject(s)
Bacteremia/diagnosis , Clostridium tertium/metabolism , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Bacteremia/microbiology , Clostridium tertium/drug effects , Clostridium tertium/isolation & purification , Humans , Male , Microbial Sensitivity Tests , Middle AgedABSTRACT
No abstract available.
Subject(s)
Humans , Male , Middle Aged , Anti-Bacterial Agents/pharmacology , Bacteremia/diagnosis , Clostridium tertium/drug effects , Microbial Sensitivity Tests , Spectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationABSTRACT
Clostridium tertium is infrequently isolated from blood in patients with underlying diseases. Laboratory diagnosis is often delayed because Clostridium tertium is aerotolerant and resistant to metronidazole. Clinically it is a problem because it is commonly resistant to metronidazole, clindamycin and cephalosporins. We present 3 cases illustrating these characteristics.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacteremia , Clostridium Infections , Clostridium tertium , Adult , Anti-Bacterial Agents/pharmacology , Bacteremia/drug therapy , Bacteremia/microbiology , Blood/microbiology , Child , Clostridium Infections/drug therapy , Clostridium Infections/microbiology , Clostridium tertium/classification , Clostridium tertium/drug effects , Clostridium tertium/genetics , Culture Media , Drug Resistance, Bacterial , Female , Humans , Male , Microbial Sensitivity Tests , Middle AgedABSTRACT
Clostridium tertium septicemia is a rare condition that predominantly occurs in neutropenic patients with concomitant abdominal disease. We report the fatal case of a nonneutropenic, 51-year-old patient with mechanical ileus and post-operative C. tertium septicemia, resulting in widespread pathology with multi-organ failure. As C. tertium is aerotolerant, often gram-variable and mostly resistant to broad-spectrum cephalosporins, differentiation is difficult and empirical therapeutic strategies may fail.
