Abstract：
BACKGROUND: Bacteroides fragilis is the most frequent cause of anaerobic bacteraemia. Although recent data suggest a rise in antimicrobial resistance (AMR) of this and other anaerobic bacteria, surveillance remains limited due to a lack of both data availability and comparability. However, a newly introduced standardised method for antimicrobial susceptibility testing (AST) of anaerobic bacteria has made larger scale surveillance possible for the first time.
OBJECTIVE: To investigate phenotypic AMR of Bacteroides fragilis isolates from bacteraemia across Europe in 2022.
METHODS: In a multicentre approach, clinical microbiology laboratories in Europe were invited to contribute results of AST for Bacteroides fragilis blood culture isolates (including only the first isolate per patient and year). AST of a selection of four antibiotics was performed locally by participating laboratories in a prospective or retrospective manner, using the new EUCAST disc diffusion method on fastidious anaerobe agar (FAA-HB).
RESULTS: A total of 16 European countries reported antimicrobial susceptibilities in 449 unique isolates of Bacteroides fragilis from blood cultures in 2022. Clindamycin demonstrated the highest resistance rates (20.9%, range 0 - 63.6%), followed by piperacillin-tazobactam (11.1%, 0 - 54.5%), meropenem (13.4%, 0 - 45.5%), and metronidazole (1.8%, 0 - 20.0%), all with wide variation between countries.
CONCLUSIONS: Considering that the mean resistance rates across Europe were higher than expected for three of the four anti-anaerobic antibiotics under surveillance, both local AST of clinically relevant isolates of Bacteroides fragilis and continued surveillance on an international level is warranted.
OBJECTIVE: To investigate phenotypic AMR of Bacteroides fragilis isolates from bacteraemia across Europe in 2022.
METHODS: In a multicentre approach, clinical microbiology laboratories in Europe were invited to contribute results of AST for Bacteroides fragilis blood culture isolates (including only the first isolate per patient and year). AST of a selection of four antibiotics was performed locally by participating laboratories in a prospective or retrospective manner, using the new EUCAST disc diffusion method on fastidious anaerobe agar (FAA-HB).
RESULTS: A total of 16 European countries reported antimicrobial susceptibilities in 449 unique isolates of Bacteroides fragilis from blood cultures in 2022. Clindamycin demonstrated the highest resistance rates (20.9%, range 0 - 63.6%), followed by piperacillin-tazobactam (11.1%, 0 - 54.5%), meropenem (13.4%, 0 - 45.5%), and metronidazole (1.8%, 0 - 20.0%), all with wide variation between countries.
CONCLUSIONS: Considering that the mean resistance rates across Europe were higher than expected for three of the four anti-anaerobic antibiotics under surveillance, both local AST of clinically relevant isolates of Bacteroides fragilis and continued surveillance on an international level is warranted.
摘要：
背景：脆弱拟杆菌是厌氧菌血症的最常见原因。尽管最近的数据表明这种细菌和其他厌氧菌的抗菌素耐药性（AMR）上升，由于缺乏数据可用性和可比性，监测仍然有限。然而,一种新引入的厌氧菌抗菌药物敏感性试验(AST)标准化方法首次使大规模监测成为可能.
目的：调查2022年欧洲各地菌血症脆弱拟杆菌分离株的表型AMR。
方法：在多中心方法中，欧洲的临床微生物学实验室被邀请提供脆弱拟杆菌血培养分离株的AST结果(仅包括每个患者和每个年份的第一个分离株).参与实验室以前瞻性或回顾性方式在当地进行了四种抗生素的AST。使用新的EUCAST圆盘扩散法在挑剔的厌氧菌琼脂（FAA-HB）上扩散。
结果：2022年，共有16个欧洲国家报告了来自血液培养物的449种脆弱拟杆菌独特分离株的抗菌敏感性。克林霉素的耐药率最高(20.9%,范围0-63.6%)，其次是哌拉西林-他唑巴坦(11.1%，0-54.5%），美罗培南（13.4%，0-45.5%），和甲硝唑（1.8%，0-20.0%），各国之间差异很大。
结论：考虑到整个欧洲的平均耐药率高于监测的四种抗厌氧抗生素中的三种，临床相关脆弱拟杆菌分离株的本地AST和国际层面的持续监测都是必要的.
目的：调查2022年欧洲各地菌血症脆弱拟杆菌分离株的表型AMR。
方法：在多中心方法中，欧洲的临床微生物学实验室被邀请提供脆弱拟杆菌血培养分离株的AST结果(仅包括每个患者和每个年份的第一个分离株).参与实验室以前瞻性或回顾性方式在当地进行了四种抗生素的AST。使用新的EUCAST圆盘扩散法在挑剔的厌氧菌琼脂（FAA-HB）上扩散。
结果：2022年，共有16个欧洲国家报告了来自血液培养物的449种脆弱拟杆菌独特分离株的抗菌敏感性。克林霉素的耐药率最高(20.9%,范围0-63.6%)，其次是哌拉西林-他唑巴坦(11.1%，0-54.5%），美罗培南（13.4%，0-45.5%），和甲硝唑（1.8%，0-20.0%），各国之间差异很大。
结论：考虑到整个欧洲的平均耐药率高于监测的四种抗厌氧抗生素中的三种，临床相关脆弱拟杆菌分离株的本地AST和国际层面的持续监测都是必要的.
