Antimicrobial susceptibility of non-Bacteroides fragilis group anaerobic Gram-negative bacilli in Europe.

OBJECTIVE: To investigate the in vitro activity of a range of anti-anaerobe antimicrobials against non-Bacteroides fragilis group anaerobic Gram-negative bacilli isolated in Europe. METHODS: Isolates from 15 laboratories in 13 countries were identified by conventional methods. The MICs of 20 antibiotics were determined by an agar dilution method. RESULTS: There were 488 Prevotella spp., 174 fusobacteria, 69 Porphyromonas spp., 33 Bacteroides spp., 28 Bilophila wadsworthia and 16 Campylobacter spp. isolates, one Sutterella wadsworthensis isolate and four unidentified isolates. Penicillin resistance (and diminished susceptibility to piperacillin) was most common in Prevotella spp. and Bilophila wadsworthia but was also seen in many other species. All isolates, except three of Bilophila wadsworthia, were susceptible to amoxycillin/clavulanate. Most isolates were susceptible to cefoxitin (except Bilophila wadsworthia) and all were susceptible to the carbapenems. Clinafloxacin was the most active quinolone, followed by trovafloxacin and then sparfloxacin. Most fusobacteria were inherently resistant to the macrolides, as expected, but resistance to macrolides and a ketolide in other species was uncommon. Most Fusobacterium varium isolates were resistant to clindamycin, but resistance to clindamycin in all other species was rare. Tetracycline resistance was common but this did not affect the glycylcyclines. There was one isolate of Bacteroides putredinis resistant to chloramphenicol, and three isolates, a Bacteroides ureolyticus isolate, the Sutterella wadsworthensis isolate and one of the unnamed isolates, were metronidazole resistant. Rifampicin was active against most Prevotella and Porphyromonas spp., but not against many other genera. CONCLUSIONS: Penicillin resistance has increased in Europe among non-Bacteroides fragilis anaerobic Gram-negative bacilli, much of it due to beta-lactamase. Acquired resistance to other beta-lactams, macrolides and rifampicin has not significantly increased, and chloramphenicol and metronidazole are unaffected. However, resistance to tetracycline is common. The new compounds, a ketolide (HMR 3647), the glycylcyclines and clinafloxacin, are highly active.