Multirresistencia en el mundo anaerobio: Bacteroides fragilis

Inicio>>Volumen>>Vol 25, N ° 2 mayo – agosto 2019>>Multirresistencia en el mundo anaerobio: Bacteroides fragilis

Multirresistencia en el mundo anaerobio: Bacteroides fragilis


Autores


Daniel Cascante-Serrano

Resumen


Bacteroides fragilis es la bacteria anaerobia más frecuentemente aislada en casos de infecciones intestinales debido a su capacidad de persistir en alto número en el intestino como comensal y patógeno. Posee múltiples mecanismos de resistencia a los antimicrobianos que se encuentran expresados constitutivamente en su cromosoma, sin embargo algunos de estos mecanismos pueden ser parte de elementos genéticos móviles y transferirse lateralmente a otras especies bacterianas. Se ha demostrado que B. fragilis posee alta resistencia a los principales antimicrobianos de uso clínico, además se ha registrado una resistencia emergente hacia antimicrobianos de la familia de los carbapenémicos con cursos clínicos letales lo cual implica un reforzamiento en la vigilancia epidemiológica de la resistencia hacia los antimicrobianos de esta familia con el fin de evitar fallos terapéuticos.

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Abstract


Bacteroides fragilis is the most frequently isolated anaerobic bacterium in cases of intestinal infections because of its ability to persist in high numbers in the human intestine as a commensal and pathogen. It has multiple mechanisms of resistance to antimicrobials which are expressed constitutively in its chromosome, however some of these mechanisms can be encoded in mobile genetic elements and transferred laterally to other bacterial species. It has been shown that B. fragilis has high resistance to the main antimicrobials for clinical use, in addition there has been an emerging resistance to antimicrobials of the family of carbapenems with lethal clinical courses which implies a strengthening in the epidemiological surveillance of the resistance towards the antimicrobials of this family in order to avoid therapeutic failures.


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Referencias

Referencias
1. Hecht, D. W. (2006). Anaerobes: antibiotic resistance, clinical significance, and the role of susceptibility testing. Anaerobe, 12(3), 115-121.
2. Pumbwe, L., Skilbeck, C. A., Nakano, V., Avila-Campos, M. J., Piazza, R. M., & Wexler, H. M. (2007). Bile salts enhance bacterial co-aggregation, bacterial-intestinal epithelial cell adhesion, biofilm formation and antimicrobial resistance of Bacteroides fragilis. Microbial pathogenesis, 43(2-3), 78-87
3. Cerdeño-Tárraga, A. M., Patrick, S., Crossman, L. C., Blakely, G., Abratt, V., Lennard, N & Barron, A. (2005). Extensive DNA inversions in the B. fragilis genome control variable gene expression. Science, 307(5714), 1463-1465.
4. Turgeon, P., Turgeon, V., Gourdeau, M., Dubois, J., & Lamothe, F. (1994). Longitudinal study of susceptibilities of species of the Bacteroides fragilis group to five antimicrobial agents in three medical centers. Antimicrobial agents and chemotherapy, 38(10), 22762279.
5. Milatovic, D., Schmitz, F. J., Brisse, S., Verhoef, J., & Fluit, A. C. (2000). In vitro activities of sitafloxacin (DU-6859a) and six other fluoroquinolones against 8,796 clinical bacterial isolates. Antimicrobial agents and chemotherapy, 44(4), 1102-1107.
6. Teng, L. J., Hsueh, P. R., Tsai, J. C., Liaw, S. J., Ho, S. W., & Luh, K. T. (2002). High incidence of cefoxitin and clindamycin resistance among anaerobes in Taiwan. Antimicrobial agents and chemotherapy, 46(9), 2908-2913.
7. Hecht, D. W. (2006). Anaerobes: antibiotic resistance, clinical significance, and the role of susceptibility testing. Anaerobe, 12(3), 115-121.
8. Aldridge, K. E., Ashcraft, D., Cambre, K., Pierson, C. L., Jenkins, S. G., & Rosenblatt, J. E. (2001). Multicenter Survey of the Changing In Vitro Antimicrobial Susceptibilities of Clinical Isolates of Bacteroides fragilis Group, Prevotella, Fusobacterium, Porphyromonas, and Peptostreptococcus Species. Antimicrobial agents and chemotherapy, 45(4), 1238-1243.
9. Snydman, D. R., Jacobus, N. V., McDermott, L. A., Ruthazer, R., Goldstein, E. J. C., Finegold, S. M., ... & Venezia, R. (2002). National survey on the susceptibility of Bacteroides fragilis group: report and analysis of trends for 1997–2000. Clinical infectious diseases, 35(Supplement_1), S126-S134.
10. Rogers, M. B., Parker, A. C., & Smith, C. J. (1993). Cloning and characterization of the endogenous cephalosporinase gene, cepA, from Bacteroides fragilis reveals a new subgroup of Ambler class A beta-lactamases. Antimicrobial agents and chemotherapy, 37(11), 2391-2400.
11. Hecht, D. W. (2006). Anaerobes: antibiotic resistance, clinical significance, and the role of susceptibility testing. Anaerobe, 12(3), 115-121.
12. Whittle, G., Shoemaker, N. B., & Salyers, A. A. (2002). The role of Bacteroides conjugative transposons in the dissemination of antibiotic resistance genes. Cellular and Molecular Life Sciences CMLS, 59(12), 2044-2054.
13. Sóki, J., Edwards, R., Hedberg, M., Fang, H., Nagy, E., Nord, C. E., & ESCMID Study Group on Antimicrobial Resistance in Anaerobic Bacteria. (2006). Examination of cfiAmediated carbapenem resistance in Bacteroides fragilis strains from a European antibiotic susceptibility survey. International journal of antimicrobial agents, 28(6), 497-502.
14. Nakamura, I., Aoki, K., Miura, Y., Yamaguchi, T., & Matsumoto, T. (2017). Fatal sepsis caused by multidrug-resistant Bacteroides fragilis, harboring a cfiA gene and an upstream insertion sequence element, in Japan. Anaerobe, 44, 36-39.