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Chapter 72 : Susceptibility Test Methods: Anaerobic Bacteria

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Abstract:

This chapter describes the currently available methodologies and their interpretation for susceptibility testing of anaerobes. At present, alternative testing methods include limited agar dilution, broth microdilution (for the group), and the Etest gradient strip method. Tigecycline, a glycylcycline derivative of minocycline, was recently introduced for treatment of intra-abdominal and skin and soft tissue infections. Several studies have found very good activity against anaerobes, with rare strains exhibiting tigecycline MICs of >8 µg/ml. Extensive taxonomic changes have occurred within the non-spore-forming gram-positive bacilli, especially with those previously in the genus . It is important to compare the drug-containing plates to the drug-free control plate when reading the tests, as different species of anaerobic bacteria can have very differently appearing spots, ranging from mucoid-opaque, as with the group, to gray-transparent, as with . Broth microdilution MIC determinations require criteria similar to those for the agar dilution procedure for reading end points: the concentration at which the most significant reduction in growth is observed and interpreted as the MIC. Current methodologies allow for accurate surveillance or individual isolate testing by most laboratories. Future studies comparing broth microdilution to the reference agar method and the anticipated development of an improved microdilution system will result in better standardization of the more-user-friendly method and, possibly, more widespread commercial availability.

Citation: Citron D, Hecht D. 2011. Susceptibility Test Methods: Anaerobic Bacteria, p 1204-1214. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch72

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Bacteria
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beta-Lactamase Inhibitors
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Gram-Negative Bacilli
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Antimicrobial Susceptibility Testing
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Disk Diffusion Test
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References

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Tables

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TABLE 1

Indications for susceptibility testing of anaerobic bacteria

These are examples only and are not intended as all-inclusive. See the text for specific recommendations.

Citation: Citron D, Hecht D. 2011. Susceptibility Test Methods: Anaerobic Bacteria, p 1204-1214. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch72
Generic image for table
TABLE 2

Methods for susceptibility testing of anaerobic bacteria

Media are commercially available.

Frozen or lyophilized panels are available from Trek Diagnostic Systems, Inc., (Cleveland, OH).

Citation: Citron D, Hecht D. 2011. Susceptibility Test Methods: Anaerobic Bacteria, p 1204-1214. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch72
Generic image for table
TABLE 3

Interpretive categories for MICs for anaerobic bacteria

Adapted from reference with permission of the publisher.

>Members of the group are presumed to be resistant. Other gramnegative anaerobes may be screened for β-lactamase activity by use of a chromogenic cephalosporins test if penicillin therapy is contemplated. Higher blood levels are achievable; infection with non-β-lactamase-producing organisms with higher MICs might be treatable.

Citation: Citron D, Hecht D. 2011. Susceptibility Test Methods: Anaerobic Bacteria, p 1204-1214. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch72

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