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Antimicrobial susceptibility testing is crucial when treating Finegoldia magna infections
European Journal of Clinical Microbiology & Infectious Diseases ( IF 3.7 ) Pub Date : 2022-04-07 , DOI: 10.1007/s10096-022-04439-y
Fabienne Walser 1 , Julia Prinz 1, 2 , Yvonne Achermann 1, 3 , Stefan Rahm 4 , Patrick O. Zingg 4 , Stefano Mancini 5 , Frank Imkamp 5 , Reinhard Zbinden 5
Affiliation  

Finegoldia magna is an anaerobic gram-positive bacterium that can cause invasive human infections. Recently, a 52-year-old patient suffering from a periprosthetic joint infection (PJI) due to F. magna was treated with cefepime on hemodialysis; however, treatment failed due to relapse caused by antibiotic-resistant strains. Reports on the antimicrobial susceptibility of F. magna clinical isolates are rare. We collected 57 clinical F. magna isolates from Zurich, Switzerland, between September 2019 and July 2020 and tested their antimicrobial susceptibility to investigate the local resistance pattern. Antimicrobial susceptibility testing (AST) was evaluated for nine antibiotics (benzylpenicillin, amoxicillin/clavulanic acid, cefuroxime, cefepime, levofloxacin, rifampicin, metronidazole, doxycycline, and clindamycin) by E-test according to CLSI guidelines. All F. magna strains were susceptible to benzylpenicillin, amoxicillin/clavulanic acid, and metronidazole, while 75% to clindamycin. F. magna isolates showed MIC values lower than species-unrelated breakpoints for cefuroxime, levofloxacin, and cefepime in 93%, 56%, and 32% of the cases, respectively. MIC values for rifampicin and doxycycline were lower than locally determined ECOFFs in 98% and 72% of the cases, respectively. In summary, we recommend the use of benzylpenicillin, amoxicillin/clavulanic acid, or metronidazole without prior AST as first-line treatment option against F. magna PJI infections. If cefuroxime, cefepime, levofloxacin, rifampicin, doxycycline, or clindamycin are used, AST is mandatory.



中文翻译:

在治疗 Finegoldia magna 感染时,抗菌药物敏感性测试至关重要

Finegoldia magna是一种厌氧革兰氏阳性细菌,可引起侵入性人类感染。最近,一名 52 岁的患者因F. magna导致假体周围感染(PJI) ,在血液透析时用头孢吡肟治疗;然而,由于耐药菌株引起的复发,治疗失败。关于F. magna临床分离株的抗菌药物敏感性的报告很少见。我们收集了 57 个临床F. magna2019 年 9 月至 2020 年 7 月期间从瑞士苏黎世分离出的菌株,并测试了它们的抗菌敏感性,以调查当地的耐药模式。根据 CLSI 指南,通过 E-test 评估了九种抗生素(苄青霉素、阿莫西林/克拉维酸、头孢呋辛、头孢吡肟、左氧氟沙星、利福平、甲硝唑、强力霉素和克林霉素)的抗菌药敏试验 (AST)。所有F. magna菌株都对苄青霉素、阿莫西林/克拉维酸和甲硝唑敏感,而 75% 对克林霉素敏感。F. magna头孢呋辛、左氧氟沙星和头孢吡肟的 MIC 值分别在 93%、56% 和 32% 的病例中低于与种属无关的折点。在 98% 和 72% 的病例中,利福平和强力霉素的 MIC 值分别低于当地确定的 ECOFF。总之,我们建议使用苄青霉素、阿莫西林/克拉维酸或甲硝唑作为抗F. magna PJI 感染的一线治疗选择,而无需事先进行 AST 。如果使用头孢呋辛、头孢吡肟、左氧氟沙星、利福平、强力霉素或克林霉素,则必须进行 AST。

更新日期:2022-04-07
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