Antimicrobial resistance among anaerobic bacteria is increasingly recognized with geographic differences. In this study we analyzed the distribution and antimicrobial susceptibility profiles of 358 Gram-positive clinically significant anaerobes, isolated from 2017 to 2019, in a Greek tertiary-care hospital.

The species identification was performed by Vitek 2 and conventional biochemical methods, and the antimicrobial susceptibility testing by the E-test method. The antimicrobial agents tested were penicillin, ampicillin, amoxicillin-clavulanic acid, piperacillin-tazobactam, cefoxitin, imipenem, meropenem, clindamycin, metronidazole, moxifloxacin, chloramphenicol, tigecycline and vancomycin. Clostridioides difficile isolates were also tested against tetracycline. The results were interpreted using the CLSI and the EUCAST breakpoints.

Clostridium species accounted for 35.5% of the isolates, followed by Gram-positive cocci (GPAC) (33.2%) and non-spore-forming bacilli (31.3%). Beta-lactams, β-lactam/β-lactamase inhibitors, cefoxitin, carbapenems, chloramphenicol, tigecycline and vancomycin proved all effective against the GPAC tested. Clindamycin, moxifloxacin and metronidazole resistance varied among different species of GPAC. Clindamycin and moxifloxacin resistance observed was 10% and 5% for Cutibacterium acnes, 25% and 6.2% for Actinomyces odontolyticus and 40% and 5% for Clostridium perfringens. C. difficile isolates were fully susceptible to metronidazole, vancomycin, and tigecycline. Resistance rates to clindamycin, moxifloxacin and tetracycline were 62.9%, 30% and 24.3%, respectively.

These data highlight the need for periodic surveillance to monitor changes in susceptibility profiles.

厌氧细菌之间的耐药性越来越受到地理差异的认可。在这项研究中，我们分析了从2017年至2019年在希腊一家三级医院分离的358例革兰氏阳性临床上重要的厌氧菌的分布和抗菌药敏曲线。

通过Vitek 2和常规生化方法进行物种鉴定，并通过E-test方法进行抗菌药敏测试。测试的抗菌剂是青霉素，氨苄青霉素，阿莫西林-克拉维酸，哌拉西林-他唑巴坦，头孢西丁，亚胺培南，美罗培南，克林霉素，甲硝唑，莫西沙星，氯霉素，替加环素和万古霉素。还测试了艰难梭菌分离物对四环素的抵抗力。使用CLSI和EUCAST断点解释了结果。

梭状芽胞杆菌属占分离株的35.5％，其次是革兰氏阳性球菌（GPAC）（33.2％）和非芽孢杆菌（31.3％）。β-内酰胺，β-内酰胺/β-内酰胺酶抑制剂，头孢西丁，碳青霉烯类，氯霉素，替加环素和万古霉素均证明对测试的GPAC有效。不同种类的GPAC对克林霉素，莫西沙星和甲硝唑的耐药性不同。观察到的对克林霉素和莫西沙星的耐药性对痤疮皮肤炎杆菌分别为10％和5％，对解牙放线菌为25％和6.2％，对产气荚膜梭状芽胞杆菌为40％和5％。艰难梭菌分离株对甲硝唑，万古霉素和替加环素完全敏感。对克林霉素，莫西沙星和四环素的耐药率分别为62.9％，30％和24.3％。

这些数据强调了需要定期监测以监测药敏图谱的变化。