Eleven metronidazole resistant Bacteroides and one newly classified Phocaeicola dorei strain from Kuwait were investigated for their resistance mechanisms and the emergence of their resistant plasmids. All but one strain harbored nimE genes on differently sized plasmids. Of the 11 nimE genes, 9 were preceded by full copies of the prototype ISBf6 insertion sequence element, one carried a truncated ISBf6 and one was activated by an additional copy of IS612B. Nucleotide sequencing results showed that the nimE ISBf6 distances were constant and all five different plasmids shared a common region, suggesting that (i) the nimE-ISBf6 configuration was inserted into an undisclosed common genetic element, (ii) over time, this common element was mutated by insertions and deletions, spreading the resultant plasmids. Of the 10 B. fragilis strains in this collection, 6 were also cfiA-positive, one with full imipenem resistance, indicating a tendency for multidrug resistance (MDR) among such isolates. The significant number of metronidazole resistant Bacteroides spp. and P. dorei strains with the MDR phenotype warns of difficulties in treatment and suggests promoting adherence to antibiotic stewardship recommendations in Kuwait.

对来自科威特的11 种甲硝唑耐药拟杆菌和一种新分类的Phocaeicola dorei菌株的耐药机制及其耐药质粒的出现进行了研究。除一种菌株外，所有菌株都在不同大小的质粒上含有nimE基因。在 11 个nimE基因中，9 个前面有原型 IS Bf6插入序列元件的完整拷贝，一个携带截短的 IS Bf6 ，一个被额外的 IS 612 B拷贝激活。核苷酸测序结果显示nimE IS Bf6距离是恒定的，并且所有五个不同的质粒共享一个共同区域，这表明（i）nimE -IS Bf6构型被插入到一个未公开的共同遗传元件中，（ii）随着时间的推移，这个共同元件通过插入和删除而发生突变，从而传播了所得质粒。在该集合中的10 个脆弱拟杆菌菌株中，有 6 个也是cfiA阳性，其中一个具有完全亚胺培南耐药性，表明此类分离株具有多药耐药性 (MDR) 的趋势。大量的甲硝唑耐药拟杆菌属。具有MDR 表型的P. dorei菌株警告治疗困难，并建议促进科威特遵守抗生素管理建议。