Selection of constitutively resistant mutants of inducible clindamycin-resistant Bacteroides vulgatus

Inducible expression of ribosomal clindamycin resistance in Bacteroides vulgatus

The abilities of erythromycin and clindamycin to act as inducers of clindamycin resistance in the strain Bacteroides vulgatus RYC18F6 is evaluated in vivo (efficiency of plating of inhibitory clindamycin concentrations) and in vitro [efficiency of poly(U)-directed polypeptide synthesis by ribosomes]. Uninduced cells failed to grow during the first 72 h, even at a very low clindamycin concentration (0.1 microgram/ml); after induction with erythromycin or clindamycin, cells were able to form colonies at 32 micrograms/ml after 48 h. The in vitro polymerization test with B. vulgatus RYC18F6 ribosomes (S-30 extract) showed that ribosomes from uninduced cells were fully sensitive to the inhibitory effect of clindamycin. Ribosomes obtained from erythromycin- or clindamycin-induced cells presented a reduced sensitivity to clindamycin inhibition. These results show that resistance to clindamycin in B. vulgatus RYC18F6 is an inducible phenomenon involving a ribosomal modification, probably similar to that previously described for gram-positive bacteria.

Resistance of Peptostreptococcus spp. to macrolides and lincosamides: inducible and constitutive phenotypes

The activities of erythromycin and clindamycin against 350 Peptostreptococcus strains were studied during a 5-year period (1986 to 1991). In 5.1% of the Peptostreptococcus strains, which presented dissociated resistance (clindamycin MIC, less than or equal to 1 microgram/ml; erythromycin MIC, greater than 8 micrograms/ml), evidence of inducible macrolide-lincosamide resistance was shown. A total of 17.7% of the strains presented a constitutive phenotype; the clindamycin and erythromycin MICs for these strains were greater than 8 micrograms/ml.

Susceptibility testing of anaerobic bacteria: myth, magic, or method?

The demand for susceptibility testing of anaerobes has increased, yet consensus as to procedure and interpretation in this area has not been achieved. While routine testing of anaerobic isolates is not needed, certain isolates in specific clinical settings should be tested. Also, laboratories may monitor their local antibiograms by doing periodic surveillance batch testing. The National Committee for Clinical Laboratory Standards has published a protocol of methods approved for susceptibility testing of anaerobic bacteria. Both agar and broth microdilution are included; however, the broth disk elution method is no longer approved by the National Committee for Clinical Laboratory Standards because of method-related interpretive errors. A number of newer methods are undergoing evaluation and seem promising. Clinicians and microbiologists reviewing susceptibility reports should be aware of sources of variability in the test results. Variables in susceptibility testing of anaerobes include the media and methods used, organisms chosen for testing, breakpoints chosen for interpretation, antibiotic, and determination of endpoint. Clustering of MICs around the breakpoint may lead to significant variability in test results. Adherence of testing laboratories to approved methods and careful descriptions of the method and the breakpoints used for interpretation would facilitate interlaboratory comparisons and allow problems of emerging resistance to be noted. A variety of resistance mechanisms occurs in anaerobic bacteria, including the production of beta-lactamase and other drug-inactivating enzymes, alteration of target proteins, and inability of the drug to penetrate the bacterial wall. Antimicrobial resistance patterns in the United States and abroad are described.