CLINDAMYCIN RESISTANCE IN THE BACTEROIDES-FRAGILIS GROUP - ASSOCIATION WITH HOSPITAL-ACQUIRED INFECTIONS

A retrospective study was conducted to assess the relationships betwee n clindamycin resistance in members of the Bacteroides fragilis group, previous antimicrobial therapy, and the contest for the development o f infection, whether in the community or during hospitalization. Eight y-five clindamycin-resistant clinical strains (one isolate per patient ) isolated from January 1988 to October 1994 were matched (one to one) with clindamycin-susceptible isolates recovered during the same perio d, and the charts of the patients from whom the isolates were recovere d were reviewed retrospectively. Of the clindamycin-resistant strains, 65% were recovered from patients with hospital-acquired infections co mpared with 40% of the clindamycin-susceptible strains (odds ratio [OR ], 2.75; 95% confidence interval [CI], 1.41-5.38; P = .002). Prior ant imicrobial therapy for greater than or equal to 48 hours was also asso ciated with clindamycin resistance (OR, 2.33; 95% CI, 1.16-4.70; P = . 02). However, clindamycin resistance remained associated with hospital -acquired infections independent of prior antimicrobial therapy (Mante l-Haenszel weighted average OR, 2.22; 95% CI, 1.03-4.89; P = .04). Cli nicians should consider the risks for clindamycin resistance when trea ting hospital-acquired infections caused by members of the B. fragilis group.