Mh. Nguyen et al., Antimicrobial resistance and clinical outcome of bacteroides bacteremia: Findings of a multicenter prospective observational trial, CLIN INF D, 30(6), 2000, pp. 870-876
There is debate regarding the correlation between in vitro susceptibility t
esting and clinical response to therapy for bacteroides bacteremia. We cond
ucted a prospective multicenter observational study of 128 patients with ba
cteroides bacteremia. Outcome was correlated with results of in vitro susce
ptibility testing of Bacteroides isolates recovered from blood and/or nonbl
ood sites, determined with use of 3 end points: mortality at 30 days, clini
cal response (cure vs, failure), and microbiological response (eradication
vs. persistence). The mortality rate among patients who received inactive t
herapy (45%) was higher than among patients who received active therapy (16
%; P = .04). Clinical failure (82%) and microbiological persistence (42%) w
ere higher for patients who received inactive therapy than for patients who
received active therapy (22% and 12%, respectively; P = .0002 and .06, res
pectively). In vitro activity of agents directed at Bacteroides species rel
iably predicts outcome: the specificity was 97%, and positive predictive va
lue was 82%. Antimicrobial susceptibility testing may be indicated for pati
ents whose blood specimens yield Bacteroides species.