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Antibiotic susceptibility of clinical isolates of Prevotella bivia in Lagos, Nigeria.

The susceptibility of 40 clinical isolates of Prevotella bivia to 11 anti-anaerobic agents was determined by disk diffusion and agar dilution methods in accordance with the NCCLS (1990) recommended guidelines. With the disk diffusion method all the P. bivia tested were susceptible to rifampicin, cefoxitin, chloramphenicol, clindamycin and metronidazole. Twelve (30%) isolates were resistant to cefotaxime and ceftriaxone while 2 (5%) each were resistant to tetracycline and erythromycin. Worthy of note, 39 (97.5%) and all 40 (100%) isolates were resistant to ampicillin and penicillin respectively. Determination of minimum inhibitory concentrations (MIC) showed that the first set of 5 antibiotics, except rifampicin, were shown to be as active against all the strains tested as with the disk diffusion sensitivity method: cefoxitin, chloramphenicol, clindamycin and metronidazole had MIC90 values ranging from 0.5-1 microgram/ml. The MIC90s of erythromycin and tetracycline were 4 micrograms/ml each while the range of MIC of cefotaxime and ceftriaxone was 0.5-32 micrograms/ml with a MIC90 of 8 micrograms/ml, well below their breakpoints, which is somewhat at variance with disk diffusion results. The clinical significance of this, however, is not clear, especially in the absence of controlled clinical trials. Ampicillin and penicillin MIC90 values were 64 micrograms/ml and 80 U/ml respectively which essentially confirmed the resistance observed by the disk method. All the P. bivia isolates were beta-lactamase producers, hence the resistance of these isolates to penicillin and ampicillin. It is conceivable that in infections with monoculture of P. bivia, agents like tetracycline, or erythromycin may still be a useful alternative for treatment.