The antibiotic susceptibility pattern of gas gangrene-forming Clostridium spp. clinical isolates from South-Eastern Hungary

Figures & data

Figure 1. Number of gas gangrene-forming clostridia isolates in the ten years of the study.

Table 1. Distribution of the clinical departments or units where the samples were collected.

Clinical departments/units	No. of strains (%)
Surgery	138 (37.1)
Internal Medicine	92 (24.7)
Emergency Department	33 (8.9)
Traumatology	31 (8.3)
Intensive Care Units	24 (6.5)
Dermatology	24 (6.5)
Pediatrics	9 (2.4)
Obstetrics and Gynaecology	3 (0.8)
Neurosurgery	3 (0.8)
Other clinics*	15 (4,0)
Total	372 (100)

^* Other clinical departments or units involved in this study: Otorhinolaryngology, Orthopaedics, Pathology, Neurology, Maxillofacial surgery, Psychiatry, Urology, Opththalmolgy, Oncotherapy.

Table 2. Distribution of sample types from which gas gangrene-forming clostridia were isolated during 2008–2017.

Sample types	No. of sample types (%)
Wound	77 (20.7)
Bile	75 (20.2)
Surgical samples	56 (15.0)
Blood culture	55 (14.8)
Abscess	55 (14.8)
Intraabdominal fluid	25 (6.7)
Other types*	29 (7.8)
Total	372 (100)

^* Other sample types were: biopsy, bronchoalveolar lavage (BAL), skin bulla, duodenum, gastric sample, middle ear, liver puncture, pancreas cyst puncture, pleural puncture, lacrimal sample, conjunctiva, pancreas cyst, nasal sample.

Table 3. Samples that contained two different gas gangrene-forming Clostridium species.

Laboratory code	Sample type	Clinical department/unit	Species 1	Species 2
8928 (2012)	Wound	Surgery	C. perfringens	C. sporogenes
52,329 (2012)	Wound	ICUs	C. perfringens	C. bifermentans
29,140 (2016)	Wound	Surgery	C. perfringens	C. sordellii
103,059 (2016)	Bile	Internal Medicine	C. perfringens	C. sporogenes
53,024 (2017)	Wound	Traumatology	C. perfringens	C. sordellii
102,554 (2017)	Bile	Internal Medicine	C. perfringens	C. bifermentans

ICUs: Intensive Care Units.

Table 4. Antibiotic susceptibility of C. perfringens isolates.

Antimicrobial agents	MIC (mg/l)			Percentage (%)
	Range	MIC50	MIC90	Susceptible	Intermediate	Resistant
Penicillin	0.002–2	0.064	0.25	95.5	1.9	2.6
Amoxicillin/clavulanic acid	0.008–3	0.032	0.125	100	0	0
Cefoxitin	0.016–8	0.5	2	100	0	0
Meropenem	0.002–1	0.016	0.125	100	0	0
Imipenem	0.002–2	0.125	0.5	100	0	0
Clindamycin	0.016–≥256	0.5	4	96.2	0	3.8
Metronidazole	0.016–3	1.5	4	100	0	0
Tigecycline	0.016–2	0.25	2	100	0	0

MIC: Minimal Inhibitory Concentration.

MIC₅₀: MIC that inhibits the growth of 50% of the bacteria.

MIC₉₀: MIC that inhibits the growth of 90% of the bacteria.

Table 5. Antibiotic susceptibility of non-perfringens gas gangrene-forming Clostridium spp. isolates.

Antimicrobial agents	MIC (mg/l)			Percentage (%)
	Range	MIC50	MIC90	Susceptible	Intermediate	Resistant
Penicillin	0.002–2	0.064	0.25	91.5	1.7	6.8
Amoxicillin/clavulanic acid	0.002–0.75	0.047	0.5	100	0	0
Cefoxitin	0.047–4	0.25	2	100	0	0
Meropenem	0.008–0.19	0.023	0.064	100	0	0
Imipenem	0.002–4	0.047	0.19	100	0	0
Clindamycin	0.008–256	0.25	4	91.5	0	8.5
Metronidazole	0.008–4	1	4	100	0	0

MIC: Minimal Inhibitory Concentration.

MIC₅₀: MIC that inhibits the growth of 50% of the bacteria.

MIC₉₀: MIC that inhibits the growth of 90% of the bacteria.