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Bactéries anaérobies
et résistances aux antibiotiques
Yann Dumont1,2,*, Remy Froissart2, Anne-Laure Bañuls2, Lucas Bonzon1, Hélène Jean-Pierre1,
Sylvain Godreuil1,2
1 Hôpital Arnaud de Villeneuve, CHU de Montpellier, Laboratoire de bactériologie, Université de Montpellier, Montpellier, 191 Avenue du
Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.
2 UMR MIVEGEC IRD-CNRS-Université de Montpellier, IRD, Montpellier, France.
*Auteur correspondant : y-dumont@chu-montpellier.fr (Y. Dumont).
RÉSUMÉ
Le terme « bactéries anaérobies » recouvre de nombreuses
espèces phylogénétiquement très différentes. Ainsi, si on retrouve
quelques résistances naturelles communes, chaque espèce pré-
sente des résistances naturelles et une épidémiologie de la résis-
tance différente qu’il faut connaître pour orienter les médecins
vers des antibiothérapies efficaces. Les résistances acquises
peuvent toucher la majorité des molécules utilisées dans les infec-
tions à anaérobies, même si dans la majorité des cas les souches
restent fréquemment sensibles aux associations pénicilline inhibi-
teur de béta-lactamase (et notamment à la pipéracilline tazobac-
tam), aux carbapénèmes et au métronidazole. Cependant, la mise
en évidence de souches multirésistantes parmi les Bacteroides du
groupe fragilis, très fréquemment impliqué dans les infections, les
© DR KARI LOUNATMAA/SPL/PHANIE
échecs cliniques associés à ces souches, et l’évolution des résis-
tances pour certains antibiotiques, montre que, comme pour les
entérobactéries au cours des dernières décennies, la situation est
en train de changer. Il est donc essentiel de tester la sensibilité des
souches isolées dans les situations cliniques critiques et pour les
espèces les plus pourvoyeuses de résistance. Pour les souches les
plus résistantes, l’utilisation d’autres classes antibiotiques (oxazo-
lidinones, nouvelles cyclines) devra alors être envisagée.
MOTS CLÉS
ABSTRACT
Anaerobic bacteria and antibiotic resistances
◗ antibiotiques The term “anaerobic bacteria” covers many phylogenetically very different species.
◗ bactéries anaérobies Thus, if we find some common natural resistance, each species has natural resis-
◗ épidémiologie tance and epidemiology of the different resistance that must be known to guide
◗ Europe physicians to effective antibiotic therapy.The resistances acquired can affect most of
◗ résistance the molecules used in anaerobic infections, although in most cases the strains are
frequently sensitive to penicillin-beta-lactamase inhibitor associations (and especially
KEY WORDS piperacillin tazobactam), carbapenems and metronidazole. However, the demonstra-
◗ anaerobic bacteria tion of multiresistant strains among the Bacteroides of the fragilis group, which is very
◗ antibiotics frequently involved in infections, the clinical failures associated with these strains, and
◗ epidemiology the evolution of resistance for certain antibiotics, shows that, as for enterobacteria-
◗ Europe ceae during in recent decades, the situation is changing. It is therefore essential to
◗ resistance test the susceptibility of isolated strains in critical clinical situations and for the most
resistant species. For the most resistant strains, the use of other antibiotic classes
© 2018 – Elsevier Masson SAS (oxazolidinones, new cyclins) should then be considered.
Tous droits réservés.
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