Third Kuwaiti Multicenter Survey of Antibiotic Susceptibility of Anaerobic Bacteria: A Comparative Analysis of 20-Year Data

<b><i>Objective:</i></b> This study aimed to evaluate antibiotic susceptibility and antimicrobial resistance trends among clinically significant anaerobes in Kuwait hospitals from 2013 to 2022, comparing these findings with data from 2002 to 2012. <b><i>Methods:</i></b> The study prospectively collected 2,317 anaerobic isolates from various body sites across four Kuwaiti hospitals between January 2013 and December 2022. The minimum inhibitory concentrations for 11 antianaerobic antibiotics were determined using E-test methodology. The study analyzed trends and resistance rates across two periods: 2013-2017 and 2018-2022, using statistical analysis for resistance comparison. <b><i>Results:</i></b> Of the 2,317 isolates, most were from wounds (42.2%), fluids (28.0%), and tissues (20.5%). <i>Bacteroides fragilis</i> was the most common pathogen (34.0%), followed by <i>Prevotella bivia</i> (13.4%). Over 90% of isolates were susceptible to imipenem, meropenem, tigecycline, and metronidazole, whereas lower susceptibility was observed for penicillin, amoxicillin-clavulanic acid, and clindamycin. Notable differences in resistance profiles since 2002 were observed, especially in amoxicillin-clavulanic acid, piperacillin, piperacillin-tazobactam, and clindamycin. <b><i>Conclusion:</i></b> Owing to detected resistance to all antibiotics, susceptibility testing for anaerobic isolates is recommended in severe infections to ensure effective antimicrobial therapy. Continuous surveillance is crucial for developing antibiotic policies to manage invasive anaerobic infections.