Systematic Review of In Vitro Antimicrobial Susceptibility Testing for Bacillus anthracis, 1947-2019.

Area of Science:

• Microbiology
• Infectious Diseases
• Public Health

Background:

• Bacillus anthracis causes anthrax, a significant threat due to natural occurrence and potential bioterrorism use.
• Understanding antimicrobial susceptibility is crucial for treating anthrax and preparing for public health emergencies.
• Current treatment guidelines rely on established antimicrobial profiles.

Purpose of the Study:

• To systematically review and analyze antimicrobial susceptibility testing data for Bacillus anthracis isolates.
• To collate findings from standardized susceptibility testing protocols for FDA-approved antimicrobials.
• To provide a comprehensive overview of B. anthracis susceptibility to inform treatment and preparedness.

Main Methods:

• Systematic literature search for studies on B. anthracis antimicrobial susceptibility testing.
• Selection of studies adhering to standardized protocols and using commercially available antimicrobials.
• Analysis of reported minimal inhibitory concentrations (MICs) from selected publications.

Main Results:

• The majority of Bacillus anthracis isolates demonstrated susceptibility to currently recommended first-line antimicrobials.
• Data on susceptibility to alternative antimicrobials were compiled.
• Minimal inhibitory concentration data were analyzed across various studies.

Conclusions:

• Most B. anthracis isolates remain susceptible to first-line anthrax treatments.
• Compiled data on alternative antimicrobials offer valuable options for resistant strains, bioengineered threats, or treatment intolerance/unavailability.
• This systematic review supports evidence-based treatment and preparedness strategies for anthrax.