1
|
Tanaka E, Hirai Y, Wajima T, Ishida Y, Kawamura Y, Nakaminami H. High-Level Quinolone-Resistant Haemophilus haemolyticus in Pediatric Patient with No History of Quinolone Exposure. Emerg Infect Dis 2022; 28:104-110. [PMID: 34932443 PMCID: PMC8714209 DOI: 10.3201/eid2801.210248] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The prevalence of antimicrobial resistance among Haemophilus spp. is a critical concern, but high-level quinolone-resistant strains had not been isolated from children. We isolated high-level quinolone-resistant H. haemolyticus from the suction sputum of a 9-year-old patient. The patient had received home medical care with mechanical ventilation for 2 years and had not been exposed to any quinolones for >3 years. The H. haemolyticus strain we isolated, 2019-19, shared biochemical features with H. influenzae. However, whole-genome analysis found this strain was closer to H. haemolyticus. Phylogenetic and mass spectrometry analyses indicated that strain 2019-19 was in the same cluster as H. haemolyticus. Comparison of quinolone resistance-determining regions showed strain 2019-19 possessed various amino acid substitutions, including those associated with quinolone resistance. This report highlights the existence of high-level quinolone-resistant Haemophilus species that have been isolated from both adults and children.
Collapse
|
2
|
Torumkuney D, Van PH, Thinh LQ, Koo SH, Tan SH, Lim PQ, Sivhour C, Lamleav L, Somary N, Sosorphea S, Lagamayo E, Morrissey I. Results from the Survey of Antibiotic Resistance (SOAR) 2016-18 in Vietnam, Cambodia, Singapore and the Philippines: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. J Antimicrob Chemother 2021; 75:i19-i42. [PMID: 32337597 DOI: 10.1093/jac/dkaa082] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates collected from community-acquired respiratory tract infections (CA-RTIs) in 2016-18 in four Asian countries. METHODS MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS In total, 260 S. pneumoniae and 258 H. influenzae isolates were tested. Pneumococci from Vietnam (n = 161) were the least susceptible, with rates of susceptibility >90% for fluoroquinolones by CLSI breakpoints, ∼60% for amoxicillin, amoxicillin/clavulanic acid and ceftriaxone but <14% for most other agents. Pneumococcal isolates from Cambodia (n = 48) and Singapore (n = 34) showed susceptibilities ranging from ∼30% for trimethoprim/sulfamethoxazole and oral penicillin to 100% for fluoroquinolones. Among isolates of H. influenzae from Cambodia (n = 30), the Philippines (n = 59) and Singapore (n = 80), rates of susceptibility using CLSI breakpoints were >90% for amoxicillin/clavulanic acid, cephalosporins [except cefaclor in Singapore (77.5%)], macrolides and fluoroquinolones; for isolates from Vietnam (n = 89) the rates of susceptibility were >85% only for amoxicillin/clavulanic acid (95.5%), ceftriaxone (100%) and macrolides (87.6%-89.9%). Susceptibility to other antibiotics ranged from 7.9% (trimethoprim/sulfamethoxazole) to 57.3%-59.6% (fluoroquinolones) and 70.8% (cefixime). The application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. A limitation of the study was the small sample sizes and only one or two sites participating per country; however, since susceptibility data are scarce in some of the participating countries any information concerning antibiotic susceptibility is of value. CONCLUSIONS Antibiotic susceptibility varied across countries and species, with isolates from Vietnam demonstrating the lowest susceptibility. Knowledge of resistance patterns can be helpful for clinicians when choosing empirical therapy options for CA-RTIs.
Collapse
Affiliation(s)
- D Torumkuney
- GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
| | - P H Van
- Nguyen Tri Phuong Hospital, Ho Chi Minh City, Vietnam
| | - L Q Thinh
- Children Hospital 1, Ho Chi Minh City, Vietnam
| | - S H Koo
- Clinical Trials & Research Unit, Changi General Hospital, 2 Simei Street 3, 529889 Singapore
| | - S H Tan
- Department of Laboratory Medicine, 2 Simei Street 3, 529889 Singapore
| | - P Q Lim
- Clinical Trials & Research Unit, Changi General Hospital, 2 Simei Street 3, 529889 Singapore
| | - C Sivhour
- Battambang Provincial Referral Hospital Prek Mohatep Village, Svaypor Commune, Battambang City and Battambang Province, Cambodia
| | - L Lamleav
- Siem Reap Provincial Referral Hospital Mondul 1 Village, Svay Dangum Commune, Siem Reap City, Siem Reap Province, Cambodia
| | - N Somary
- Kampong Cham Provincial Referral Hospital, Praketmealea Road, #7 Village, Kampong Cham Commune, Kampong Cham City, Kampong Cham Province, Cambodia
| | - S Sosorphea
- Takeo Provincial Referral Hospital, Phumi 3 Village, RokaKnong Commune, Daunkeo Town, Takeo Province, Cambodia
| | - E Lagamayo
- St. Luke's Medical Center Quezon City, Institute of Pathology, Microbiology Section, 279 E Rodriguez SR. BLVD Cathedral Heights, Quezon City, Philippines
| | - I Morrissey
- IHMA Europe Sàrl, Route de l'Ile-au-Bois 1A, 1870 Monthey/VS, Switzerland
| |
Collapse
|
3
|
Chang CM, Shih HI, Wu CJ, Lauderdale TL, Lee NY, Lee CC, Chen YC, Huang CC, Ko WC. Fluoroquinolone resistance in Haemophilus influenzae from nursing home residents in Taiwan: correlation of MICs and mutations in QRDRs. J Appl Microbiol 2020; 128:1624-1633. [PMID: 31951091 DOI: 10.1111/jam.14580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 11/28/2022]
Abstract
AIMS To study the association between number and positions of mutations with MICs of fluoroquinolone non-susceptible Haemophilus influenzae. METHODS AND RESULTS More than 40% of 48 H. influenzae isolated from nursing home residents were not susceptible to fluoroquinolone. Amino acid changes in the quinolone resistance determining regions, and correlation with MICs and inhibition zone diameters were analysed. All isolates with reduced susceptibility to fluoroquinolones (MIC ≥0·125 µg ml-1 ) had at least one mutation in gyrA at position 84 and were resistant to nalidixic acid. Compared to isolates with reduced susceptibility, resistant isolates were associated with mutations in gyrA at positions 88 and 134, and in parC at position 88 (P < 0·001). Inhibition zone diameter for nalidixic acid disk ≥23 mm may detect susceptible isolates. CONCLUSIONS Reduced susceptibility to fluoroquinolones was associated with mutations at position 84 in gyrA. A further increase in fluoroquinolone MIC was associated with mutations in gyrA at positions 88 and 134, and parC at position 88. SIGNIFICANCE AND IMPACT OF THE STUDY Due to limited resistant H. influenzae strains, prior studies on association between positions of mutations and fluoroquinolone MICs were inconclusive. The comparison of mutations between isolates with susceptibility, reduced susceptibility and high resistance supported the importance of the present study.
Collapse
Affiliation(s)
- C-M Chang
- Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Center of Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Medicine, National Cheng Kung University Medical College, Tainan, Taiwan
| | - H-I Shih
- Department of Emergency Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - C-J Wu
- Division of Infectious Diseases, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan, Taiwan
| | - T-L Lauderdale
- Division of Infectious Diseases, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - N-Y Lee
- Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Center of Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan
| | - C-C Lee
- Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Center of Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Y-C Chen
- Division of Infectious Diseases, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - C-C Huang
- Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - W-C Ko
- Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Center of Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Medicine, National Cheng Kung University Medical College, Tainan, Taiwan
| |
Collapse
|