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Ai L, Fang L, Liu B, Zhou C, Gong F. Impact of the COVID-19 pandemic on Haemophilus influenzae infections in pediatric patients hospitalized with community acquired pneumonia. Sci Rep 2024; 14:12737. [PMID: 38830922 PMCID: PMC11148099 DOI: 10.1038/s41598-024-62728-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/21/2024] [Indexed: 06/05/2024] Open
Abstract
The COVID-19 pandemic has altered the infection landscape for many pathogens. This retrospective study aimed to compare Haemophilus influenzae (H. influenzae) infections in pediatric CAP patients hospitalized before (2018-2019) and during (2020-2022) the COVID-19 pandemic. We analyzed the clinical epidemiology and antimicrobial resistance (AMR) patterns of H. influenzae from a tertiary hospital in southwest China. A total of 986 pediatric CAP patients with H. influenzae-associated infections were included. Compared to 2018, the positivity rate increased in 2019 but dropped significantly in 2020. Although it rose in the following 2 years, the rate in 2022 remained significantly lower than in 2019. Patients' age during the pandemic was significantly higher than in 2018 and 2019, while gender composition remained similar across both periods. Notably, there were significant changes in co-infections with several respiratory pathogens during the pandemic. Resistance rates of H. influenzae isolates to antibiotics varied, with the highest resistance observed for ampicillin (85.9%) and the lowest for cefotaxime (0.0%). Resistance profiles to various antibiotics underwent dramatic changes during the COVID-19 pandemic. Resistance to amoxicillin-clavulanate, cefaclor, cefuroxime, trimethoprim-sulfamethoxazole, and the proportion of multi-drug resistant (MDR) isolates significantly decreased. Additionally, MDR isolates, alongside isolates resistant to specific drugs, were notably prevalent in ampicillin-resistant and β-lactamase-positive isolates. The number of pediatric CAP patients, H. influenzae infections, and isolates resistant to certain antibiotics exhibited seasonal patterns, peaking in the winter of 2018 and 2019. During the COVID-19 pandemic, sharp decreases were observed in February 2020, and there was no resurgence in December 2022. These findings indicate that the COVID-19 pandemic has significantly altered the infection spectrum of H. influenzae in pediatric CAP patients, as evidenced by shifts in positivity rate, demographic characteristics, respiratory co-infections, AMR patterns, and seasonal trends.
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Affiliation(s)
- Ling Ai
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, No. 439, Xuanhua Street, Chongqing, 402160, China
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Liang Fang
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Beizhong Liu
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, Department of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Chanjuan Zhou
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Fang Gong
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, No. 439, Xuanhua Street, Chongqing, 402160, China.
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China.
- Department of Pediatrics, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China.
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Ruiz Del Pino M, Rosales-Castillo A, Navarro-Marí JM, Gutiérrez-Fernández J. Clinical significance of isolation of Haemophilus no ducreyi in genital samples. Systematic review. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:468-484. [PMID: 36443187 DOI: 10.1016/j.eimce.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION AND OBJECTIVES Currently, the microbiological diagnosis of genital infections is carried out with molecular methods, which allow the detection of less frequent etiological agents but with potential pathogenic importance, such as Haemophilus spp. The objective of this review is to analyse and highlight the clinical importance of the isolation of Haemophilus spp. in genital and rectal infections, excluding Haemophilus ducreyi. MATERIAL AND METHODS A systematic review was carried out based on an exhaustive search of the publications included in the MEDLINE database up to August 5, 2021, on the presence of Haemophilus spp. in genital and rectal infections, excluding H. ducreyi. RESULTS After reviewing what was described in the literature, Haemophilus spp. (excluding H. ducreyi: HSNOD) was detected in 2397 episodes of genital infection, the most frequently isolated species being H. influenzae and H. parainfluenzae. Most of the episodes (87,6%) are constituted by single isolation. There is a slight predominance in women (48,3%) where it can cause vaginitis, salpingitis, endometritis or complications during pregnancy. In men, the clinical picture usually corresponds to urethritis. Most of the samples correspond to vaginal and urethral exudates, with a minority representation at the rectal level (2.3%). CONCLUSION HSNOD plays a relevant pathogenic role in episodes of genital infection, so microbiological diagnostic protocols must include methods that allow their detection, as well as include them in the etiological spectrum of this type of clinical picture.
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Affiliation(s)
- Marta Ruiz Del Pino
- Departamento de Microbiología, Facultad de Medicina, Universidad de Granada-ibs, Granada, Spain
| | - Antonio Rosales-Castillo
- Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves-ibs, Granada, Spain; Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain.
| | - José María Navarro-Marí
- Departamento de Microbiología, Hospital Universitario Virgen de las Nieves-ibs, Granada, Spain; Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain
| | - José Gutiérrez-Fernández
- Departamento de Microbiología, Facultad de Medicina, Universidad de Granada-ibs, Granada, Spain; Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain
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Zhang M, Liu J, Pan YC, Liu HL, Shu J, Wu XM, Yang Y. Analysis of Pathogenic Bacteria and Drug Resistance Among Girls with Bacterial Vaginitis. Infect Drug Resist 2023; 16:1849-1863. [PMID: 37020796 PMCID: PMC10069431 DOI: 10.2147/idr.s403304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/16/2023] [Indexed: 03/31/2023] Open
Abstract
Objective The aim of this study was to analyze the prevalence of vaginal flora and drug resistance in bacterial vaginitis among girls. Methods A total of 3099 girls (0-10 years old) with vaginitis who visited the Beijing Children's Hospital from January 2020 to December 2021 were included in the present study. The clinical data, results of bacterial culture of vaginal secretions, and drug sensitivity reports of the subjects were collected and analyzed. Results Of the 3099 girls with vaginitis, 399 girls had a positive bacterial culture of vaginal secretions. Nineteen types of bacteria were cultured from the vaginal secretions of these 399 girls, with a total of 419 strains. The top three infective bacteria were Haemophilus influenzae (127 strains, 30.31%), Staphylococcus aureus (66 strains, 15.75%), and Streptococcus agalactiae (32 strains, 7.64%). Additionally, 20 girls were simultaneously infected with two types of bacteria. Staphylococcus aureus, Group G Streptococcus, Haemophilus parainfluenzae, and Pseudomonas aeruginosa more frequently occurred in mixed infections. The number and bacterial detection rate among school-age girls were higher than those of preschool-age girls. We found seasonal variation in infection rates, and vaginitis among girls was higher in summer. Recurrence of vaginitis in girls was not related to the type of pathogenic bacteria in the infection. Drug sensitivity analyses showed that the resistance rates of clindamycin and erythromycin were generally high, 70-100%. After the coronavirus disease 2019 outbreak, the resistance rates of some antibiotics had decreased to varying degrees. Conclusion Improving the understanding of vaginal flora and drug resistance in girls with vaginitis will facilitate the selection of highly effective and sensitive antibacterial drugs and reduce the production of drug-resistant strains.
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Affiliation(s)
- Miao Zhang
- Department of Pediatric Gynecology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, China
| | - Jing Liu
- Department of Pediatric Gynecology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, China
- Correspondence: Jing Liu, Department of Pediatric Gynecology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China, Tel +86 010 59616889, Email
| | - Yu-Chen Pan
- Department of Pediatric Gynecology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, China
| | - Hui-Li Liu
- Department of Pediatric Gynecology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, China
| | - Jing Shu
- Department of Pediatric Gynecology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, China
| | - Xiao-Ming Wu
- Department of Pediatric Gynecology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, China
| | - Yang Yang
- Department of Pediatric Gynecology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, China
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Ma X, Lang J, Chen P, Tang W, Shindler S, Yang R. A cascade nanozyme with antimicrobial effects against nontypeable Haemophilus influenzae. NANOSCALE 2023; 15:1014-1023. [PMID: 36602182 DOI: 10.1039/d2nr04306h] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Otitis media (OM) is the main cause of pediatric antibiotic prescriptions. Nontypeable Haemophilus influenzae (NTHi) is a major OM pathogen, which forms a biofilm that resists conventional antimicrobials and immune clearance. Thus, novel treatments that are effective against NTHi and its biofilm are urgently required. Nanozymes (often inorganic nanoparticles) mimic natural enzymes' catalytic activities to generate strong antimicrobials at the site of infection, and thus represent one of the emerging solutions to the crisis of antimicrobial resistance. They mimic natural enzymes' activities, such as generating strong antimicrobials catalytically at the site of infection, to minimize overexposure. However, that in situ generation often relies on Reactive Oxygen Species (ROS) as precursors, a prerequisite that limits the broad deployment of nanozymes. To address this challenge, we designed a cascade nanozyme that generates an antiseptic, HOBr, from a ubiquitous non-ROS, i.e., O2, which successfully eradicates NTHi. The cascade nanozyme simultaneously exhibits glucose oxidase (GOx)-like activity from gold nanoparticles (AuNPs) and haloperoxidase (HPO)-mimicking activity from vanadium pentoxide nanowires (V2O5 NWs) connected using dopamine (DPA). The cascade nanozyme demonstrated strong antimicrobial efficacy against NTHi and its biofilm, while showing improved biocompatibility compared to the nanozyme of V2O5 NWs alone. The cascade nanozyme thus points to a material-oriented infectious disease treatment strategy, where small-molecule antimicrobials are generated in real time at the site of infection for the benefit of autonomous dosing. This strategy potentially mitigates the development of antimicrobial resistance and reduces side effects.
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Affiliation(s)
- Xiaojing Ma
- Robert F. Smith School of Chemical & Biomolecular Engineering, Cornell University, Ithaca, NY 14853, USA.
| | - Jiayan Lang
- Robert F. Smith School of Chemical & Biomolecular Engineering, Cornell University, Ithaca, NY 14853, USA.
| | - Pengyu Chen
- Robert F. Smith School of Chemical & Biomolecular Engineering, Cornell University, Ithaca, NY 14853, USA.
| | - Wenjing Tang
- Robert F. Smith School of Chemical & Biomolecular Engineering, Cornell University, Ithaca, NY 14853, USA.
| | - Simon Shindler
- Robert F. Smith School of Chemical & Biomolecular Engineering, Cornell University, Ithaca, NY 14853, USA.
| | - Rong Yang
- Robert F. Smith School of Chemical & Biomolecular Engineering, Cornell University, Ithaca, NY 14853, USA.
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Ruiz del Pino M, Rosales-Castillo A, Navarro-Marí JM, Gutiérrez-Fernández J. Importancia clínica del aislamiento de Haemophilus spp. (excluyendo H. ducreyi) en muestras genitales. Revisión sistemática. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Microbiological findings in prepubertal and pubertal girls with vulvovaginitis. Eur J Pediatr 2022; 181:4149-4155. [PMID: 36163515 PMCID: PMC9649474 DOI: 10.1007/s00431-022-04631-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/01/2022] [Accepted: 09/19/2022] [Indexed: 11/03/2022]
Abstract
UNLABELLED Vulvovaginitis is a common and challenging gynaecological problem in prepubertal and pubertal girls. Such an infection, owing to a wide range of aetiologies, if not responding to hygienic measures, needs further investigation through vaginal cultures, since treatment should be tailored accordingly. This study aimed to investigate the pathogens isolated in prepubertal and pubertal girls with signs and symptoms of vulvovaginitis. A total of 2314 symptomatic girls, 1094 prepubertal and 1220 pubertal, aged 2 to 16 years, were included. Vaginal samples were inoculated on specific culture plates followed by incubation in aerobic, anaerobic or CO2 atmosphere at 37 °C for 24 or 48 h, as appropriate. The identification of the isolated pathogens was carried out using Gram stain, conventional methods and the automated system VITEK 2 (BioMerieux, Marcy l'Etoile, France). Positive cultures were obtained from 587 (53.7%) of prepubertal girls and 926 (75.9%) of pubertal girls. A total of 613 and 984 pathogens were detected in prepubertal and pubertal subjects, respectively. Isolated bacteria included 40.1% and 22.8% Gram-positive cocci, 35.6% and 24.8% Gram-negative rods in the prepubertal and pubertal groups, respectively, with faecal pathogens being the most prevalent. Bacterial vaginosis was diagnosed in 22.8% of prepubertal and 37.9% of pubertal girls. Candida species were isolated mostly in the pubertal girls (14.5%). CONCLUSION Culture results should be evaluated with caution in children with vulvovaginitis. In the prepubertal girls, the most common isolated pathogens were opportunistic bacteria of faecal origin while girls in late puberty were more susceptible to bacterial vaginosis and vulvovaginal candidiasis. WHAT IS KNOWN • Vulvovaginitis is the most frequent and challenging reason for referral to paediatric and adolescent gynaecology services. • Microbiological examination can prove to be a significant tool to help diagnosis although results should be evaluated with caution in children. WHAT IS NEW • Significantly more positive vaginal cultures and pathogens were recorded in symptomatic pubertal girls compared to prepubertal children. • The prevalence of bacterial vaginosis was increased in both prepubertal and pubertal girls with vulvovaginitis although significantly more in girls at puberty.
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Hu BF, Hua CZ, Sun LY, Chao-Fang, Zhou MM. Microbiological Findings of Symptomatic Vulvovaginitis in Chinese Prepubertal Girls. J Pediatr Adolesc Gynecol 2021; 34:799-804. [PMID: 34166822 DOI: 10.1016/j.jpag.2021.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 05/23/2021] [Accepted: 05/26/2021] [Indexed: 12/31/2022]
Abstract
STUDY OBJECTIVE To study the bacteria and fungi causing vulvovaginitis in prepubertal girls. DESIGN Swabs from vaginal introitus were collected from patients with vulvovaginitis in 2018, and cultured for the identification of microorganisms with standard microbiological techniques. SETTING A children's hospital in Hangzhou, East China. PARTICIPANTS A total of 1235 Chinese prepubertal girls diagnosed with vulvovaginitis. MAIN OUTCOME MEASURE Bacteria or fungi in pure cultures or as the predominant organism were defined as pathogens. RESULTS A total of 1235 cases were diagnosed as vulvovaginitis, and 515 isolates were identified from 494 patients (40%, 494/1235). The most common pathogen was Streptococcus pyogenes (27.6%,142/515), followed by Haemophilus influenzae (27.2%,140/515), Candida albicans (22.3%,115/515), Staphylococcus aureus (5.8%, 30/515) and Escherichia coli (4.7%,24/515). All S pyogenes isolates were sensitive to penicillin, whereas 53.7% (73/136) of H influenzae isolates were sensitive to ampicillin, and 70.4% (19/27) of S aureus isolates were sensitive to oxacillin. CONCLUSION S pyogenes and H influenzae were the 2 most commonly identified pathogenic bacteria found in prepubertal girls with vulvovaginitis. Vulvovaginitis in prepubertal girls caused by C albicans may be more common in older children.
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Affiliation(s)
- Bo-Fei Hu
- Division of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People's Republic of China
| | - Chun-Zhen Hua
- Division of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People's Republic of China.
| | - Li-Ying Sun
- Department of Children's Gynecology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People's Republic of China
| | - Chao-Fang
- Department of Clinical Laboratory Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, People's Republic of China
| | - Ming-Ming Zhou
- Department of Clinical Laboratory Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, People's Republic of China
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Zhou M, Fu P, Fang C, Shang S, Hua C, Jing C, Xu H, Chen Y, Deng J, Zhang H, Zhang T, Wang S, Lin A, Huang W, Cao Q, Wang C, Yu H, Cao S, Deng H, Gao W, Hao J. Antimicrobial resistance of Haemophilus influenzae isolates from pediatric hospitals in Mainland China: Report from the ISPED program, 2017-2019. Indian J Med Microbiol 2021; 39:434-438. [PMID: 34556347 DOI: 10.1016/j.ijmmb.2021.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/10/2021] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This study set out to determine the antimicrobial resistance trends of Haemophilus influenzae isolates from pediatric hospitals in Mainland China, which would provide basis for clinical treatment. METHODS The Infectious Disease Surveillance of Pediatrics (ISPED) collaboration group conducted this study. H. influenzae strains isolated from nine pediatric hospitals in Mainland China were included. Disk diffusion method was used for antimicrobial susceptibility test. Cefinase disc was used for detection of β-lactamase. RESULTS In total, 13810 H. influenzae isolates were included during 2017-2019: 93.17% of which were from respiratory tract specimens, 4.63% from vaginal swabs, 1.10% from secretion, and 1.10% from others. Of all strains, 63.32% isolates produced β-lactamase; 8.22% isolates were β-lactamase-negative and ampicillin-resistant (BLNAR). The resistance to sulfamethoxazole-trimethoprim was 70.98%, followed by resistance to ampicillin (69.37%), cefuroxime (51.35%), ampicillin-sulbactam (38.82%), azithromycin (38.21%), amoxicillin-clavulanate (35.28%). More than 90% of H. influenzae isolates were susceptible to ceftriaxone, cefotaxime, meropenem, levofloxacin and chloramphenicol. The resistance rate of ampicillin and azithromycin in H. influenzae showed an increasing trend through the years. Statistically significant differences in antibiotic-resistance rates of all the antibiotics except chloramphenicol were found in different regions. The major Multi-Drug Resistance pattern was resistant to β-lactams, macrolides, and sulfonamides. CONCLUSIONS There is a rising trend of resistance rate of ampicillin and azithromycin in H. influenzae. Antimicrobial resistance of H. influenzae deserves our ongoing attention. Third-generation cephalosporin could be the preferred treatment option of infections caused by ampicillin-resistant H. influenzae.
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Affiliation(s)
- Mingming Zhou
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, PR China
| | - Pan Fu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, 201102, PR China
| | - Chao Fang
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, PR China
| | - Shiqiang Shang
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, PR China.
| | - Chunzhen Hua
- Department of Infectious Disease, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310003, PR China.
| | - Chunmei Jing
- Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, 400014, PR China
| | - Hongmei Xu
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing, 400014, PR China
| | - Yunsheng Chen
- Department of Clinical Laboratory, Shenzhen Children's Hospital, Shenzhen, 518038, PR China
| | - Jikui Deng
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, PR China
| | - Hong Zhang
- Department of Clinical Laboratory, Children's Hospital of Shanghai Jiaotong University, Shanghai, 200040, PR China
| | - Ting Zhang
- Department of Infectious Diseases, Children's Hospital of Shanghai Jiaotong University, Shanghai, 200040, PR China
| | - Shifu Wang
- Department of Clinical Laboratory, Qilu Children's Hospital of Shandong University, Jinan, 250022, PR China
| | - Aiwei Lin
- Department of Infectious Diseases, Qilu Children's Hospital of Shandong University, Jinan, 250022, PR China
| | - Weichun Huang
- Department of Clinical Laboratory, Shanghai Children's Medical Center, Shanghai, 200127, PR China
| | - Qing Cao
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai, 200127, PR China
| | - Chuanqing Wang
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, 201102, PR China
| | - Hui Yu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, PR China
| | - Sancheng Cao
- Department of Clinical Laboratory, Xi'an Children's Hospital, Xi'an, 710043, PR China
| | - Huiling Deng
- Department of Infectious Diseases, Xi'an Children's Hospital, Xi'an, 710043, PR China
| | - Wei Gao
- Department of Clinical Laboratory, Kaifeng Children's Hospital, Kaifeng, 475099, PR China
| | - Jianhua Hao
- Department of Infectious Diseases, Kaifeng Children's Hospital, Kaifeng, 475099, PR China
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Watts SC, Judd LM, Carzino R, Ranganathan S, Holt KE. Genomic Diversity and Antimicrobial Resistance of Haemophilus Colonizing the Airways of Young Children with Cystic Fibrosis. mSystems 2021; 6:e0017821. [PMID: 34463568 DOI: 10.1128/msystems.00178-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 08/04/2021] [Indexed: 11/20/2022] Open
Abstract
Respiratory infection during childhood is a key risk factor in early cystic fibrosis (CF) lung disease progression. Haemophilus influenzae and Haemophilus parainfluenzae are routinely isolated from the lungs of children with CF; however, little is known about the frequency and characteristics of Haemophilus colonization in this context. Here, we describe the detection, antimicrobial resistance (AMR), and genome sequencing of H. influenzae and H. parainfluenzae isolated from airway samples of 147 participants aged ≤12 years enrolled in the Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) program, Melbourne, Australia. The frequency of colonization per visit was 4.6% for H. influenzae and 32.1% for H. parainfluenzae, 80.3% of participants had H. influenzae and/or H. parainfluenzae detected on at least one visit, and using genomic data, we estimate 15.6% of participants had persistent colonization with the same strain for at least two consecutive visits. Isolates were genetically diverse and AMR was common, with 52% of H. influenzae and 82% of H. parainfluenzae displaying resistance to at least one drug. The genetic basis for AMR could be identified in most cases; putative novel determinants include a new plasmid encoding blaTEM-1 (ampicillin resistance), a new inhibitor-resistant blaTEM allele (augmentin resistance), and previously unreported mutations in chromosomally carried genes (pbp3, ampicillin resistance; folA/folP, cotrimoxazole resistance; rpoB, rifampicin resistance). Acquired AMR genes were more common in H. parainfluenzae than H. influenzae (51% versus 21%, P = 0.0107) and were mostly associated with the ICEHin mobile element carrying blaTEM-1, resulting in more ampicillin resistance in H. parainfluenzae (73% versus 30%, P = 0.0004). Genomic data identified six potential instances of Haemophilus transmission between participants, of which three involved participants who shared clinic visit days. IMPORTANCE Cystic fibrosis (CF) lung disease begins during infancy, and acute respiratory infections increase the risk of early disease development and progression. Microbes involved in advanced stages of CF are well characterized, but less is known about early respiratory colonizers. We report the population dynamics and genomic determinants of AMR in two early colonizer species, namely, Haemophilus influenzae and Haemophilus parainfluenzae, collected from a pediatric CF cohort. This investigation also reveals that H. parainfluenzae has a high frequency of AMR carried on mobile elements that may act as a potential reservoir for the emergence and spread of AMR to H. influenzae, which has greater clinical significance as a respiratory pathogen in children. This study provides insight into the evolution of AMR and the colonization of H. influenzae and H. parainfluenzae in a pediatric CF cohort, which will help inform future treatment.
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Affiliation(s)
- Stephen C Watts
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbournegrid.1008.9, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Central Clinical School, Monash Universitygrid.1002.3, Melbourne, Victoria, Australia
| | - Louise M Judd
- Department of Infectious Diseases, Central Clinical School, Monash Universitygrid.1002.3, Melbourne, Victoria, Australia
| | - Rosemary Carzino
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sarath Ranganathan
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbournegrid.1008.9, Melbourne, Victoria, Australia
| | - Kathryn E Holt
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbournegrid.1008.9, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Central Clinical School, Monash Universitygrid.1002.3, Melbourne, Victoria, Australia
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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Characteristics and Antibiotic Resistance of Haemophilus influenzae in Children with Lower Respiratory Tract Infection in Chengdu, China. Jundishapur J Microbiol 2021. [DOI: 10.5812/jjm.114210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Haemophilus influenzae is an opportunistic pathogen of the human respiratory tract. Haemophilus influenzae can cause not only respiratory tract infection in children but also otitis media, epiglottitis and sinusitis. With the widespread use of antibiotics, the positive rate of β-lactamase in H. influenzae is increasing, and the rate of antimicrobial resistance is also increasing, which increases the difficulty of clinical treatment. Objectives: To study the infection characteristics of patients and the antibiotic resistance of H. influenzae in lower respiratory tract samples of children in Chengdu, so as to provide a reference for its clinical diagnosis and the rational use of antibiotics. Methods: Sputum samples of 15891 children aged 0-14 years with lower respiratory tract infection were collected. Haemophilus influenzae was cultured and identified, its drug susceptibility tested, and the results determined according to the guidelines of CLSI 2020. Results: A total of 15891 clinical isolate strains in sputum were detected for drug sensitivity from December 2018 to January 2020, of which 5488 were H. influenzae, accounting for 34.54% (5488/15891). The sex of children infected with H. influenzae was not skewed (P > 0.05). The detection rate of H. influenzae was the highest in children aged 7 - 11 months, and the lowest was in the age group ≤ 28 d. The detection rate was the highest in spring and the lowest in autumn. The positive rate of β-lactamase was 92.0%, the resistance rate to ampicillin was 92.0%, the sensitivity to amoxicillin/clavulanate was 70.2%, and the sensitivity to cefotaxime, ofloxacin, tetracycline, chloramphenicol, and rifampicin was more than 90.0%. Conclusions: Children aged 7 months to 14 years were generally susceptible to H. influenzae in spring, and the positive rate of β-lactamase was high. Doctors should refer to the infection characteristics and drug resistance of H. influenzae and choose antibiotics correctly to better control the infection.
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Yang Y, Hua CZ, Fang C, Xie YP, Li W, Fu Y, Gao F, Yao KH. Properties of Mucoid Serotype 3 Streptococcus pneumoniae From Children in China. Front Cell Infect Microbiol 2021; 11:648040. [PMID: 33842394 PMCID: PMC8024565 DOI: 10.3389/fcimb.2021.648040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/08/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the characteristics of hosts, antimicrobial susceptibility, and molecular epidemiology of mucoid serotype 3 Streptococcus pneumoniae (S. pneumoniae) isolated from children in China. Method S. pneumoniae isolates collected between January 2016 and December 2019 were analyzed. S. pneumoniae isolates with mucoid phenotype were selected visually, and serotype 3 isolates were confirmed by Quellung reaction. The antimicrobial susceptibility was measured by E-test. Multilocus sequence typing was used for clonal analysis. Results Twenty (3.04%) isolates of mucoid serotype 3 S. pneumoniae were identified from 657 clinical isolates, and all of them were noninvasive strains. The mean age of the hosts was 5.69 ± 3.28 years. The isolates included: 50.0% from the dissected tonsil or adenoid tissue in children with obstructive sleep apnea-hypopnea syndrome, 45.0% from sputum or bronchial lavages in children with pneumonia, and 5.0% from vaginal secretions of one patient with vulvovaginitis. All isolates were susceptible to penicillin, cefuroxime, ceftriaxone, meropenem, vancomycin, levofloxacin, trimethoprim/sulfamethoxazole, and rifampin but resistant to erythromycin. Sequence type (ST)505 and its clonal complex (CC) were the main genotypes (95%). Antimicrobial susceptibility of ST180 and ST505 were compared, and the minimum inhibitory concentration (MIC) of ST505 isolates was significantly higher than that of ST180 for tetracycline, trimethoprim/sulfamethoxazole, and meropenem. Conclusions Mucoid serotype 3 Streptococcus pneumoniae can be isolated from various body parts, among which the respiratory system is the most common. It can cause noninvasive infection in children, and it has high susceptibility to a variety of antibiotics, especially β-lactams, but is resistant to macrolides. CC505 is the novel clonal complex found in China, which may be related to the worldwide mainstream clonal complex (CC180) but has its own biological characteristics.
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Affiliation(s)
- Ying Yang
- Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China.,Department of Neurology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Chun-Zhen Hua
- Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Chao Fang
- Clinical Laboratory Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Yong-Ping Xie
- Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Wei Li
- Clinical Laboratory Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Yong Fu
- Department of Otolaryngology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Feng Gao
- Department of Neurology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Kai-Hu Yao
- Department of Microbiology, Beijing Children's Hospital, Capital Medical University, Beijing, China
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Hua CZ, Wang HJ, Yu H, Wang CQ, Zhang T, Zhang H, Wang SF, Lin AW, Cao Q, Huang WC, Deng HL, Cao SC, Chen XJ. Response to: Comment on "Antibiotic Resistance Profiles of Haemophilus influenzae Isolates from Children in 2016: A Multicenter Study in China". THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2021; 2021:1541506. [PMID: 33727995 PMCID: PMC7935562 DOI: 10.1155/2021/1541506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 06/03/2020] [Indexed: 11/23/2022]
Affiliation(s)
- Chun-Zhen Hua
- Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310003, China
| | - Hong-Jiao Wang
- Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310003, China
| | - Hui Yu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Chuan-Qing Wang
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Ting Zhang
- Department of Infectious Diseases, Children's Hospital of Shanghai Jiaotong University, Shanghai 200240, China
| | - Hong Zhang
- Department of Clinical Laboratory, Children's Hospital of Shanghai Jiaotong University, Shanghai 200240, China
| | - Shi-Fu Wang
- Department of Clinical Microbiology, Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - Ai-Wei Lin
- Division of Infectious Diseases, Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - Qing Cao
- Division of Infectious Diseases, Shanghai Children's Medical Center of Shanghai Jiaotong University, Shanghai 200127, China
| | - Wei-Chun Huang
- Department of Clinical Laboratory, Shanghai Children's Medical Center of Shanghai Jiaotong University, Shanghai 200127, China
| | - Hui-Ling Deng
- Division of Infectious Diseases, Xi'an Children's Hospital, Xi'an 710043, China
| | - San-Cheng Cao
- Department of Clinical Laboratory, Xi'an Children's Hospital, Xi'an 710043, China
| | - Xue-Jun Chen
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Hess C, Grafl B, Bagheri S, Kaesbohrer A, Zloch A, Hess M. Antimicrobial Resistance Profiling of Gallibacterium anatis from Layers Reveals High Number of Multiresistant Strains and Substantial Variability Even Between Isolates from the Same Organ. Microb Drug Resist 2019; 26:169-177. [PMID: 31526229 DOI: 10.1089/mdr.2019.0056] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In this investigation, data on antimicrobial resistance (AMR) profiles of 213 Gallibacterium anatis isolates were determined from 93 laying hens originating from 39 flocks. Each flock was sampled three times during its life time for the presence of G. anatis. The broth microdilution method was applied comprising 21 antimicrobial substances. Multidrug resistance was found in 96.2% of the G. anatis isolates. Most of the isolates were resistant to tetracycline (89.2%), tylosin (94.8%), enrofloxacin (58.2%), nalidixic acid (77.4%), and sulfamethoxazole (77.0%). Resistance against antimicrobial substances increased significantly with the age of birds. A total of 99 different AMR profiles were detected. On flock level, different AMR profiles were found in 71.8% of the flocks independent of the sampling time point. On bird level, identical AMR profiles were mostly found in isolates originating from the same organ of a single bird, but 22 such paired isolates differed in their AMR profile. Variations of AMR profiles were found within isolates from a single bird, but from different organs. Isolates from systemic organs were significantly more resistant to different antimicrobial substances compared to isolates from the reproductive tract. No influence could be found in regard to an increase of resistance and applied antibiotic treatment.
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Affiliation(s)
- Claudia Hess
- Department for Farm Animals and Veterinary Public Health, Clinic for Poultry and Fish Medicine, University of Veterinary Medicine, Vienna, Austria
| | - Beatrice Grafl
- Department for Farm Animals and Veterinary Public Health, Clinic for Poultry and Fish Medicine, University of Veterinary Medicine, Vienna, Austria
| | - Sina Bagheri
- Department for Farm Animals and Veterinary Public Health, Clinic for Poultry and Fish Medicine, University of Veterinary Medicine, Vienna, Austria
| | - Annemarie Kaesbohrer
- Department for Farm Animals and Veterinary Public Health, Institute of Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria
| | - Angelika Zloch
- Department for Farm Animals and Veterinary Public Health, Clinic for Poultry and Fish Medicine, University of Veterinary Medicine, Vienna, Austria
| | - Michael Hess
- Department for Farm Animals and Veterinary Public Health, Clinic for Poultry and Fish Medicine, University of Veterinary Medicine, Vienna, Austria
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Shooraj F, Mirzaei B, Mousavi SF, Hosseini F. Clonal diversity of Haemophilus influenzae carriage isolated from under the age of 6 years children. BMC Res Notes 2019; 12:565. [PMID: 31506105 PMCID: PMC6737650 DOI: 10.1186/s13104-019-4603-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 09/03/2019] [Indexed: 01/01/2023] Open
Abstract
Objectives Pharyngeal carriers such as H. influenzae seem to constitute the only reservoir and probably the only transmission vehicle of the invasive disease. The aims of this study were to estimate the prevalence of H. influenzae carriage, to characterize antibiotic susceptibility, and to explore genetic diversity of H. influenzae isolates. Sampling was carried out as nasopharynx swabs among children less than 6 years old volunteers. After traditional biochemical tests, isolates were confirmed by targeting omp6 sequence. Following the susceptibility tests, genomic diversity of strains was analyzed by Pulsed-Field Gel Electrophoresis procedure. Results Out of 328 nasopharynx swabs, 73 strains were identified as H. influenzae. Among H. influenzae isolates, resistance to chloramphenicol (42%) and ampicillin (43%) was observed. Levofloxacin is the most effective antibiotic and the least effect belonged to tetracycline. By genomic analysis of selected H. influenza, 28 PFGE patterns were achieved among which 11 patterns included at least 2 strains. All strains clustered into 25 different clones. The dendrogram analysis of the isolated H. influenzae strains showed that some of these strains had a clonal relationship and common genetic origin. According to our results, antibiotic resistance didn’t show any significant correlation with the clonality of strains.
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Affiliation(s)
- Fahimeh Shooraj
- Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran.,Department of Microbiology, Faculty of Biology, Islamic Azad University, North Branch, Tehran, Iran
| | - Bahman Mirzaei
- Department of Microbiology and Virology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Farzaneh Hosseini
- Department of Microbiology, Faculty of Biology, Islamic Azad University, North Branch, Tehran, Iran
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Antibiotic Resistance Profiles of Haemophilus influenzae Isolates from Children in 2016: A Multicenter Study in China. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2019; 2019:6456321. [PMID: 31485283 PMCID: PMC6710757 DOI: 10.1155/2019/6456321] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 02/11/2019] [Accepted: 02/27/2019] [Indexed: 11/29/2022]
Abstract
Background and Objective Haemophilus influenzae (HI) is a common cause of community-acquired pneumonia in children. In many countries, HI strains are increasingly resistant to ampicillin and other commonly prescribed antibiotics, posing a challenge for effective clinical treatment. This study was undertaken to determine the antibiotic resistance profiles of HI isolates from Chinese children and to provide guidelines for clinical treatment. Methods Our Infectious Disease Surveillance of Pediatrics (ISPED) collaboration group includes six children's hospitals in different regions of China. The same protocols and guidelines were used by all collaborators for the culture and identification of HI. The Kirby–Bauer method was used to test antibiotic susceptibility, and a cefinase disc was used to detect β-lactamase activity. Results We isolated 2073 HI strains in 2016: 83.9% from the respiratory tract, 11.1% from vaginal secretions, and 0.5% from blood. Patients with respiratory isolates were significantly younger than nonrespiratory patients (P < 0.001). Of all 2073 strains, 50.3% were positive for β-lactamase and 58.1% were resistant to ampicillin; 9.3% were β-lactamase-negative and ampicillin-resistant. The resistance rates of the HI isolates to trimethoprim-sulfamethoxazole, azithromycin, cefuroxime, ampicillin-sulbactam, cefotaxime, and meropenem were 71.1%, 32.0%, 31.2%, 17.6%, 5.9%, and 0.2%, respectively. Conclusions More than half of the HI strains isolated from Chinese children were resistant to ampicillin, primarily due to the production of β-lactamase. Cefotaxime and other third-generation cephalosporins could be the first choice for the treatment of ampicillin-resistant HI infections.
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Zhang Z, Chen M, Yu Y, Pan S, Liu Y. Antimicrobial susceptibility among Streptococcus pneumoniae and Haemophilus influenzae collected globally between 2015 and 2017 as part of the Tigecycline Evaluation and Surveillance Trial (TEST). Infect Drug Resist 2019; 12:1209-1220. [PMID: 31190909 PMCID: PMC6524636 DOI: 10.2147/idr.s203121] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 04/08/2019] [Indexed: 12/23/2022] Open
Abstract
Purpose: In order to understand the prevalence of Streptococcus pneumoniae and Haemophilus influenzae globally and provide the basis for rational use of antimicrobials in clinical settings, in vitro activity of tigecycline and comparative agents was evaluated against 3929 S. pneumoniae and 4043 H. influenzae isolates obtained from 150 centers globally between 2015 and 2017 as a part of the Tigecycline Evaluation and Surveillance Trial (TEST). Methods: Broth microdilution methods were performed to determine the minimum inhibitory concentration (MIC) of the isolates according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). The CLSI breakpoint was used to determine antimicrobial susceptibilities, except for that of tigecycline, for which the US Food and Drug Administration (FDA) breakpoints were used. Results: More than 99% of S. pneumoniae isolates were susceptible to vancomycin (100%), linezolid (100%), tigecycline (99.9%), and levofloxacin (99.1%). Macrolides (erythromycin, azithromycin, and clarithromycin, 67.1–69.4% susceptibility globally) and penicillin (61.7% in globally) were the drugs with more resisitance to S. pneumoniae. Penicillin-intermediate and -resistant isolates were found in 24.8% and 13.6% of S. pneumoniae isolates. H. influenzae was highly susceptible (>98.7%) to all antibiotics tested except for ampicillin, for which susceptibility was 76.1%. The number of drugs with the lowest susceptibility calculated in Asia were far more than other regions, with 61.5% (8 in 13 drugs) in S. pneumoniae and 70.0% (7 in 10 drugs) in H. influenzae, respectively. Conclusions: Vancomycin, linezolid, tigecycline, and levofloxacin can be used as the first choice in the empirical therapy of infection disease caused by S. pneumoniae. But macrolides and penicillin should be used prudently in treatment of the infection caused by S. pneumoniae, as well as ampicillin treat the infection caused by H. influenzae. Asia was the region with the most severe resistance in S. pneumoniae and H. influenzae.
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Affiliation(s)
- Zhijie Zhang
- Clinical Laboratory Department, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Meng Chen
- Department of Rheumatology, Affiliated Hospital of Hebei University, Baoding, People's Republic of China
| | - Ying Yu
- Medical Affairs Department, Pfizer Investment Co., Ltd, People's Republic of China
| | - Sisi Pan
- Medical Affairs Department, Pfizer Investment Co., Ltd, People's Republic of China
| | - Yong Liu
- Clinical Laboratory Department, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
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Han MS, Jung HJ, Lee HJ, Choi EH. Increasing Prevalence of Group III Penicillin-Binding Protein 3 Mutations Conferring High-Level Resistance to Beta-Lactams Among Nontypeable Haemophilus influenzae Isolates from Children in Korea. Microb Drug Resist 2018; 25:567-576. [PMID: 30484742 DOI: 10.1089/mdr.2018.0342] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This study investigated the roles of β-lactamase and penicillin-binding protein 3 (PBP3) alterations in the development of recent antimicrobial resistance in nontypeable Haemophilus influenzae (NTHi) isolated from Korean children. Nasopharyngeal NTHi isolates from children at a tertiary children's hospital were tested for antimicrobial susceptibility using E-test. β-lactamase production was screened by the paper disc test, and polymerase chain reaction amplification of blaTEM and blaROB-1 was performed. The ftsI gene was amplified to identify PBP3 alteration. Of the 53 NTHi isolates, 69.8% were ampicillin nonsusceptible. The nonsusceptibility rates for cefaclor were 81.1%, cefpodoxime 69.8%, and amoxicillin/clavulanate 32.1%. About 60.3% and 32.1% of the isolates were genetically β-lactamase-nonproducing ampicillin-resistant (gBLNAR) and genetically β-lactamase-producing amoxicillin/clavulanate-resistant (gBLPACR) strains, respectively. Group III amino acid substitutions comprised 65.6% of the gBLNAR strains and 70.6% of the gBLPACR strains. MIC50 for amoxicillin/clavulanate, cefaclor, cefuroxime, cefpodoxime, and cefixime were more than 2-80 times higher in the gBLNAR and gBLPACR strains compared with gBLPAR strains. Group III gBLNAR strains had significantly higher ampicillin, amoxicillin/clavulanate, cefpodoxime, and cefixime minimum inhibitory concentrations than group II strains. Group III gBLNAR and gBLPACR NTHi strains are highly prevalent in Korea, raising the alarm about increasing β-lactam resistance in NTHi.
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Affiliation(s)
- Mi Seon Han
- 1 Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.,2 Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Hyun Joo Jung
- 3 Department of Pediatrics, School of Medicine, Ajou University, Suwon, Korea
| | - Hoan Jong Lee
- 1 Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.,2 Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Eun Hwa Choi
- 1 Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.,2 Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
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