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Kaur R, Schulz S, Sherman A, Andrejko K, Kobayashi M, Pichichero M. Anticipated Effects of Higher-valency Pneumococcal Conjugate Vaccines on Colonization and Acute Otitis Media. Pediatr Infect Dis J 2024:00006454-990000000-00886. [PMID: 38838209 DOI: 10.1097/inf.0000000000004413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND Bacterial etiologies of acute otitis media (AOM) have shifted from the introduction of pneumococcal conjugate vaccines (PCVs), antibiotic selection and competition among species. We characterized Streptococcus pneumoniae ( Spn ), Haemophilus influenzae ( Hflu ) and Moraxella catarrhalis ( Mcat ) in the nasopharynx during well-child healthy visits and at the onset of AOM, and in middle ear fluid (MEF) of children with AOM to assess anticipated effects of higher-valency PCVs (PCV15 and PCV20). METHODS From September 2021 to September 2023, we conducted a prospective longitudinal cohort study of PCV13 immunized children 6-36 months old. MEF was collected via tympanocentesis. Serotyping and antibiotic susceptibility testing were performed on Spn , Hflu and Mcat isolates. RESULTS We obtained 825 nasopharyngeal and 216 MEF samples from 301 children. The order of frequency of nasopharyngeal colonization was Mcat , Spn and Hflu ; Hflu was the predominant otopathogen in MEF. Among Spn isolates, non-PCV15, non-PCV20 serotypes predominated in the nasopharynx and in MEF; the most frequent serotype was 35B. Among MEF samples, 30% of Spn isolates were amoxicillin nonsusceptible; 23% of Hflu isolates and 100% of Mcat isolates were β-lactamase-producing. CONCLUSION The majority of Spn isolates among young children were non-PCV15, non-PCV20 serotypes, especially serotype 35B; therefore, the impact of higher-valency PCVs in reducing pneumococcal colonization or AOM is expected to be limited. Hflu continues to be the most frequent AOM pathogen. Antibiotic susceptibility data suggest a high dose of amoxicillin/clavulanate or alternative drugs that are effective against contemporary mix of otopathogens could be considered for optimal empiric selection to provide the best efficacy.
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Affiliation(s)
- Ravinder Kaur
- From the Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York
| | - Steven Schulz
- From the Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York
| | - Andrew Sherman
- From the Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York
| | - Kristin Andrejko
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Miwako Kobayashi
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michael Pichichero
- From the Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York
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Sarlin S, Koskela U, Honkila M, Ruuska TS, Mattila S. The occurrence of acute otitis media according to nasopharyngeal pathogen detections in acutely ill children. Acta Paediatr 2024; 113:783-785. [PMID: 38305499 DOI: 10.1111/apa.17139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Affiliation(s)
- Suvi Sarlin
- Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Ulla Koskela
- Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Minna Honkila
- Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Terhi Susanna Ruuska
- Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Suvi Mattila
- Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland
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Duff AF, Jurcisek JA, Kurbatfinski N, Chiang T, Goodman SD, Bakaletz LO, Bailey MT. Oral and middle ear delivery of otitis media standard of care antibiotics, but not biofilm-targeted antibodies, alter chinchilla nasopharyngeal and fecal microbiomes. NPJ Biofilms Microbiomes 2024; 10:10. [PMID: 38310144 PMCID: PMC10838340 DOI: 10.1038/s41522-024-00481-0] [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: 07/24/2023] [Accepted: 01/22/2024] [Indexed: 02/05/2024] Open
Abstract
Otitis media (OM) is one of the most globally pervasive pediatric conditions. Translocation of nasopharynx-resident opportunistic pathogens like nontypeable Haemophilus influenzae (NTHi) assimilates into polymicrobial middle ear biofilms, which promote OM pathogenesis and substantially diminish antibiotic efficacy. Oral or tympanostomy tube (TT)-delivered antibiotics remain the standard of care (SOC) despite consequences including secondary infection, dysbiosis, and antimicrobial resistance. Monoclonal antibodies (mAb) against two biofilm-associated structural proteins, NTHi-specific type IV pilus PilA (anti-rsPilA) and protective tip-region epitopes of NTHi integration host factor (anti-tip-chimer), were previously shown to disrupt biofilms and restore antibiotic sensitivity in vitro. However, the additional criterion for clinical relevance includes the absence of consequential microbiome alterations. Here, nine chinchilla cohorts (n = 3/cohort) without disease were established to evaluate whether TT delivery of mAbs disrupted nasopharyngeal or fecal microbiomes relative to SOC-OM antibiotics. Cohort treatments included a 7d regimen of oral amoxicillin-clavulanate (AC) or 2d regimen of TT-delivered mAb, AC, Trimethoprim-sulfamethoxazole (TS), ofloxacin, or saline. Fecal and nasopharyngeal lavage (NPL) samples were collected before and several days post treatment (DPT) for 16S sequencing. While antibiotic-treated cohorts displayed beta-diversity shifts (PERMANOVA, P < 0.05) and reductions in alpha diversity (q < 0.20) relative to baseline, mAb antibodies failed to affect diversity, indicating maintenance of a eubiotic state. Taxonomic and longitudinal analyses showed blooms in opportunistic pathogens (ANCOM) and greater magnitudes of compositional change (P < 0.05) following broad-spectrum antibiotic but not mAb treatments. Collectively, results showed broad-spectrum antibiotics induced significant fecal and nasopharyngeal microbiome disruption regardless of delivery route. Excitingly, biofilm-targeting antibodies had little effect on fecal and nasopharyngeal microbiomes.
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Affiliation(s)
- Audrey F Duff
- Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Joseph A Jurcisek
- Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Nikola Kurbatfinski
- Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Tendy Chiang
- Department of Otolaryngology at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Wexner Medical Center, Columbus, OH, USA
| | - Steven D Goodman
- Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Wexner Medical Center, Columbus, OH, USA
- Oral and Gastrointestinal Microbiology Research Affinity Group, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Lauren O Bakaletz
- Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Wexner Medical Center, Columbus, OH, USA
| | - Michael T Bailey
- Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
- Department of Pediatrics, The Ohio State University, Wexner Medical Center, Columbus, OH, USA.
- Oral and Gastrointestinal Microbiology Research Affinity Group, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
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Morton AB, Vareechon C, Pettengill MA. Is β-lactamase testing acceptably accurate for predicting Haemophilus influenzae susceptibility to β-lactams? Epidemiological data from Philadelphia, USA, 2017-2023. Microbiol Spectr 2023; 11:e0129223. [PMID: 37671890 PMCID: PMC10580958 DOI: 10.1128/spectrum.01292-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Affiliation(s)
- Arianna B. Morton
- Department of Pathology and Genomic Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Chairut Vareechon
- Department of Pathology and Genomic Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Matthew A. Pettengill
- Department of Pathology and Genomic Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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Ziniel SI, Preciado D, Lee R, Kerschner JE, Ryan AF, Santos-Cortez RLP. Ensuring the future of otitis media research: Interest in and feasibility of a mentoring network program within the otitis media research community. Int J Pediatr Otorhinolaryngol 2023; 172:111693. [PMID: 37579520 PMCID: PMC10523683 DOI: 10.1016/j.ijporl.2023.111693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/03/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVES The goal of this study was to assess the feasibility of the implementation of a mentoring network program based on expressed interest and the diverse composition of the otitis media research community in order to address attrition of the scientific workforce. METHODS An online survey was sent to basic, translational, and clinical researchers with a known interest in otitis media. RESULTS Of 509 eligible participants, 119 (23.4%) responded to the survey. Survey respondents had a diverse background by completed education, current job description, and membership in an underrepresented group in science. Most faculty respondents (76.4%) were willing to participate in the proposed program as mentors and faculty lecturers, or had early-career researchers or trainees in their research group who were willing to participate as mentees in the mentoring network. Scientific and non-scientific topics for inclusion in the training program were ranked, with immunology and inflammation, microbiology, science leadership and collaboration, mentoring, and grantsmanship as main foci of interest among respondents. CONCLUSION Our survey results showed enthusiastic participation among responding otitis media researchers, indicating the feasibility of implementing a mentoring network program that will address workforce attrition, particularly among underrepresented groups in science.
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Affiliation(s)
- Sonja I Ziniel
- Section of Pediatric Hospital Medicine, Children's Hospital Colorado, Aurora, CO, 80045, United States; Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, United States.
| | - Diego Preciado
- Departments of Pediatrics and Surgery, George Washington University School of Medicine, Washington D.C., District of Columbia, 20010, United States; Department of Pediatric Otolaryngology, Children's Research Institute, Children's National Health System, Washington D.C., District of Columbia, 20010, United States.
| | - Rita Lee
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, United States.
| | | | - Allen F Ryan
- Department of Otolaryngology, University of California San Diego School of Medicine and Veterans Affairs Medical Center, La Jolla, CA, 92093, United States.
| | - Regie Lyn P Santos-Cortez
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, United States; Center for Children's Surgery, Children's Hospital Colorado, Aurora, CO, 80045, United States.
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Yuan M, Ma M, Jiang H, Fan M, Sun Y, Zhou B, Feng X, Yang J, Su M, He X. Characterization of Serotypes and Molecular Drug Resistance Patterns of Haemophilus influenzae in Kunming Children. Pol J Microbiol 2023:pjm-2023-006. [PMID: 37144671 DOI: 10.33073/pjm-2023-006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/31/2023] [Indexed: 05/06/2023] Open
Abstract
The present study aimed to determine the capsular serotype distribution and antimicrobial drug resistance patterns of Haemophilus influenzae from children in the Kunming region of China. This information could guide policymakers in clinical treatment. In the present study, H. influenzae isolates were tested for their serotypes, antimicrobial susceptibility pattern, and presence of β-lactamases. One-hundred forty-eight H. influenzae strains isolated from children 0-2 years old were investigated for capsular types by glass slide agglutination and molecular methods, and biotyped by the biochemical reactions. The drug resistance-encoding genes TEM-1, ROB-1, and the ftsI gene mutations PBP3-3, and PBP3-BLN were detected with real-time quantitative polymerase chain reaction (qPCR). The prevalence of β-lactamase-producing strains (60.3%) was significantly higher (p < 0.05) than non-enzyme-producing strains. β-Lactamase-producing strains were multidrug resistant to various antibiotics such as ampicillin, tetracycline, sulfamethoxazole/trimethoprim, chloramphenicol, cefuroxime, and cefaclor. Among β-lactamase-producing strains, the detection rates of the TEM-1, PBP3-BLN, PBP3-s, and ROB-1 were 54.1%, 18.9%, 11.8%, and 6.9%, respectively. The biotyping results show that most H. influenzae strains were of type II and III. Non-typeable H. influenzae (NTHi) accounted for 89.3% of the strains. NTHi strains were the most prevalent in this region; most belonged to biological types II and III. β-Lactamase-positive ampi-cillin-resistant (BLPAR) strains were prevalent among H. influenzae isolates in this region.
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Affiliation(s)
- Mei Yuan
- 1Department of Laboratory, Children's Hospital affiliated with Kunming Medical University, Kunming, China
| | - Mingbiao Ma
- 1Department of Laboratory, Children's Hospital affiliated with Kunming Medical University, Kunming, China
| | - Hongchao Jiang
- 2Science and Education Section, Children's Hospital affiliated with Kunming Medical University, Kunming, China
| | - Mao Fan
- 1Department of Laboratory, Children's Hospital affiliated with Kunming Medical University, Kunming, China
| | - Ying Sun
- 3Epilepsy Center of Children, Children's Hospital affiliated with Kunming Medical University, Kunming, China
| | - Bailing Zhou
- 1Department of Laboratory, Children's Hospital affiliated with Kunming Medical University, Kunming, China
| | - Xingxing Feng
- 1Department of Laboratory, Children's Hospital affiliated with Kunming Medical University, Kunming, China
| | - Junyi Yang
- 1Department of Laboratory, Children's Hospital affiliated with Kunming Medical University, Kunming, China
| | - Min Su
- 1Department of Laboratory, Children's Hospital affiliated with Kunming Medical University, Kunming, China
| | - Xiaoli He
- 4Institute of Pediatrics, Children's Hospital affiliated with Kunming Medical University, Kunming, China
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El Feghaly RE, Nedved A, Katz SE, Frost HM. New insights into the treatment of acute otitis media. Expert Rev Anti Infect Ther 2023; 21:523-534. [PMID: 37097281 PMCID: PMC10231305 DOI: 10.1080/14787210.2023.2206565] [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: 02/20/2023] [Accepted: 04/20/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION Acute otitis media (AOM) affects most (80%) children by 5 years of age and is the most common reason children are prescribed antibiotics. The epidemiology of AOM has changed considerably since the widespread use of pneumococcal conjugate vaccines, which has broad-reaching implications for management. AREAS COVERED In this narrative review, we cover the epidemiology of AOM, best practices for diagnosis and management, new diagnostic technology, effective stewardship interventions, and future directions of the field. Literature review was performed using PubMed and ClinicalTrials.gov. EXPERT OPINION Inaccurate diagnoses, unnecessary antibiotic use, and increasing antimicrobial resistance remain major challenges in AOM management. Fortunately, effective tools and interventions to improve diagnostic accuracy, de-implement unnecessary antibiotic use, and individualize care are on the horizon. Successful scaling of these tools and interventions will be critical to improving overall care for children.
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Affiliation(s)
- Rana E. El Feghaly
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Amanda Nedved
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Sophie E. Katz
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Holly M. Frost
- Department of Pediatrics, Denver Health and Hospital Authority, Denver, CO, USA
- Center for Health Systems Research, Denver Health and Hospital Authority, Denver, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
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Ruttkay Pereira DR, Pereira MR, Rotta Pereira MB, Costa SS, Mott MP, Cantarelli V. Otopathogens in the middle ear and nasopharynx of children with recurrent acute otitis media. Int J Pediatr Otorhinolaryngol 2023; 169:111552. [PMID: 37120991 DOI: 10.1016/j.ijporl.2023.111552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/03/2023] [Accepted: 04/09/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVE This study aimed to describe the microbiology of the middle ear and nasopharynx, determining the prevalence of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in a group of children vaccinated with pneumococcal conjugate vaccine (PCV) who underwent ventilation tube insertion for recurrent acute otitis media. METHODS We analyzed 278 middle ear effusion and 139 nasopharyngeal samples obtained from 139 children who underwent myringotomy and ventilation tube insertion for recurrent acute otitis media between June 2017 and June 2021. The children's ages ranged from 9 months to 9 years, 10 months, with a median of 21 months. The patients had no signs of acute otitis media or respiratory tract infection and were not on antibiotic therapy at the time of the procedure. The middle ear effusion and nasopharyngeal samples were collected with an Alden-Senturia aspirator and a swab, respectively. Bacteriological studies and multiplex PCR were performed for the detection of the three pathogens. Direct molecular determination of pneumococcal serotypes was performed by real-time PCR. The chi-square test was used to verify associations between categorical variables and measures of strength of association based on prevalence ratios, considering a 95% confidence interval a 5% significance level. RESULTS Vaccination coverage was 77.7% with the basic regimen plus booster dose and 22.3% with the basic regimen alone. Middle ear effusion culture identified H. influenzae in 27 children (19.4%), S. pneumoniae in 7 (5.0%), and M. catarrhalis in 7 (5.0%). PCR detected H. influenzae in 95 children (68.3%), S. pneumoniae in 52 (37.4%), and M. catarrhalis in 23 (16.5%), a three-to seven-fold increase compared to culture. In the nasopharynx, culture isolated H. influenzae in 28 children (20.1%), S. pneumoniae in 29 (20.9%), and M. catarrhalis in 12 (8.6%). PCR identified H. influenzae in 84 children (60.4%), S. pneumoniae in 58 (41.7%), and M. catarrhalis in 30 (21.5%), a two-to three-fold increase in detection. The most common pneumococcal serotype was 19A, both in the ears and the nasopharynx. In the ears, of the 52 children who had pneumococcus, 24 (46.2%) had serotype 19A. In the nasopharynx, of the 58 patients who had pneumococcus, 37 (63.8%) had serotype 19A. Of all 139 children, 53 (38.1%) had polymicrobial samples (more than 1 of the 3 otopathogens) in the nasopharynx. Of the 53 children who had polymicrobial samples in the nasopharynx, 47 (88.7%) also had 1 of the 3 otopathogens in the middle ear, mainly H. influenzae (40%-75.5%), especially when it was found in the nasopharynx in conjunction with S. pneumoniae. CONCLUSION The prevalence of bacteria in a group of Brazilian children immunized with the PCV who required ventilation tube insertion for recurrent acute otitis media was similar to that reported in other parts of the world after the advent of PCV. H. influenzae was the most frequent bacteria, both in the nasopharynx and the middle ear, while S. pneumoniae serotype 19A was the most common pneumococcus in the nasopharynx and middle ear. Polymicrobial colonization of the nasopharynx was strongly associated with detection of H. influenzae in the middle ear.
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Affiliation(s)
- Denise Rotta Ruttkay Pereira
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), R. Ramiro Barcelos, 2400, 90035003, Porto Alegre, RS, Brazil.
| | - Manuel Ruttkay Pereira
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, 90619900, Porto Alegre, RS, Brazil.
| | | | - Sady Selaimen Costa
- School of Medicine, UFRGS, R. Ramiro Barcelos, 2400, 90035003, Porto Alegre, RS, Brazil.
| | - Mariana Preussler Mott
- Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, 90035903, Porto Alegre, RS, Brazil.
| | - Vlademir Cantarelli
- Department of Basic Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), R. Sarmento Leite, 245, 90050170, Porto Alegre, RS, Brazil.
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Taha A, Adeline F, Taha MK, Deghmane AE. Haemophilus influenzae drug resistance in France from 2017 to 2021: consideration for treatment of otitis media. J Glob Antimicrob Resist 2022; 31:222-227. [PMID: 36195280 DOI: 10.1016/j.jgar.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Haemophilus influenzae is a prevalent agent of respiratory infections, including acute otitis media (AOM), that lead to high antibiotic prescription and may contribute to the development of bacterial resistance to antibiotics. The objective of this work was to describe and analyse antibiotic resistance of H. influenzae from 2017 to 2021 in France. METHODS We characterized H. influenzae isolates transmitted to the French national reference centre for H. influenzae between 2017 and 2021. We included all the 608 non-invasive respiratory isolates. Resistance rates to the main antibiotics were described. The relationship between resistance rate, age, and sex of patients and germ serotype was investigated. RESULTS Isolates were mainly from alveolar lavage (29.3%), expectoration (22.9%), or sputum (15%). Resistance to amoxicillin (61.4%), amoxicillin/clavulanic acid (47.4%), and cefotaxime (39.3%) was high and correlated with the presence of β-lactamase and/or modifications of the ftsI gene encoding penicillin-binding protein 3. Resistance to sulfamethoxazole/trimethoprim (33.2%) was more moderate. There were no significant differences according to serotype, age, or gender. CONCLUSIONS The benefit/risk balance of first choice use of amoxicillin and even of amoxicillin/clavulanic acid in AOM is questionable in view of the significant resistance to H. influenzae. The use of sulfamethoxazole/trimethoprim could be an alternative but may still need further evaluation.
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Affiliation(s)
- Anas Taha
- Université Paris-Est Créteil, Department of General Practice, Créteil, Frace; Maison de Santé Universitaire de Sucy-en-Brie, Sucy-en-Brie, France.
| | - Florence Adeline
- Université Paris-Est Créteil, Department of General Practice, Créteil, Frace
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Wang Y, Liu A, Fu M, Guo J, Wang L, Zuo X, Ma F. Establishment and Clinical Application of a RPA-LFS Assay for Detection of Capsulated and Non-Capsulated Haemophilus influenzae. Front Cell Infect Microbiol 2022; 12:878813. [PMID: 35531333 PMCID: PMC9068959 DOI: 10.3389/fcimb.2022.878813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
A recombinase polymerase amplification-lateral flow strip assay was established for detection of the outer membrane protein P6 (omp6) and the capsule encoding gene bexA of Haemophilus influenzae and the detection limit, sensitivity, and specificity were determined. Specific primers and probes were designed based on the published nucleotide sequences of omp6 and bexA. The minimum detection limit was determined with standard strains and the practical applicability of the RPA-LFS assay was assessed by detection of 209 clinical samples. The results confirmed that the RPA-LFS assay was both specific and sensitive for the detection of capsulated and non-capsulated H. influenzae with a detection limit of 1 CFU/µL. The detection rate of the 209 clinical samples was 97.1%, while the detection rate of capsulated H. influenzae was 63.2%. The detection results were consistent with the traditional culture method and dual polymerase chain reaction (PCR), confirming the applicability of the RPA-LFS assay.
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Affiliation(s)
- Yan Wang
- Department of Medicine Laboratory, Department of Cardiac Function Examination, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China
| | - Aibo Liu
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Mei Fu
- Department of Medicine Laboratory, Department of Cardiac Function Examination, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China
| | - Jingjing Guo
- Department of Medicine Laboratory, Xuzhou Central Hospital, Xuzhou, China
| | - Lei Wang
- Department of Medicine Laboratory, Department of Cardiac Function Examination, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China
- *Correspondence: Lei Wang, ; Xiaohua Zuo, ; Fenfen Ma,
| | - Xiaohua Zuo
- Department of Pain Management, The Affiliated Huai’an Hospital of Xuzhou Medical University and The Second People’s Hospital of Huai’an, Huai’an, China
- *Correspondence: Lei Wang, ; Xiaohua Zuo, ; Fenfen Ma,
| | - Fenfen Ma
- Department of Cardiac Function Examination, The Second People’s Hospital of Lianyungang, Lianyungang City, China
- *Correspondence: Lei Wang, ; Xiaohua Zuo, ; Fenfen Ma,
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