Comparison of in vitro susceptibility of Haemophilus influenzae strains to various antimicrobial drugs

Abstract

Haemophilus species are the members of the normal flora of human upper respiratory tract. Haemphilus influenzae is the prominent organism in terms of morbidity and mortality. Haemophilus spp. cause serious infections that can progress to death. The aim of this study is to determine the frequency and antimicrobial susceptibility pattern of H.influenzae strains isolated from clinical samples between 2005 and 2010. H. influenza strains from clinical samples were identified by BBL Crystal AutoReader or Vitek 2 Compact automated system. Antibiotic susceptibility tests were performed according to the standards of CLSI for H. influenzae strains. One hundred and fifty-eight H. influenza strains isolated from clinical samples were included in the study. H. influenza strains were isolated most commonly from samples sent by chest diseases clinics (25.3%). It was observed that H. influenzae was isolated most commonly from lower respiratory tract samples (sputum and tracheal aspirate). In the study period, 29.1% and 13.9% of the isolates were found to be resistant to trimethoprim sulfamethoxazole and ampicillin, respectively. Antibiotic resistance rate was 3.7% for ceftazidime and no resistance was detected for meropenem, imipenem and cefuroxime. We found a statistically significant difference in the resistance to ampicillin and trimethoprim sulfamethoxazole between 2005 and 2010 (p<0.05). But, there was no significant difference in the resistance to ceftazidime, chloramphenicol, aztreonam and rifampicin over the years (p>0.05). We suggest that trimethoprim sulfamethoxazole and ampicillin are not appropriate options for the treatment of infections caused by H. influenzae in our hospital. Second generation cephalosporins and quinolones can be used for this purpose. We suggest that determination of the frequency of H. influenzae from clinical samples and its antibiotic susceptibility pattern may produce data for epidemiological studies and guide empirical antibiotic therapy.

Keywords

• Empirical antibiotic
• Haemophilus influenzae
• Resistance
• Treatment

References

1. Altun, B., Gür, D., 2008. Antimicrobial resistance in Haemophilus influenzae strains isolated from various clinical samples in Hacettepe University Children’s Hospital (2002-2007). Çocuk Enf. Derg. 2, 50-54.
2. Berkiten, R., 2004. Beta-Lactamase activity and ampicillin resistance in Haemophilus influenzae strains isolated in Turkey (1987-2002). Ankem Derg. 18, 53-60.
3. Cardines, R., Giufrè, M., Pompilio, A., Fiscarelli, E., Ricciotti, G., Bonaventura, G.D., Cerquetti, M., 2012. Haemophilus influenzae in children with cystic fibrosis: Antimicrobial susceptibility, molecular epidemiology, distribution of adhesins and biofilm formation. Int. J. Med. Microbiol. 302, 45-52.
4. Cobos, S.G., Campos, J., Cercenado, Román F, Lázaro, E., Pérez-Vázquez, M., de Abajo, F, Oteo, J.E., 2008. Antibiotic resistance in Haemophilus influenzae decreased, except for-Lactamase-Negative Amoxicillin-Resistant isolates, in parallel with community antibiotic consumption in Spain from 1997 to 2007. Antimicrob. Agents Chemother. 52, 2760-2766.
5. Doern, G.V., Brueggemann, A.B., Pıerce, G., Holley, H.P., Rauch A., 1997. Antibiotic Resistance among clinical isolates of Haemophilus influenzae in the United States in 1994 and 1995 and detection of b-Lactamase-Positive strains Resistant to Amoxicillin-Clavulanate: Results of a national multicenter surveillance study. Antimicrob. Agents Chemother. 292-297.
6. Eşel, D., Karaca, N., Sümerkan, B., 2000. Antibiotic susceptibilities of Haemophilus influenzae strains isolated from clinical specimens. Ankem Derg. 14, 555.
7. Giufrè, M., Cardines, R., Caporali, M.G., Accogli, M., D’Ancona, F., Cerquetti, M., 2011. Ten years of Hib vaccination in Italy: Prevalence of non-encapsulated Haemophilus influenzae among invasive isolates and the possible impact on antibiotic resistance. Vaccine. 29, 3857-3862.
8. Harrison, C.J., Woods, C., Stout, G., Martin, B., Selvarangan, R., 2009. Susceptibilities of Haemophilus influenzae, Streptococcus pneumoniae, including serotype 19A, and Moraxella catarrhalis paediatric isolates from 2005 to 2007 to commonly used antibiotics. J. Antimicrob. Chemother. 63, 511–519.

9. Ilki, A., Sağiroğlu, P., Elgörmüş, N., Söyletir, G., 2010. Trends in antibiotic susceptibility patterns of Streptococcus pneumoniae and Haemophilus influenzae isolates: Four years follow up. Mikrobiyol. Bul. 44, 169-175.
10. Jansen, W.T.M., Verel, A., Beitsma, M., Verhoef, J., Milatovic, D., 2006. Longitudinal European surveillance study of antibiotic resistance of Haemophilus influenzae. J. Antimicrob. Chemother. 58, 873-877.
11. Kilian, M., Haemophilus. 2007. In Patrick R., Murray, Ellen Jo Baron, James H. Jorgensen, Marie Louise Landry, Michael A., Pfaller (eds). 9th ed. Manual of Clinical Microbiology. ASM Press 1752 N St. N.W. 41, 636-648.
12. Ladhani, S., Heath, P.T., Ramsay, M.E., Slack, M.P.E., 2008. Changes in antibiotic resistance rates of invasive Haemophilus influenzae isolates in England and Wales over the last 20 years. J. Antimicrob. Chemother. 62, 776-779.
13. Murphy, T.F., 2009. Haemophilus infections, in Mandell GL, Bennett JE, Dolin R (eds). 7th ed. Mandell, Douglas and Bennett’s principles and practice of infectious diseases. Philadelphia: Elsevier, Churchill, Livingstone. 225, 2911-2919.
14. Perez-Trallero, E., Martín-Herrero, J.E., Mazon, A., García-Delafuente, C., Robles, P., Iriarte, V., Dal-Re´, R., García-de-Lomas, J., 2010. Antimicrobial resistance among respiratory pathogens in Spain: Latest data and changes over 11 Years (1996-1997 to 2006-2007). Antimicrob. Agents Chemother. 54, 2953.
15. Sener, B., Tunçkanat, F., Ulusoy, S., Tünger, A., Söyletir, G., Mülazimoğlu, L., Gürler, N., Oksüz, L., Köksal, I., Aydin, K., Yalçin, A.N., Oğünç,
16. D., Acar, A., Sievers, J., 2007. A survey of antibiotic resistance in Streptococcus pneumoniae and Haemophilus influenzae in Turkey, 2004- 2005. J. Antimicrob. Chemother. 60, 587-593.
17. Şenol, G., Eriş, F.N., 2000. Haemophilus influenzae, Moraxella catarrhalis and Streptoccus pneumoniae strains isolated from respiratory infections and their resistance to antibiotics. Toraks Dergisi. 1 , 46-50.
18. Tristram, S., Jacobs, M.R., Appelbaum, P.C., 2007. Antimicrobial Resistance in Haemophilus influenzae. Clin. Mıcrobıol. Rev. 20, 368-389.
19. Uncu, H., Colakoğlu, S., Turunç, T., Demiroğlu, Y.Z., Arslan, H., 2007. In vitro resistance rates of Streptococcus pneumoniae and Haemophilus influenzae clinical isolates to the antibiotics used in therapy. Mikrobiyol. Bul. 41, 441-446.