Longitudinal European surveillance study of antibiotic resistance of Haemophilus influenzae

• Published in: Journal of antimicrobial chemotherapy Vol. 58; no. 4; pp. 873 - 877
• Main Authors: Jansen, W. T. M., Verel, A., Beitsma, M., Verhoef, J., Milatovic, D.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.10.2006; Oxford Publishing Limited (England)
• Subjects: amoxicillin; Amoxicillin - pharmacology; Anti-Bacterial Agents - pharmacology; Antibiotics. Antiinfectious agents. Antiparasitic agents; beta-Lactam Resistance; beta-Lactamases - metabolism; beta-Lactams - pharmacology; Biological and medical sciences; Drug resistance; Europe; Haemophilus influenzae; Haemophilus influenzae - drug effects; Haemophilus influenzae - genetics; Haemophilus influenzae - isolation & purification; Humans; Influenza; Medical sciences; Microbial Sensitivity Tests; Mutation; Penicillin; penicillin binding proteins; Penicillin-Binding Proteins - genetics; Penicillin-Binding Proteins - metabolism; Pharmacology. Drug treatments; Polymerase Chain Reaction; Population Surveillance; Proteins; Sequence Analysis, DNA; β-lactams; Europe; β-Lactams; Haemophilus influenzae; Penicillin binding protein; Pasteurellaceae; Penicillin derivatives; Resistance; Antibiotic; Surveillance; Follow up study; Amoxicillin; Bacteria; Antibacterial agent; penicillin binding proteins
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkl310

Objectives: We assessed the current resistance rates of Haemophilus influenzae against β-lactams and other agents in Europe and compared the results with those of our previously performed surveillance study. Methods: MICs of the antibiotics were determined using broth microdilution. The penicillin-binding domain of PBP3 of β-lactamase (BL)-negative, amoxicillin-resistant (BLNAR) isolates was sequenced. Results: The percentage of BL-positive and BLNAR strains ranged from 0% to 17.6% and 0% to 33.9%, respectively. Compared with 1997/98 and 2002/03, the overall percentage of strains non-susceptible to amoxicillin decreased from 19.8% and 23.3%, respectively, to 16.4% in 2004/05. The percentage of BL-producing strains decreased from 11.0% and 13.7%, respectively, to 7.6%, whereas the number of BLNAR strains remained stable (8.8% and 9.6%, respectively, versus 8.8% in 2004/05). Comparison of penicillin binding protein (PBP) 3B gene sequences between BLNAR and susceptible strains revealed novel amino acid mutations. Conclusions: In spite of large inter-regional differences, the overall resistance of H. influenzae to amoxicillin in Europe seems to decline due to a decreasing number of BL-producing strains, whereas the overall percentage of BLNAR strains seems relatively constant.