Antimicrobial resistance among respiratory isolates of Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae in the United States

Abstract

A national surveillance study was conducted to determine trends in antimicrobial resistance patterns among three common causes of community-acquired respiratory tract infections. Fifteen participating U.S. medical centers submitted clinically significant isolates of Haemophilus influenzae, MoraxeeUa (BranhameUla) isolates, 1 (0.2%) was penicillin resistant, while 3.8% were relatively resistant to penicillin, 4.5% were resistant to trimethoprim-sulfamethoxazole, 2.3% were resistant to tetracycline, 1.2% were resistant to chloramphenicol, and 0.2% were resistant to erythromycin. Overall, the lowest resistance rates for these common bacterial respiratory pathogens were noted with amoxicillin-clavulanate, cefuroxime, and cefaclor.Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella (Branhamella) catarrhalis are bacterial agents responsible for a number of upper and lower respiratory tract infections, including otitis media (3, 4, 6, 12), maxillary sinusitis (3,6,12,22), community-acquired pneumonia (6, 11), and in some cases, exacerbations of chronic bronchitis (6,12,29). These species may harbor resistance mechanisms which affect several antimicrobial agents commonly used to treat such infections (2,3,5,6,14,15,17,23,24,26,31

Antimicrobial resistance patterns of Haemophilus influenzae isolated from patients with meningitis in São Paulo, Brazil

“…Non-ß-lactamase-mediated ampicillin resistance was not detected among the H. influenzae strains studied. This is in agreement with numerous previous surveillance studies, which have indicated that such observations remain uncommon (11,13,14). It has been postulated that BLNAR is associated with altered penicillin-binding proteins (PBPs) and might be due to a lower virulence of strains with abnormal PBPs (13,16,26).…”

“…Similar results have also been obtained in a collaborative study conducted in the US during the 80s and in São Paulo during the 90s (20,21). In Finland and in South Africa the overall rate of ß-lactamasemediated ampicillin resistance in H. influenzae was 10% (11,22,23).…”

“…Subsequently, strains producing a second ß-lactamase named ROB-1 enzyme were reported (10). More recently, H. influenzae strains referred to as ß-lactamase negative ampicillin resistant (BLNAR) have also been described, although such strains seem to be relatively uncommon as shown by recent national and multinational surveillance studies (2,(11)(12)(13)(14). The prevalence of ampicillin resistance in H. influenzae strains has been the subject of multinational surveillance studies in several countries and the overall rate reported was between 10 and 60% (8,9,(11)(12)(13)(14).…”

“…More recently, H. influenzae strains referred to as ß-lactamase negative ampicillin resistant (BLNAR) have also been described, although such strains seem to be relatively uncommon as shown by recent national and multinational surveillance studies (2,(11)(12)(13)(14). The prevalence of ampicillin resistance in H. influenzae strains has been the subject of multinational surveillance studies in several countries and the overall rate reported was between 10 and 60% (8,9,(11)(12)(13)(14). The emergence of resistant H. influenzae strains, particularly to ampicillin, all over the world has limited the routine use of ampicillin and as a result third-generation cephalosporins have become a therapeutic option (15,16).…”

Susceptibilidad antimicrobiana de Streptococcus pneumoniae colonizante de nasofaringe en niños colombianos con neumonía

“…La resistencia a eritromicina y a cloranfenicol se encontró en pocos casos, lo que concuerda con datos de Estados Unidos y Australia (32,33). Por tanto, parece ser que la resistencia a estos dos agentes no es todavía un problema en nuestro medio si se compara con paí-ses como Francia, donde la resistencia a los macrólidos llega a 29% (34) o, como España, donde se ha hallado 30% de resistencia al cloranfenicol (35).…”