Effects of cefixime or co-amoxiclav treatment on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae in children with acute otitis media

Dabernat, H.; Geslin, P.; Mégraud, Françis; Bègué, P; Boulesteix, J.; Dubreuil, C.; Roque, F de La; Trinh, Annie; Scheimberg, A.

doi:10.1093/jac/41.2.253

Cited by 74 publications

(41 citation statements)

References 15 publications

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“…Antibiotic use is known to be a major risk factor for the occurrence of resistant bacteria. Several studies have revealed the potential impact of antibiotic use on the increase in the rate of nasopharyngeal carriage of resistant H. influenzae isolates in children (3,6,28,29,40). In our study, the percentage of children who were under treatment for common infantile inflammatory diseases did not differ between the summer and the winter.…”

Section: Discussionmentioning

confidence: 40%

Nasopharyngeal Haemophilus influenzae Carriage in Japanese Children Attending Day-Care Centers

Hashida¹,

Shiomori²,

Hohchi³

et al. 2008

J Clin Microbiol

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We conducted a prospective bacteriological survey to investigate antibiotic resistance-related genetic characteristics and the turnover of nasopharyngeal Haemophilus influenzae carriage in healthy children in day-care centers (DCCs). A total of 363 nasopharyngeal mucus samples were collected from children aged 0 to 6 years attending two DCCs in the summer of 2004 (n ‫؍‬ 184) and the following winter (n ‫؍‬ 179). We obtained 172 H. influenzae isolates and analyzed them by antimicrobial susceptibility testing, PCR for bla TEM-1 and the penicillin-binding protein (PBP) gene, and pulsed-field gel electrophoresis (PFGE). The overall carriage rate was 47.4% (172/363), and 37.2% of the isolates (64/172) were ampicillin (AMP) resistant. All the resistant isolates had a PBP mutation(s), while only three isolates had TEM-1. The carriage rate was significantly higher in the winter than in the summer (56.4% and 38.6%, respectively), owing to the increase in the numbers of AMP-susceptible H. influenzae isolates in the winter. Children aged <3 years showed a higher rate of carriage of H. influenzae isolates with an AMP resistance gene(s) than those aged >4 years (21.9% and 12.6%, respectively). Forty-two strains with different PFGE patterns were obtained from among the 172 isolates. Only five strains were observed in both seasons. None of the strains isolated in the summer was isolated from the same carrier in the winter. Twenty-seven strains (64.3%) were isolated from two or more children, and 25 of these were each isolated from children belonging to the same DCC. These results indicate the spread of H. influenzae, particularly those with a PBP mutation(s), and the highly vigorous genetic turnover and substantial horizontal transmission of this pathogen in healthy children attending DCCs in Japan.

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Section: Discussionmentioning

confidence: 40%

Nasopharyngeal Haemophilus influenzae Carriage in Japanese Children Attending Day-Care Centers

Hashida¹,

Shiomori²,

Hohchi³

et al. 2008

J Clin Microbiol

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“…In H. influenzae, it is the production of TEM-type ␤-lactamase that is the most frequent. Unlike in other countries, where the prevalence of ␤-lactamase is low (lower than 10%) (17,26), in France the frequency of ␤-lactamase-producing strains is high, over 35%, in particular for strains isolated from the nasopharynx or those causing acute otitis media (6,13,27).…”

Section: Discussionmentioning

confidence: 89%

“…These invasive diseases have decreased sharply since the generalization of anti-Haemophilus b (anti-Hib) vaccination (22, 37). Noncapsulated strains frequently cause acute otitis media in children (6,20,29,32). H. influenzae is often part of the nasopharynx flora and is frequently found in the upper respiratory tract of healthy children, with reported carriage rates of up to 60% (12,17,23,32).…”

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confidence: 99%

Haemophilus influenzae Carriage in Children Attending French Day Care Centers: a Molecular Epidemiological Study

et al. 2003

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The nasopharyngeal Haemophilus influenzae flora of healthy children under the age of 3 years attending day care centers in three distinct French geographic areas was analyzed by sampling during two periods, spring 1999 (May and June) and fall 1999 (November and December). The average carrier rate among 1,683 children was 40.9%. The prevalence of capsulated H. influenzae carriers was 0.4% for type f and 0.6% for type e. No type b strains were found among these children, of whom 98.5% had received one or more doses of anti-Haemophilus b vaccine. Among the strains, 44.5% were TEM-type beta-lactamase producers and nine (1.3%) were betalactamase-negative ampicillin-resistant strains. Pulsed-field gel electrophoresis restriction patterns showed a large diversity with 366 SmaI patterns from 663 strains. Among the strains isolated during a given period, 33% were isolated simultaneously in more than one area. In each area, depending on the sampling period, 68 to 72% of the strains had new pulsotypes and persistence of 28 to 32% of the strains was noted. For the 297 beta-lactamase-producing strains, 194 patterns were found. The genomic diversity of these strains was comparable to that of the whole set of strains and does not suggest a clonal diffusion. Among the beta-lactamaseproducing strains isolated in November and December, depending on the area, 66 to 73% had new pulsotypes with persistence of only 27 to 33% of the strains. In any given geographic area, colonization by H. influenzae appears to be a dynamic process involving a high degree of genomic heterogeneity among the noncapsulated colonizing strains.Haemophilus influenzae is one of the main bacterial species causing infection in children. Encapsulated strains are responsible for a variety of invasive diseases, the most frequent being meningitis, but epiglottitis, arthritis, pneumonia, and cellulitis also occur (36). These invasive diseases have decreased sharply since the generalization of anti-Haemophilus b (anti-Hib) vaccination (22, 37). Noncapsulated strains frequently cause acute otitis media in children (6,20,29,32). H. influenzae is often part of the nasopharynx flora and is frequently found in the upper respiratory tract of healthy children, with reported carriage rates of up to 60% (12,17,23,32).In the study of Faden et al. (9), 200 children were monitored from birth through to 2 years of age to determine the nasopharyngeal colonization pattern of nontypeable H. influenzae. Forty-four percent of the children were colonized on one or more occasions, and the acquisition rate was greatest in the first year. Colonization mainly involves a dominant strain which can be followed by a series of other strains (1,9,15,24). The level of carriage varies according to different factors, i.e., age, siblings, and living conditions. All of these factors can also have repercussions on the carriage of strains resistant to antibiotics or encapsulated type b strains. Anti-Hib vaccination has led to a sharp drop in the carriage of encapsulated type b strains (33).The turnove...

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“…It has frequently been clinically noted that antimicrobial agents often fail to eradicate bacteria from the nasopharynx, making colonization a more challenging target than treatment of invasive disease (18,19,(21)(22)(23)26). The reason for this is unknown, but it could suggest that biofilm formation is an important aspect of pneumococcal carriage.…”

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confidence: 99%

Pneumococcal Interactions with Epithelial Cells Are Crucial for Optimal Biofilm Formation and Colonization In Vitro and In Vivo

2012

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The human nasopharynx is the main reservoir for Streptococcus pneumoniae (the pneumococcus) and the source for both horizontal spread and transition to infection. Some clinical evidence indicates that nasopharyngeal carriage is harder to eradicate with antibiotics than is pneumococcal invasive disease, which may suggest that colonizing pneumococci exist in biofilm communities that are more resistant to antibiotics. While pneumococcal biofilms have been observed during symptomatic infection, their role in colonization and the role of host factors in this process have been less studied. Here, we show for the first time that pneumococci form highly structured biofilm communities during colonization of the murine nasopharynx that display increased antibiotic resistance. Furthermore, pneumococcal biofilms grown on respiratory epithelial cells exhibited phenotypes similar to those observed during colonization in vivo, whereas abiotic surfaces produced less ordered and more antibiotic-sensitive biofilms. The importance of bacterial-epithelial cell interactions during biofilm formation was shown using both clinical strains with variable colonization efficacies and pneumococcal mutants with impaired colonization characteristics in vivo. In both cases, the ability of strains to form biofilms on epithelial cells directly correlated with their ability to colonize the nasopharynx in vivo, with colonization-deficient strains forming less structured and more antibiotic-sensitive biofilms on epithelial cells, an association that was lost when grown on abiotic surfaces. Thus, these studies emphasize the importance of host-bacterial interactions in pneumococcal biofilm formation and provide the first experimental data to explain the high resistance of pneumococcal colonization to eradication by antibiotics.

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Effects of cefixime or co-amoxiclav treatment on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae in children with acute otitis media

Cited by 74 publications

References 15 publications

Nasopharyngeal Haemophilus influenzae Carriage in Japanese Children Attending Day-Care Centers

Nasopharyngeal Haemophilus influenzae Carriage in Japanese Children Attending Day-Care Centers

Haemophilus influenzae Carriage in Children Attending French Day Care Centers: a Molecular Epidemiological Study

Pneumococcal Interactions with Epithelial Cells Are Crucial for Optimal Biofilm Formation and Colonization In Vitro and In Vivo

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