Trend of Antibiotic Susceptibility of <i>Haemophilus influenzae</i> Isolated from Children, 2014–2019

이은택,; 박세라,; 김미나,; 이진아,

doi:10.14776/piv.2020.27.e25

Cited by 1 publication

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“…Our previous study conducted in a single tertiary children’s hospital in South Korea highlighted a rising trend of ceftriaxone-resistant H. influenzae since 2017. 16 In this study, we aimed to investigate the resistance mechanisms of ceftriaxone in H. influenzae isolated from Korean children, with a particular focus on PBP3 alterations and β-lactamase production.…”

Section: Introductionmentioning

confidence: 99%

Characterization of Ceftriaxone-Resistant Haemophilus influenzae Among Korean Children

Lee,

Kim,

Kim

et al. 2024

J Korean Med Sci

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Background Haemophilus influenzae is a frequently encountered pathogen responsible for respiratory tract infections in children. Following the detection of ceftriaxone-resistant H. influenzae at our institution, we aimed to investigate the resistance mechanisms of ceftriaxone in H. influenzae , with a particular focus on alterations in penicillin-binding protein 3 (PBP3) and β-lactamase production. Methods Among H. influenzae isolates collected at Asan Medical Center Children’s Hospital from March 2014 to April 2019, ceftriaxone-resistant strains by the disk-diffusion test were included. Ceftriaxone minimum inhibitory concentrations (MICs) were determined using the E-test according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. The presence of β-lactamase was assessed through cefinase test and TEM-1/ROB-1 polymerase chain reaction (PCR). PBP3 alterations were explored via ftsI gene sequencing. Results Out of the 68 collected strains, 21 exhibited resistance to ceftriaxone in disk diffusion tests. Two strains were excluded due to failed subculture. Among 19 ceftriaxone-resistant H. influenzae isolates, eighteen were non-typeable H. influenzae, and twelve were positive for TEM-1 PCR. Isolates were classified into groups II (harboring only N526K, n = 3), III (N526K+S385T, n = 2), III+ (S385T+L389F+N526K, n = 11), and III-like+ (S385T+L389F+R517H, n = 3) according to the PBP3 alteration pattern. With a median ceftriaxone MIC of 0.190 mg/L (range, 0.008–0.750), the median ceftriaxone MIC was the highest in group III-like+ (0.250 mg/L), followed by groups III+ (0.190 mg/L), III (0.158 mg/L), and II (0.012 mg/L). All three strains belonging to group II, which did not harbor the S385T substitution, had ceftriaxone MICs of ≤ 0.125 mg/L. Conclusion The emergence of ceftriaxone-resistant H. influenzae with ceftriaxone MIC values of up to 0.75 mg/L was observed even in children in South Korea, with most associated with S385T and L389F substitutions. The N526K mutation alone does not significantly impact ceftriaxone resistance. Further large-scale studies are essential to investigate changes in antibiotic resistance patterns and factors influencing antibiotic resistance in H. influenzae isolated from pediatric patients in Korea.

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Section: Introductionmentioning

confidence: 99%