Abstract
Background and Objective Haemophilus influenzae (HI) is a common cause of community-acquired pneumonia in children. In many countries, HI strains are increasingly resistant to ampicillin and other commonly prescribed antibiotics, posing a challenge for effective clinical treatment. This study was undertaken to determine the antibiotic resistance profiles of HI isolates from Chinese children and to provide guidelines for clinical treatment. Methods Our Infectious Disease Surveillance of Pediatrics (ISPED) collaboration group includes six children's hospitals in different regions of China. The same protocols and guidelines were used by all collaborators for the culture and identification of HI. The Kirby–Bauer method was used to test antibiotic susceptibility, and a cefinase disc was used to detect β-lactamase activity. Results We isolated 2073 HI strains in 2016: 83.9% from the respiratory tract, 11.1% from vaginal secretions, and 0.5% from blood. Patients with respiratory isolates were significantly younger than nonrespiratory patients (P < 0.001). Of all 2073 strains, 50.3% were positive for β-lactamase and 58.1% were resistant to ampicillin; 9.3% were β-lactamase-negative and ampicillin-resistant. The resistance rates of the HI isolates to trimethoprim-sulfamethoxazole, azithromycin, cefuroxime, ampicillin-sulbactam, cefotaxime, and meropenem were 71.1%, 32.0%, 31.2%, 17.6%, 5.9%, and 0.2%, respectively. Conclusions More than half of the HI strains isolated from Chinese children were resistant to ampicillin, primarily due to the production of β-lactamase. Cefotaxime and other third-generation cephalosporins could be the first choice for the treatment of ampicillin-resistant HI infections.
Highlights
Haemophilus influenzae (HI) is one of the most common pathogens that cause community-acquired pneumonia and otitis media in children [1,2,3,4]
Between 2012 and 2014, the ampicillin resistance rates of HI strains isolated in India, Singapore, ailand, and South Korea were 7.4%, 21.7%, 39.5%, and 69.4%, respectively [10]. e ampicillin resistance rate of HI strains in China was 19.9% between 2009 and 2011 and 32.4% between 2013 and 2014 [11]. e increase of ampicillin resistance rate of HI posed a challenge for effective therapy. is study was undertaken to determine the antibiotic resistance profiles of HI isolates from Chinese children in 2016 and to provide guidelines for clinical treatment
HI cases were unevenly distributed throughout the year, with 1498 HI strains (72.3%) isolated between January and June (Figure 1); the number of HI strains peaked in March (297 HI strains; 14.3%; Figure 1)
Summary
Haemophilus influenzae (HI) is one of the most common pathogens that cause community-acquired pneumonia and otitis media in children [1,2,3,4]. As antibiotic usage has become increasingly widespread globally, the resistance of HI strains to ampicillin has gradually increased [8,9,10,11]. The ampicillin resistance rate of Japanese HI strains increased from 28.8% (2000–2001) to 63.5% (in 2012) [9]. E increase of ampicillin resistance rate of HI posed a challenge for effective therapy. HI strains are increasingly resistant to ampicillin and other commonly prescribed antibiotics, posing a challenge for effective clinical treatment. Is study was undertaken to determine the antibiotic resistance profiles of HI isolates from Chinese children and to provide guidelines for clinical treatment. Of all 2073 strains, 50.3% were positive for β-lactamase and 58.1% were resistant to ampicillin; 9.3% were β-lactamase-negative and ampicillin-resistant
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
