Abstract
Background: Haemophilus influenzae and Haemophilus parainfluenzae are commonly identified in the lower airways of patients with cystic fibrosis (CF). Little is known of the change in prevalence and antimicrobial susceptibility in this population over time. We examined the epidemiology of both organisms over 15 years in our CF clinic. Results: 1538 isolates from respiratory specimens of 349 CF patients over 15 years were investigated. Annual prevalence increased significantly for both bacteria, being more pronounced for H. parainfluenzae. Average percentage of resistant cultures increased by 46% (H. Influenzae) and 61% (H. Parainfluenzae). For H. influenzae, resistance to ampicillin was 34.4%, co-trimoxazole 21.4%. For H. parainfluenzae, resistance to ampicillin was 50.0%, co-trimoxazole 26.8%. Resistance in H. influenzae and H. parainfluenzae to ampicillin and in H. parainfluenzae to amoxicillin/ clavulanic acid and co-trimoxazole increased over the study. Conclusion: This present study has shown an increased annual prevalence of H. influenzae and H. parainfluenzae in a large group of CF patients. Resistance to ampicillin significantly increased for H. influenzae and H. parainfluenzae, but increased resistance to amoxicillin/ clavulanic acid and co-trimoxazole was only significant in H. parainfluenzae.
Highlights
Cystic fibrosis (CF) is an autosomal recessive, genetic disease characterised by chronic inflammation and infection, which is associated with accelerated lung damage, increased morbidity and premature death [1]
The ages of the patients growing H. influenzae isolates ranged from 1 month to 20.4 years and the ages of the patients growing H. parainfluenzae isolates ranged from 2 months to 21.0 years
We found an average annual prevalence of 12% in H. influenzae and 20% in H. parainfluenzae over 15 years
Summary
Cystic fibrosis (CF) is an autosomal recessive, genetic disease characterised by chronic inflammation and infection, which is associated with accelerated lung damage, increased morbidity and premature death [1]. Haemophilus parainfluenzae and Haemophilus influenzae are commonly identified in the lower airways in patients with CF with the former being the less aggressive organism in eliciting an inflammatory response. The latter organism is regularly involved in chronic lung infections and acute exacerbations in CF patients and has recently been shown to be associated with lower lung function in infants with CF [3,4]. The wide use of aggressive antibiotic treatments in CF disease has resulted in an increased risk of emergent antibiotic resistance, as demonstrated in the pathogens S. aureus and P. aeruginosa [6]. We examined the epidemiology of both organisms over 15 years in our CF clinic
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