Abstract
(1) Background: Beta-lactams are the most frequently used antimicrobials, and are the first-line drugs in many infectious diseases, e.g., pneumonia, otitis media. Due to this fact, various bacteria have developed resistance to this group of drugs. (2) Methods: Eighty-seven Haemophilus parainfluenzae isolates were obtained from adults 18–70 years old in eastern Poland. The presence of 10 bla genes and 2 substitutions in ftsI reported as the most frequent in H. parainfluenzae were analyzed. (3) Results: Among 57 beta-lactam-resistant isolates, 63.2% encoded bla genes; blaTEM-1 predominated (54.4%), followed by blaOXA (19.3%), blaDHA (12.3%), blaSHV (10.5%), blaGES (7.0%), blaCMY (5.3%), blaVEB (1.8%) and blaROB-1 (1.8%). Lys-526 was the most common substitution in ftsI gene. The resistance genotypes were as follows: gBLNAS (17.5%), low-gBLNAR I (1.8%), low-gBLNAR II (1.8%), gBLNAR II (15.8%), gBLPAS (15.8%), gBLPAR (19.3%), gBLPBS I (8.8%) and gBLPBS II (1.8%); (4) Conclusions: This has been the first study to report on the high diversity of bla genes in H. parainfluenzae isolates in Poland. High sensitivity and specificity of benzylpenicillin test, as well as PCR of bla genes were shown, indicating that these methods may be useful as tools for the rapid screening of beta-lactamase prevalence and resistance to beta-lactams among H. parainfluenzae isolated from respiratory microbiota.
Highlights
Beta-lactam antibiotics and especially penicillins, are the most frequently used group of antimicrobials in the European Union
Haemophilus influenzae infections, while a second- or third-generation cephalosporins or beta-lactams combined with beta-lactamase inhibitors are preferred for infections caused by beta-lactamase-producing bacteria [2,3,4]
Increasing resistance to antimicrobial agents is a global phenomenon nowadays, commonly occurring among haemophilic bacteria, including the rare etiological factor of such infections as caused by H. parainfluenzae [13,14,15,21]. This may have a huge impact on therapeutic treatment for infections caused by these bacteria. The importance of this issue has been evidenced by an increasing number of reports on beta-lactamase-producing strains and the weakening activity of beta-lactam antibiotics against H. parainfluenzae [7,13,14,16,21]
Summary
Beta-lactam antibiotics and especially penicillins, are the most frequently used group of antimicrobials in the European Union. Beta-lactams (e.g., amoxicillin, second- or third-generation cephalosporins) are of great importance in the treatment of many infections, including those caused by haemophilic rods (Haemophilus spp., Pasteurellaceae family). They are the first-line drugs in the outpatient treatment of pneumonia, with suspicion of aspiration pneumonia in adults, and in treatment of acute bacterial rhinosinusitis, acute otitis media, and bacterial meningitis [2]. Bacteria have developed a number of mechanisms of resistance to beta-lactam agents as follows: (1) production of specific enzymes that hydrolyze antibiotic molecules, (2) production of PBP proteins with a reduced affinity for beta-lactam antibiotics, (3) lowering the permeability of cellular shields or (4) active efflux of drug outside the bacterial cell [13,16,21,24]
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