SURVEILLANCE OF ANTIMICROBIAL RESISTANCE IN STRAINS OF HAEMOPHILUS INFLUENZAE FROM RESPIRATORY TRACT IN SLOVENIA IN 2002
Abstract
Background. Haemophilus influenzae is quite often a cause of respiratory tract infections. The authors present the results of surveillance of antimicrobial resistance of this bacteria in Slovenia. Antibiotic sensitivity rates in the individual region are necessary for the estimation of the situation, for the empirical therapy guidelines and for planning the actions to limit the spread of resistance.
Methods. In 2002 the results of antibiotic resistance testing of H. influenzae, isolated from respiratory tract were surveyed in eight regions of Slovenia. In the survey seven microbiological laboratories of Public Health Institutes and the laboratory of The National Institute of Public Health collaborated. 680 strains of H. influenzae isolated from either out-patients or in patients from regional hospitals were analysed. Susceptibility to antibiotics was determined using the disk-diffusion method.
Results and conclusions. All strains, which were tested with amoxicillin with clavulanic acid, azitromycin, cefuroxime, cefotaxime, levofloksacin and moxifloxacin were susceptible to these agents. Ampicillin (amoxicillin) resistance that is caused by beta lactamase enzyme, was found in all regions. The rate of beta lactamase positive strains was 8.4% (from 1.9% to 14.8%). Resistance rate to co-trimoxazole was 13.2% (from 9.3% to 21.2%), to tetracycline 1.0% (0 to 3.0%) and to cefaclor there were only three strains resistant (0.4%). The rate of resistance is different among regions and among age groups inside regions. In many regions the number of isolated strains was very low, so reliability of the surveillance results is questionable in these regions.
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References
Hoban DJ, Doern GV, Fluit AC, Roussel-Devallez M, Jones RN. Worldwide prevalence of antimicrobial resistance in Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in the SENTRY Antimicrobial Surveillance Program, 1997–1999. Clin Infect Dis 2001; 32: Suppl 2: 81–93.
Moxon RE. Haemophilus influenzae. In: Mandell GL, Bennett JE, Mandell DR eds. Douglas and Bennett’s principles and practice of infectious diseases. 4th ed. New York: Churchill Livingstone, 1995: 2039–45.
Lovšin B, Beović B. Predpisovanje antibiotikov v ambulanti splošnega zdravnika ljubljanske regije. Med Razgl 2003; 42: Suppl 1: 43–52.
Sahm DF, Jones ME, Hickey ML, Diakun DR, Mani SV, Thornsberry C. Resistance surveillance of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolated in Asia and Europe, 1997–1998. J Antimicrob Chemother 2000; 45: 457–66.
Blosser-Middleton R, Sahm DF, Thornsberry C et al. Antimicrobial susceptibility of 840 clinical isolates of Haemophilus influenzae collected in four European countries in 2000–2001. Clin Microbiol Infect 2003; 9: 431–6.
Čižman M, Pokorn M, Seme K, Oražem A, Paragi M. The relationship between trends in macrolide use and resistance to macrolides of common respiratory pathogens. JAC 2001; 47: 475–7.
Štrumbelj I, Ribič H, Franko-Kancler T et al. Streptococcus pyogenes in Streptococcus pneumoniae – odpornost izolatov iz dihal v prvem tričetrtletju leta 2001 in 2002. Med Razgl 2003; 42: Suppl 1: 3–10.
Khan W, Ross A, Rodriguez W, Controni G, Saz AK. Haemophilus influenzae type b resistant to ampicillin: a report of two cases. JAMA 1974; 229: 298–301.
Felmingham D, Feldman C, Hryniewicz W et al. Surveillance of resistance in bacteria causing community-acquired respiratory tract infection. Clin Microbiol Infect 2002; 8: Suppl 2: 12–42.
Bandak SI, Turnak MR, Allen BS et al. Antibiotic susceptibilities among recent clinical isolates of Haemophilus influenzae and Moraxella catarrhalis from fifteen countries. Eur J Clin Microbiol Infect Dis 2001; 20: 55–60.
Turnak MR, Bandak SI, Bouchillon SK, Allen BS, Hoban DJ. Antimicrobial susceptibilities of clinical isolates of Haemophilus influenzae and Moraxella catarrhalis collected during 1999–2000 from 13 countries. Clin Microbiol Infect 2001; 7: 671–7.
Pechere JC. Chairman’s discussion and conclusions. Clin Microbiol Infect 2002; 8: Suppl 3: 33–5.
Karlowsky JA, Verma G, Zhanel GG, Hoban DJ. Presence of ROB-1 β-lactamase correlates with cefaclor resistance among recent isolates of Haemophilus influenzae. J Antimicrob Chemother 2000; 45: 871–5.
Zahnel GG, Karlowsky JA, Low DE, The Canadian Respiratory Infection Study Group, Hoban DJ. Antibiotic resistance in respiratory tract isolates of Haemophilus influenzae and Moraxella catarrhalis from across Canada in 1997–1998. J Antimicrob Chemother 2000; 45: 655–62.
Livermore DM, Macgowan AP, Wale MCJ. Surveillance of antimicrobial resistance. BMJ 1998; 317: 614–5.
WHO Global strategy for containment of antimicrobial resistance. WHO/ CDS/CSR/DRS2001.2.
Ribič H, Sočan M. Spremljanje odpornosti neinvazivnih sevov Haemophilus influenzae proti antibiotikom v ljubljanski regiji. Zdrav Var 2003: 5–9.
Tomič V. Mikrobiološki vidiki okužb na spodnjih dihalih. In: Simpozij: Okužbe na spodnjih dihalih v ambulantni praksi. Brdo pri Kranju: Krka, 1999.
Campos JM. Haemophilus. In: Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH eds. Manual of clinical microbiology. 7th ed. Washington: ASM, 1999: 604–13.
NCCLS (National Committee for Clinical Laboratory Standards). Performance standards for antimicrobial disk susceptibility tests; Approved standard – Seventh Edition. NCCLS document M2-A7. NCCLS: Villanova, PA: 2000.
NCCLS (National Committee for Clinical Laboratory Standards). Performance standards for antimicrobial susceptibility testing. Twelfth informational supplement. Document M100-S12. NCCLS: Villanova, PA: 2002.
Zerva L, Biedenbach DJ, Jones RN. Reevaluation of interpretive criteria for Haemophilus influenzae by using meropenem (10-microgram), imipenem (10-microgram), and ampicillin (2- and 10-microgram) disks. J Clin Microbiol 1996; 34: 1970–4.
Čižman M, Beović B. Priročnik za ambulantno predpisovanje protimikrobnih zdravil. Ljubljana: Založba Arkadija; 2002: 7–43.
Jacobs MR, Bajaksouzian S, Zilles A et al. Susceptibilities of Streptococcus pneumoniae and Haemophilus influenzae to 10 oral antimicrobial agents based on pharmacodynamic paramete: 1997 U. S. surveillance study. Antimicrob Agents Chemother 1999; 43: 1901–8.
Livermore DM, Winstanley TG, Shannon KP. Interpretative reading: recognizing the unusual and inferring resistance mechanisms from resistance phenotypes. J Antimicrob Chemother 2001; 48: 87–102.
Schito GC, Debbia EA, Marchese A. The evolving threat of antibiotic resistance in Europe: new data from the Alexander project. J Antimicrob Chemother 2000; 46: Suppl T1: 3–9.
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