Author/Authors :
Wang, Hong-Jiao Division of Infectious Diseases - the Children’s Hospital - Zhejiang University School of Medicine, China , Wang, Chuan-Qing Department of Clinical Laboratory - Children’s Hospital of Fudan University, Shanghai, China , Hua, Chun-Zhen Division of Infectious Diseases - the Children’s Hospital - Zhejiang University School of Medicine, China , Yu, Hui Division of Infectious Diseases - Children’s Hospital of Fudan University, Shanghai, China , Zhang, Ting Division of Infectious Diseases - Children’s Hospital of Shanghai Jiaotong University - Shanghai, China , Zhang, Hong Department of Clinical Laboratory - Children’s Hospital of Shanghai Jiaotong University, Shanghai, China , Wang, Shi-Fu Department of Clinical Laboratory - Qilu Children’s Hospital of Shandong University, China , Lin, Ai-Wei Division of Infectious Diseases - Qilu Children’s Hospital of Shandong University, Jinan, China , Cao, Qing Division of Infectious Diseases - Shanghai Children’s Medical Center, Shanghai, China , Huang, Wei-Chun Department of Clinical Laboratory - Shanghai Children’s Medical Center, Shanghai, China , Deng, Hui-Ling Department of Clinical Laboratory - Xi’an Children’s Hospital, China , Cao, Shan-Cheng Division of Infectious Diseases - Xi’an Children’s Hospital, China , Chen, Xue-jun Department of Clinical Laboratory - the Children’s Hospital - Zhejiang University School of Medicine, China
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.
