Prevalence of Moraxella catarrhalis in the nasopharyngeal specimen from 1082 hospitalized children with respiratory infection and the drug resistance of the isolates
TANG Ping1, SHI Wei3, ZENG Hai-Ling1, DING Wei2, WANG Cheng2, YAO Kai-Hu3, WEN De-Nian2
Department of Laboratory Medicine, People's Hospital of Zhongjiang County, Zhongjiang, Sichuan 618100, China
Abstract Objective To investigate the prevalence of Moraxella catarrhalis in the nasopharyngeal region of children with respiratory infection and the sensitivity of Moraxella catarrhalis isolates to common antimicrobial drugs. Methods Nasopharyngeal swabs were collected from 1082 children with respiratory infection, and Moraxella catarrhalis strains were isolated. The E-test method and disc diffusion test were used to determine the sensitivity of these strains to 11 common antimicrobial drugs. The test results were interpreted with reference to the standards of European Committee on Antimicrobial Susceptibility Testing (EUCAST), Clinical and Laboratory Standards Institute (CLSI), and British Society for Antimicrobial Chemotherapy (BSAC). The nitrocefin disc method was used to detect whether the isolated strains produced β-lactamase. Results Among the 1 082 children with respiratory infection, 77 (77/1082, 7.12%) carried Moraxella catarrhalis in the nasopharyngeal region. All the strains produced β-lactamase. With reference to all the three standards, all the strains were sensitive to amoxycillin-clavulanate and had a susceptibility rate of >95% towards ciprofloxacin and tetracycline. According to the EUCAST and CLSI standards, the susceptibility rate of the strains towards sulfamethoxazole-trimethoprim was as high as 98.7%, and more than 80% of all strains were sensitive to the three cephalosporins detected; however, with reference to the BSAC standard, only 2.6% of the strains were sensitive to cefuroxime, with an intermediate rate of 44.2% and a drug resistance rate of 53.2%. The rate of resistance to ampicillin was 81.8%. According to the CLSI standard, the non-susceptibility rate of the strains to erythromycin was 79.2%, and according to the EUCAST or BSAC standards, their non-susceptibility rate reached 90.9%; more than one third of the strains (27/77, 35.1%) had a minimal inhibitory concentration of >256 mg/L. Conclusions All of the Moraxella catarrhalis isolates in the nasopharyngeal region of children with respiratory infection produce β-lactamase and are sensitive to amoxycillin-clavulanate. These isolates have high susceptibility rates to the third- and fourth-generation cephalosporins and sulfamethoxazole-trimethoprim, but most of the isolates are resistant to ampicillin, cefuroxime, and erythromycin.
TANG Ping,SHI Wei,ZENG Hai-Ling et al. Prevalence of Moraxella catarrhalis in the nasopharyngeal specimen from 1082 hospitalized children with respiratory infection and the drug resistance of the isolates[J]. CJCP, 2016, 18(8): 707-712.
TANG Ping,SHI Wei,ZENG Hai-Ling et al. Prevalence of Moraxella catarrhalis in the nasopharyngeal specimen from 1082 hospitalized children with respiratory infection and the drug resistance of the isolates[J]. CJCP, 2016, 18(8): 707-712.
Wang H,Chen M,Xu Y,et al.Antimicrobial susceptibility of bacterial pathogens associated with community-acquired respiratory tract infections in Asia:report from the Community-Acquired Respiratory Tract Infection Pathogen Surveillance (CARTIPS) STUDY,2009-2010[J].Int J Antimicrob Agents,2011,38(5):376-383.
Aebi C.Moraxella catarrhalis-pathogen or commensal?[J].Adv Exp Med Biol,2011,697:107-116.
[5]
Morrissey I,Maher K,Williams L,et al.Non-susceptibility trends among Haemophilus influenzae and Moraxella catarrhalis from community-acquired respiratory tract infections in the UK and Ireland,1999-2007[J].J Antimicrob Chemother,2008,62 Suppl 2:ii97-ii103.
[6]
Bandet T,Whitehead S,Blondel-Hill E,et al.Susceptibility of clinical Moraxella catarrhalis isolates in British Columbia to six empirically prescribed antibiotic agents[J].Can J Infect Dis Med Microbiol,2014,25(3):155-158.
Clinical and Laboratory Standards Institute (CLSI).Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria;Approved Guideline[S].M45-A,2014,26(19):28-29.
[11]
Andrews JM;BSAC Working Party on Susceptibility Testing.BSAC standardized disc susceptibility testing method (version 8)[J].J Antimicrob Chemother,2009,64(3):454-489.
Sheikh SO,Fasih N,Irfan S,et al.β-Lactamase production and antimicrobial susceptibility pattern of Moraxella catarrhalis isolates:report from Pakistan[J].Asian Pac J Trop Med,2014,7S1:S228-S231.
Abdullah FE,Ahuja KR,Kumar H.Prevalence and emerging resistance of Moraxella catarrhalis in lower respiratory tract infections in Karachi[J].J Pak Med Assoc,2013,63(11):1342-1344.
[22]
Liu Y,Xu H,Xu Z,et al.High-level macrolide-resistant Moraxella catarrhalis and development of an allele-specific PCR assay for detection of 23S rRNA gene A2330T mutation:a three-year study at a Chinese tertiary hospital[J].Microb Drug Resist,2015,21(5):507-511.
[23]
Iwata S,Sato Y,Toyonaga Y,et al.Genetic analysis of pediatric clinical isolate of Moraxella catarrhalis with resistance to macrolides and quinolones[J].J Infect Chemother,2015,21(4):308-311.
[24]
Kasai A,Ogihara S,Yamada K,et al.Prevalence and molecular analysis of macrolide-resistant Moraxella catarrhalis isolates in Japan,following emergence of the highly macrolide-resistant strain NSH1 in 2011[J].J Med Microbiol,2015,64(7):708-713.
