Abstract Objective To investigate the basic clinical characteristics and drug resistance of Haemophilus influenzae (Hi) infection in hospitalized children in the past two years. Methods A retrospective cross-sectional study was conducted to analyze Hi strains isolated from the sputum and pharyngeal swabs of children aged 0-17 years who were hospitalized in the Third People's Hospital of Chengdu between June 2011 and May 2013. Results A total of 117 strains were isolated from 111 hospitalized children. There were 102 cases (91.9%) of respiratory infection and 9 cases (8.1%) of other diseases. The positive rates of Hi in children with bronchopneumonia or pneumonia (50.8%, 30/59) and in children with acute laryngotracheobronchitis (50.0%, 2/4) were relatively high, followed by in children with capillary bronchitis (34.6%, 9/26), in children with acute bronchitis (24.2%, 32/132), in children with herpangina (19.0%, 4/21), in children with asthmatoid bronchitis (17.9%, 5/28), in children with acute upper respiratory tract infection (11.8%, 9/76), in children with acute tonsillitis (8.2%, 7/85), and in children with neonatal pneumonia (5.6%, 3/54). There were significant differences in the rates of resistance to amoxicillin-clavulanate (15% vs 23%; P=0.010) and chloramphenicol (25% vs 8%; P=0.015) between the two survey years. The frequencice of β-lactamase-nonproducing-ampicillin-resistant (BLNAR) strains and β-lactamase-producing-amoxicilli/clavulanate-resistant (BLPACR) strains increased from 12% to 21% and from 13% to 19% respectively during the two survey years (P>0.05). Conclusions Hi plays an important role in the respiratory tract infection of children aged 0-17 years. The increasing trend of BLNAR and BLPACR rates makes it harder for antibiotic selection in clinical practice.
Van EJ, Slack MPE, Ladhani S, et al. Non-typeable Haemophilus influenzae, an under-recognised pathogen[J]. Lancet Infect Dis, 2014, 14(12):1281-1292.
[2]
Peltola H. Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century:global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates[J]. Clin Microbiol Rev 2000, 13(2):302-317.
[3]
Gessner BD, Adegbola RA. The impact of vaccines on pneumonia:key lessons from Haemophilus influenzae type b conjugate vaccines[J]. Vaccine, 2008, 26(suppl 2):B3-B8.
Tian GZ, Zhang L, Li MC, et al. Genotypic Characteristics of Haemophilus influenzae Isolates from Pediatric Pneumonia Patients in Chengdu City, Sichuan, China[J]. J Microbiol, 2009, 47(4):494-497.
Murdoch DR, O'Brien KL, Driscoll AJ, et al. Laboratory methods for determing pneumonia etiology in children[J]. Clin Infect Dis, 2012, 54(Suppl 2):S146-S152.
[12]
Clinical and Laboratory Standards Institute (CLSI):Performance standards for antimicrobial susceptibility testing[S]. 2012, M100-S22.
[13]
MacNeil JR, Cohn AC, Farley M, et al. Current epidemiology and trends in invasive Haemophilus influenzae disease-United States, 1989-2008[J]. Clin Infect Dis, 2011, 53(12):1230-1236.
Courcol RJ, Damien JM, Ramon P, et al. Presence of alveolar macrophages as a criterion for determining the suitability of sputum specimens for bacterial culture[J]. Eur J Clin Microbiol, 1984, 3(2):122-125.
[16]
Klein DW, Beasley PA, Ilstrup DM, et al. Can microscopic screening be used to determine the suitability of sputum for culture of Haemophilus species?[J]. Am J Clin Pathol, 1986, 86(6):771-773.
[17]
Chiang WC, Teoh OH, Chong CY, et al. Epidemiology, clinical characteristics and antimicrobial resistance patterns of community-acquired pneumonia in 1702 hospitalized children in Singapore[J]. Respirology, 2007, 12(2):254-261.
[18]
De Schutter I, De Wachter E, Crokaert F, et al. Microbiology of bronchoalveolar lavage fluid in children with acute nonresponding or recurrent community-acquired pneumonia:identification of nontypeable Haemophilus influenzae as a major pathogen[J]. Clin Infect Dis, 2011, 52(12):1437-1444.
[19]
Ingarfield SL, Celenza A, Jacobs IG, et al. The bacteriology of pneumonia diagnosed in Western Australian emergency departments[J]. Epidemiol Infect, 2007, 135(8):1376-1383.
[20]
Falla TJ, Dobson SR, Crook DW, et al. Population-based study of non-typable Haemophilus infl uenzae invasive disease in children and neonates[J]. Lancet, 1993, 341(8849):851-854.
[21]
Heath PT, Booy R, Azzopardi HJ, et al. Non-type b Haemophilus influenzae disease:clinical and epidemiologic characteristics in the Haemophilus influenzae type b vaccine era[J]. Pediatr Infect Dis J, 2001, 20(3):300-305.
[22]
Gkentzi D, Slack M, Ladhani S. The burden of nonencapsulated Haemophilus influenzae in children and potential for prevention[J]. Curr Opin Infect Dis, 2012, 25(3):266-272.
[23]
Clancy RL, Dunkley M. Acute exacerbations in COPD and their control with oral immunization with non-typeable Haemophilus influenzae[J/OL]. Front Immunol, 2011, 2:7.
[24]
Marchant JM, Masters IB, Taylor SM, et al. Utility of signs and symptoms of chronic cough in predicting specific cause in children[J]. Thorax, 2006, 61(8):694-698.
[25]
Marchant JM, Masters IB, Taylor SM, et al. Evaluation and outcome of young children with chronic cough[J]. Chest, 2006, 129(5):1132-1141.
[26]
Donnelly D, Critchlow A, Everard ML. Outcomes in children treated for persistent bacterial bronchitis[J]. Thorax, 2007, 62(1):80-84.
Ito M, Hotomi M, Maruyama Y, et al. Clonal spread of betalactamase- producing amoxicillin-clavulanate-resistant (BLPACR) strains of non-typeable Haemophilus influenzae among young children attending a day care in Japan[J]. Int J Pediatr Otorhinolaryngol, 2010, 74(8):901-906.
[32]
Ubukata K, Shibasaki Y, Yamamoto K, et al. Association of aminoacid substitutions in penicillin-binding protein 3 with beta-lactam resistance in beta-lactamase-negative ampicillinresistant Haemophilus influenzae[J]. Antimicrob Agents Chemother, 2001, 45(6):1693-1699.
