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The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
| ArticleTitle |
Molecular Analysis for Resistance to Multidrugs Including Fluoroquinolones in Haemophilus Influenzae Isolated from Elderly Patients with Pneumonia |
| Language |
J |
| AuthorList |
Hiroo Tokoro1), Kozue Kishii3), Nozomi Kimura1), Ayako Oura1), Yoko Suzuki2), Kimiko Ubukata3) |
| Affiliation |
1) Clinical Laboratory, Tokyo Wemen's Medical University Medical Center East
2) Department of Pediatrics, Tokyo Wemen's Medical University Medical Center East
2) Laboratory of Molecular Epidemiology for Infectious Agents, Kitasato Institute for Life Sciences, Kitasato University |
| Publication |
J.J.C.M.: 21 (2), 121-128, 2011 |
| Received |
November 7, 2010 |
| Accepted |
January 26, 2011 |
| Abstract |
Two strains of Haemophilus influenzae that show resistances to third generation β-lactam antibiotics and fluoroquinolone (FQ) agents were isolated from two elderly inpatients with pneumonia within a short term of hospitalization. We considered the possibility of hospital transmission of these multidrug resistant strains for a reason that both patients received medical cares from the same nursing staffs. To clarify the matter, the following four analysis were performed to the agents; re-testing of antibiotic susceptibility, identification of genotypic β-lactam resistance, sequence analysis for FQ resistance, and pulsed-field gel electrophoresis (PFGE). Both strains were highly resistant to ampicillin (> 64 μg/ml), sulbactam/ampicillin (1/2 μg/ml), amoxicillin (> 64 μg/ml), cefditoren (8 μg/ml), cefotaxime (32 μg/ml), ceftoriaxone(8 μg/ml), ciprofloxacin (16 μg/ml), and levofloxacin (8 μg/ml), respectively. They were also characterized genotypically as β-lactamase-producing amoxicillin clavulanic acid resistance (BLPACR-II) resulting from the presence of TEM-1 β-lactamase gene and amino acid substitutions of Ser385Thr and Arg517His in ftsI gene encoding penicillin-binding protein 3 in the strains. In FQ resistance, amino acid substitutions of Ser84Phe and Asp88Asn in GyrA encoded by a gyrA gene, Glu88Lys in ParC encoded by a parC, and Ala369Thr and Ser458Ala in ParE encoded by a parE, were identified in these strains. PFGE profiles practiced for these agents showed that they were clonally identical. Prompt interventions by the staffs of infection control team could prevent the spread of multidrug-resistant H. influenzae. It is also important to practice infection control with consideration for invasion of resistant organisms from community into hospital. |
| Keywords |
Haemophilus influenzae, gyrA, parC, BLPACR-II |
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