Lieke V. M. M鰈ler, Annette G. Regelink, Henny Grasselier, Loek van Alphen, and Jacob Dankert. Antimicrobial Susceptibility of Haemophilus influenzae in the Respiratory Tracts of Patients with Cystic Fibrosis. Antimicrob. Agents Chemother., Feb 1998; 42: 319 - 324
Antimicrobial Susceptibility of Haemophilus influenzae in the Respiratory Tracts of Patients with Cystic Fibrosis
Department of Medical Microbiology,
Received 3 March 1997/Returned for modification 19 July 1997/Accepted 26 November 1997 We analyzed the antimicrobial susceptibilities of Haemophilus influenzae isolates from 157 sputum specimens prospectively collected from 39 cystic fibrosis (CF) patients during a 2-year study. These isolates were characterized by random amplified polymorphic DNA analysis and major outer membrane protein (MOMP) analysis to identify H. influenzae strains and MOMP variants and to assess their persistence in the respiratory tract. Among the 247 H. influenzae isolates, 16 (6.5%) produced -lactamase. The 231 -lactamase-negative isolates represented 85 H. influenzae strains, 61 MOMP variants derived from 27 of these strains, and 85 persistent isolates identical to strains or MOMP variants. All -lactamase-negative isolates were tested for susceptibility to ampicillin, amoxicillin-clavulanic acid, cefuroxime, cefotaxime, cefaclor, imipenem, tetracycline, and trimethoprim-sulfamethoxazole by disk diffusion testing. Eleven (13%) H. influenzae strains, 18 (30%) MOMP variants, and 30 (35%) persistent isolates were resistant to one or more of the antibiotics tested. Antimicrobial susceptibility was decreased among MOMP variants and persistent isolates compared to nonpersistent H. influenzae strains, and changes in susceptibility occurred irrespective of MOMP variation. We conclude that the decreased antimicrobial susceptibility of H. influenzae during persistence contributes to the poor eradication of H. influenzae from the respiratory tracts of CF patients.
* Corresponding author. Mailing address: Laboratory for Vaccine Development and Mechanisms of Immunity (L.V.M.), National Institute for Public Health and Environment (RIVM), P.O. Box 1, NL-3720 BA Bilthoven, The Netherlands. Phone: 31-30-2742701. Fax: 31-30-2744429. E-mail: Loek.van.Alphen@RIVM.NL.
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