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Increasing Prevalence of Group III Penicillin-Binding Protein 3 Mutations Conferring High-Level Resistance to Beta-Lactams Among Nontypeable Haemophilus influenzae Isolates from Children in Korea

Authors
Han, MS; Jung, HJ; Lee, HJ; Choi, EH
Citation
Microbial drug resistance (Larchmont, N.Y.), 25(4). : 567-576, 2019
Journal Title
Microbial drug resistance (Larchmont, N.Y.)
ISSN
1076-62941931-8448
Abstract
This study investigated the roles of beta-lactamase and penicillin-binding protein 3 (PBP3) alterations in the development of recent antimicrobial resistance in nontypeable Haemophilus influenzae (NTHi) isolated from Korean children. Nasopharyngeal NTHi isolates from children at a tertiary children's hospital were tested for antimicrobial susceptibility using E-test. beta-lactamase production was screened by the paper disc test, and polymerase chain reaction amplification of blaTEM and blaROB-1 was performed. The ftsI gene was amplified to identify PBP3 alteration. Of the 53 NTHi isolates, 69.8% were ampicillin nonsusceptible. The nonsusceptibility rates for cefaclor were 81.1%, cefpodoxime 69.8%, and amoxicillin/clavulanate 32.1%. About 60.3% and 32.1% of the isolates were genetically beta-lactamase-nonproducing ampicillin-resistant (gBLNAR) and genetically beta-lactamase-producing amoxicillin/clavulanate-resistant (gBLPACR) strains, respectively. Group III amino acid substitutions comprised 65.6% of the gBLNAR strains and 70.6% of the gBLPACR strains. MIC50 for amoxicillin/clavulanate, cefaclor, cefuroxime, cefpodoxime, and cefixime were more than 2-80 times higher in the gBLNAR and gBLPACR strains compared with gBLPAR strains. Group III gBLNAR strains had significantly higher ampicillin, amoxicillin/clavulanate, cefpodoxime, and cefixime minimum inhibitory concentrations than group II strains. Group III gBLNAR and gBLPACR NTHi strains are highly prevalent in Korea, raising the alarm about increasing beta-lactam resistance in NTHi.
Keywords
antibiotic resistancebeta-lactamasepenicillin-binding protein
MeSH terms
Amino Acid Substitution / geneticsAmoxicillin-Potassium Clavulanate Combination / pharmacologyAmpicillin / pharmacologyAmpicillin Resistance / drug effectsAmpicillin Resistance / geneticsAnti-Bacterial Agents / pharmacology*ChildHaemophilus Infections / drug therapyHaemophilus Infections / microbiologyHaemophilus influenzae / genetics*HumansMicrobial Sensitivity Tests / methodsMutation / drug effectsMutation / genetics*Penicillin-Binding Proteins / genetics*PrevalenceRepublic of Koreabeta-Lactam Resistance / drug effectsbeta-Lactam Resistance / genetics*beta-Lactamases / geneticsbeta-Lactams / pharmacology*
DOI
10.1089/mdr.2018.0342
PMID
30484742
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Pediatrics & Adolescent Medicine
AJOU Authors
정, 현주
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