High prevalence of β-lactam-resistant Haemophilus influenzae type b isolates derived from respiratory tract specimens in Japanese patients

Summary 

Objective

Serotypeable strains of Haemophilus influenzae, which can cause invasive infections, are found in the respiratory tract at low frequencies. We compared the antibiotic resistance of the typeable and nontypeable strains of H. influenzae in respiratory tract specimens obtained in Japan.

Methods

We determined the serotypes and the antibiotic susceptibilities of 440 clinical H. influenzae strains isolated from respiratory tract specimens. We also examined the prevalence of genotypes that are associated with β-lactam resistance.

Results

The majority of the strains were nontypeable (421 strains, 95.7%). The remainder belonged to serotypes b (10 strains, 2.3%), e (three strains, 0.7%), or f (six strains, 1.4%). The type b strains exhibited the expression of β-lactamase and resistance mutations in penicillin-binding protein 3 with significantly higher frequencies than other strains.

Conclusions

H. influenzae type b strains, which are associated with meningitis and bacteremia, derived from respiratory tract specimens, shared more β-lactam-resistant mechanisms than nontypeable and other serotype strains.

Keywords: Haemophilus influenzae, Serotype, BLNAR, β-Lactamase, Antibiotic resistance, Respiratory tract specimen