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Title: [Prevalence of Moraxella catarrhalis in the nasopharyngeal specimen from 1 082 hospitalized children with respiratory infection and the drug resistance of the isolates].
Author: Tang P, Shi W, Zeng HL, Ding W, Wang C, Yao KH, Wen DN.
Journal: Zhongguo Dang Dai Er Ke Za Zhi; 2016 Aug; 18(8):707-12. PubMed ID: 27530786.
Abstract:
OBJECTIVE: To investigate the prevalence of Moraxella catarrhalis in the nasopharyngeal region of children with respiratory infection and the sensitivity of Moraxella catarrhalis isolates to common antimicrobial drugs. METHODS: Nasopharyngeal swabs were collected from 1 082 children with respiratory infection, and Moraxella catarrhalis strains were isolated. The E-test method and disc diffusion test were used to determine the sensitivity of these strains to 11 common antimicrobial drugs. The test results were interpreted with reference to the standards of European Committee on Antimicrobial Susceptibility Testing (EUCAST), Clinical and Laboratory Standards Institute (CLSI), and British Society for Antimicrobial Chemotherapy (BSAC). The nitrocefin disc method was used to detect whether the isolated strains produced β-lactamase. RESULTS: Among the 1 082 children with respiratory infection, 77 (77/1 082, 7.12%) carried Moraxella catarrhalis in the nasopharyngeal region. All the strains produced β-lactamase. With reference to all the three standards, all the strains were sensitive to amoxycillin-clavulanate and had a susceptibility rate of >95% towards ciprofloxacin and tetracycline. According to the EUCAST and CLSI standards, the susceptibility rate of the strains towards sulfamethoxazole-trimethoprim was as high as 98.7%, and more than 80% of all strains were sensitive to the three cephalosporins detected; however, with reference to the BSAC standard, only 2.6% of the strains were sensitive to cefuroxime, with an intermediate rate of 44.2% and a drug resistance rate of 53.2%. The rate of resistance to ampicillin was 81.8%. According to the CLSI standard, the non-susceptibility rate of the strains to erythromycin was 79.2%, and according to the EUCAST or BSAC standards, their non-susceptibility rate reached 90.9%; more than one third of the strains (27/77, 35.1%) had a minimal inhibitory concentration of >256 mg/L. CONCLUSIONS: All of the Moraxella catarrhalis isolates in the nasopharyngeal region of children with respiratory infection produce β-lactamase and are sensitive to amoxycillin-clavulanate. These isolates have high susceptibility rates to the third- and fourth-generation cephalosporins and sulfamethoxazole-trimethoprim, but most of the isolates are resistant to ampicillin, cefuroxime, and erythromycin. 目的了解呼吸道感染儿童鼻咽部卡他莫拉菌的携带情况及分离株对常见抗菌药物的敏感性。方法采集1082例呼吸道感染患儿鼻咽拭子并分离卡他莫拉菌，采用E-test法和纸片扩散法检测菌株对11种常见抗菌药物的敏感性，结合3种判读标准解读检测结果。用头孢硝噻吩纸片法检测分离株是否产β-内酰胺酶。结果 1082例呼吸道感染患儿中，鼻咽部卡他莫拉菌携带率为7.12%（77/1082）。所有菌株均产β-内酰胺酶。无论使用哪种判读标准，所有菌株对阿莫西林-克拉维酸均敏感；对环丙沙星和四环素的敏感率>95.0%。根据EUCAST和CLSI标准，分离株对磺胺甲噁唑-甲氧苄啶的敏感率高达98.7%，对所检测的3种头孢菌素的敏感率均超过80%。但根据BSAC标准判读时，菌株对头孢呋辛的敏感率仅为2.6%，对氨苄西林耐药率为81.8%。依据CLSI判读时，分离株对红霉素的不敏感率为79.2%，根据EUCAST或BSAC判断时，其不敏感率高达90.9%，且超过三分之一的菌株（27/77，35.1%）MIC值>256mg/L。结论呼吸道感染患儿鼻咽部卡他莫拉菌分离株均产β-内酰胺酶，对阿莫西林-克拉维酸全部敏感，对第三代和第四代头孢菌素、磺胺甲噁唑-甲氧苄啶敏感率高，但多对氨苄青霉素、头孢呋辛和红霉素耐药。

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