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  • Title: Rise in Haemophilus influenzae With Reduced Quinolone Susceptibility and Development of a Simple Screening Method.
    Author: Seyama S, Wajima T, Yanagisawa Y, Nakaminami H, Ushio M, Fujii T, Noguchi N.
    Journal: Pediatr Infect Dis J; 2017 Mar; 36(3):263-266. PubMed ID: 27870809.
    Abstract:
    BACKGROUND: β-Lactamase-nonproducing ampicillin-resistant Haemophilus influenzae are prevalent in Japan. Resistance has increased as a consequence of the expanded use of antimicrobial agents, raising concerns about the rise of multidrug (macrolide and fluoroquinolone)-resistant H. influenzae. METHODS: In this study, we investigated susceptibility to fluoroquinolones in H. influenzae clinical isolates from 2013 to 2014 and identified the amino acid substitutions in quinolone resistance-determining regions of gyrA and parC. RESULTS: All isolates (n = 145) were susceptible to fluoroquinolones; however, some showed reduced susceptibility. The minimum inhibitory concentration of levofloxacin for these strains was 0.063-0.5 µg/mL, and the strains harbored the amino acid substitution S84L in GyrA. Such strains have seen a significant increase. Importantly, all mutants from 2014 were isolated from pediatric patients. In addition, we developed a simple polymerase chain reaction-based screening method for detecting isolates with reduced fluoroquinolone susceptibility. CONCLUSIONS: The mutation in GyrA is important as a first step in the development of fluoroquinolone resistance. Hence, detection of reduced susceptible strains may influence the choice of antimicrobial treatment.
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