High prevalence of type b beta-lactamase-non-producing ampicillin-resistant Haemophilus influenzae in meningitis: the situation in Japan where Hib vaccine has not been introduced.
High prevalence of type b beta-lactamase-non-producing ampicillin-resistant Haemophilus influenzae in meningitis: the situation in Japan where Hib vaccine has not been introduced.
复制标题
脑膜炎中不产β-内酰胺酶的耐氨苄西林流感嗜血杆菌的高患病率：尚未引入 Hib 疫苗的日本的情况。
DOI：
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发表时间：
2006
影响因子：
5.2
通讯作者：
K. Ubukata
中科院分区：
文献类型：
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作者：
K. Hasegawa;Reiko Kobayashi;E. Takada;Akiko Ono;Naoko Chiba;Miyuki Morozumi;S. Iwata;K. Sunakawa;K. Ubukata
目标
研究脑膜炎患者流感嗜血杆菌耐药性的年度变化，并确定不产β-内酰胺酶的氨苄青霉素耐药（BLNAR）和产TEM-1 β-内酰胺酶的阿莫西林/克拉维酸耐药（BLPACR）分离株中的ftsI突变。
方法
2000年1月至2004年12月，我们收到了621株H。来自全国细菌性脑膜炎监测研究小组285个成员机构的流感病毒。通过PCR分析所有分离株以鉴定耐药基因，并检测对β-内酰胺类药物的敏感性。在所有BLNAR和BLPACR分离株中对ftsI基因进行测序。
结果
除4个分离株外，所有分离株均为血清型B。菌株可分为6类，即不产β-内酰胺酶的氨苄青霉素敏感型（25.0%），产TEM-1 β-内酰胺酶的氨苄青霉素耐药（11.0%），不产生β-内酰胺酶，对氨苄青霉素低水平耐药，ftsI基因中存在N526 K或R517 H置换（30.4%），在ftsI中具有S385 T置换以及N526 K或R517 H置换的BLNAR（22.2%）、在ftsI中具有N526 K或R517 H取代的BLPACR-I（9.5%）和在ftsI中具有S385 T取代以及N526 K或R517 H取代的BLPACR-II（1.9%）。BLNAR的流行率迅速上升，从2000年的5.8%上升到2004年的34.5%。所有BLNAR和BLPACR-II菌株被分为九个亚组的基础上的ftsI基因的取代模式。头孢菌素类抗生素对H.导入了来自九个亚组中每一个的BLNAR菌株的ftsI基因的流感转化体根据突变不同程度地增加。
结论
结果表明，H.在日本，对婴儿和儿童接种B型流感（HiB）疫苗对于预防严重的HiB感染是必要的。
OBJECTIVES
To study yearly changes in resistance and to identify ftsI mutations in beta-lactamase-non-producing ampicillin-resistant (BLNAR) and TEM-1 beta-lactamase-producing amoxicillin/clavulanic acid-resistant (BLPACR) isolates of Haemophilus influenzae from patients with meningitis.
METHODS
Between January 2000 and December 2004, we received 621 isolates of H. influenzae from 285 member institutions of the Nationwide Surveillance Study Group for Bacterial Meningitis. All isolates were analysed by PCR to identify resistance genes and tested for susceptibility to beta-lactams. The ftsI gene was sequenced in all BLNAR and BLPACR isolates.
RESULTS
All but four isolates were of serotype b. The isolates could be divided into six classes, namely beta-lactamase-non-producing ampicillin-susceptible (25.0%), TEM-1 beta-lactamase-producing ampicillin-resistant (11.0%), beta-lactamase-non-producing low-level ampicillin-resistant with N526K or R517H substitution in the ftsI gene (30.4%), BLNAR with an S385T substitution together with either N526K or R517H substitution in ftsI (22.2%), BLPACR-I with either a N526K or R517H substitution in ftsI (9.5%) and BLPACR-II with an S385T substitution together with either a N526K or R517H substitution in ftsI (1.9%). The prevalence of BLNAR has increased rapidly, from 5.8% in 2000 to 34.5% in 2004. All BLNAR and BLPACR-II strains were classified into nine subgroups on the basis of substitution patterns in the ftsI gene. The MICs of cephalosporin antibiotics for H. influenzae transformants into which the ftsI genes from BLNAR strains of each of the nine subgroups were introduced increased to varying degrees depending on the mutations.
CONCLUSIONS
The results suggest that introduction of H. influenzae type b (Hib) vaccination into infants and children is necessary for the prevention of severe Hib infections in Japan.