AAC Accepts, published online ahead of print on 2 November 2009

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Google Scholar Articles by Bae, S. Articles by Kang, Y. PubMed PubMed Citation Articles by Bae, S. Articles by Kang, Y.

 Previous Article  |  Next Article 

Antimicrob. Agents Chemother. doi:10.1128/AAC.00966-09
Copyright (c) 2009, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Antimicrobial Resistance in Haemophilus influenzae Respiratory Tract Isolates in Korea: Results of the Nationwide Acute Respiratory Infections Surveillance

Songmee Bae^*, Jaehoon Lee, Jaehwa Lee, Eunah Kim, Sunhwa Lee, Jaeyon Yu, and Yeonho Kang

Division of Bacterial Respiratory Infections, Center for Infectious Diseases, National Institute of Health, Korea Centers for Disease Control and Prevention, Seoul, NeoDin Medical Institute, Seoul, Korea

^* To whom correspondence should be addressed. Email: songmee{at}hanmail.net.

Antimicrobial susceptibility patterns and -lactam resistance mechanisms of 544 H. influenzae isolates through the nationwide Acute Respiratory Infections Surveillance (ARIS) network in Korea during 2005 and 2006 were determined. Resistance to ampicillin was 58.5%, followed by cefuroxime (23.3%), clarithromycin (18.7%), cefaclor (17.0%), amoxicillin/clavulanate (10.4%), and chloramphenicol (8.1%). Levofloxacin and cefotaxime were the most active agents tested in this study. -lactamase production (52.4%) was the main mechanism of ampicillin resistance, with the rate (96.1%) of TEM-1 type -lactamase. According to their -lactam resistance mechanisms, all isolates were classified into the following groups: -lactamase-negative, ampicillin-sensitive (BLNAS) strains (n= 224; 41.5%); -lactamase-positive, ampicillin-resistant (BLPAR) strains (n = 255; 47.2%); -lactamase-negative, ampicillin-resistant (BLNAR) strains (n = 33; 6.1%); and -lactamase-positive, amoxicillin/clavulanate-resistant (BLPACR) strains (n = 28; 5.2%). Among the BLNAR and BLPACR strains, there were various patterns of multiple amino acid substitutions in penicillin binding protein 3. Particularly, among BLNAR, group III isolates, which had three simultaneous substitutions (Met377Ile, Ser385Thr, and Leu389Phe) were identified for the first time in Korea. Three group III strains displayed the highest minimum inhibitory concentration of cefotaxime (1–2 μg/ml). The results indicate the importance of monitoring a changing situation pertaining to the increase and spread of BLNAR and BLPACR strains of H. influenzae for appropriate antibiotic therapy for patients with RTIs in Korea.