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Klinik örneklerden izole edilen Haemophilus influenzae suşlarının serotiplendirilmesi ve bazı antimikrobiyallere duyarlılık durumlarının araştırılması

Year 2019, Volume: 11 Issue: 4, 497 - 503, 01.12.2019
https://doi.org/10.21601/ortadogutipdergisi.544493

Abstract

Amaç: Çocuklarda, ciddi enfeksiyonların etkeni olan Haemophilus influenzae, önemli bir mortalite ve morbidite nedenidir. Kapsüllü suşları a’dan f’ye kadar 6 gruptur. İçlerinde tip b en invaziv olanıdır. Diğer serotipler de ciddi enfeksiyonlar ve invaziv hastalıklara yol açabilir. Giderek artan beta laktamaz üretimi ve beta laktamaz negatif olup ampisilin dirençli suşlar nedeniyle antibiyotik duyarlılık testi tedavinin yönlendirilmesi açısından yararlı olmaktadır.

Bu çalışma ile çeşitli klinik örneklerden izole edilen H. influenzae suşlarının serotiplendirilmesi, beta laktamaz üretimi ve antimikrobiyallere duyarlılık durumunun araştırılması amaçlanmıştır.
Gereç ve Yöntemler: Çeşitli klinik örneklerde üreyen 100 H. influenzae çalışmaya alındı. Bakteriler X ve V faktörü ihtiyacına bakılarak veya API NH kullanılarak tanımlandı. Beta laktamaz üretimi, nitrosefin diskleriyle araştırıldı. Serotiplendirme, spesifik antiserumlarla lam aglütinasyon yöntemiyle yapıldı. Çeşitli antimikrobiyallere duyarlılıkları, Haemophilus Test Medium’da gradient testle belirlendi.
Bulgular: Örneklerin 59’u balgam, 23’ü nazotrakeal aspirat, 3’ü bronkoalveoler lavaj, 7’si orta kulak sıvısı, 3’ü beyin omurilik sıvısı, 2’si göz, 2’si plevra sıvısı ve 1’i kan idi. Yaş grupları dikkate alınmaksızın yapılan sıralamada a> b> d> THi> c> e idi. Suşlar arasında serotip f bulunamadı. Steril vücut boşluğu sıvılarının hepsinden tip b izole edildi. Beta laktamaz pozitifliğinin %2 ve BLNAR oranının %2 olduğu bulundu. Hepsi sefotaksime ve siprofloksasine duyarlı, %66,6’sı azitromisine ve %93’ü TMP-SMX’e duyarlıydı.              
Sonuçlar: Antimikrobiyal direnci izlemek amacıyla standardize duyarlılık testlerinin rutinde yapılması uygundur. H.influenzae tip b’nin aşılama programlarına alınması Hib dışı izolatlarla enfeksiyonlarda artışa yol açabileceğinden serotiplendirme yapılması önemlidir.

References

  • Jordens JZ, Slack MPE. Haemophilus influenzae: Then and Now. Eur. J. Clin. Microbiol. Infect. Dis 1995; 14: 935-48.
  • Gür D, Özalp M, Sümerkan B, ve ark. Prevalance of antimicrobial resistance in Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis and Streptococcus pyogenes: results of a multicentre study in Turkey. Int J Antimicrob Agents 2002; 19: 207-11.
  • Ubukata K, Shibasaki Y, Yamamoto K, ve ark. Association of amino acid substitution in Penicilin-Binding Protein 3 with -lactam resistance in -lactamase-negative ampicillin-resistant Haemophilus influenzae. Antimicrobial Agents Chemother 2001; 45: 1693-99.
  • CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty- Informational Supplement. CLSI Document M. Wayne, PA: Clinical Laboratory Standards Institute; 2011.
  • O’Neil MJ, St. Geme III JW, Cutter D, Adderson EE, Anyanwu J, ve ark. Invazive disease due to nontypeable Haemophilus influenzae among children in Arkansas. Journal of Clinical Microbiology 2003; 41: 3064-69.
  • Akçakaya N, Camcıoğlu Y, Belbek Ş, Eşkazan G, Çokuğraş H. Haemophilus influenzae type b colonization in children in a hospital-based day care center. European Journal of Epidemiology 2001; 17: 313-16.
  • Guilherme SR, Joice NR, Soraia MC, ve ark. Prevention of Haemophilus influenzae type b (Hib) meningitis and emergence of serotype replacement with type a strains after introduction of Hib immunization in Brazil. The Journal of Infectious Diseases 2003; 187: 109-16.
  • Luong DC, Ishiwada N, Takeda N, Kohno Y. Serotypes of Haemophilus influenzae strains isolated from pediatric patients with respiratory tract infections. Tohoku J. Exp. Med 2004; 202: 245-54.
  • Agrawal A, Murphy TF. Haemophilus influenzae infections in the H.influenzae type b conjugate vaccine era. J Clin Microbiol. 2011 Nov; (11): 3728-32. (doi: 10.1128/JCM.05476-11).
  • Mevsim V. H.influenzae type b aşısı. Türkiye Klinikleri J Fam Med-Special Topics 2011; 2(6): 82-6.
  • Rainbow J. H.influenzae Type b diseases in five young children-Minnesota. MMWR Weekly 2009; 58; 58-60).
  • Ödek Ç, Özdemir H, Tapısız A, ve ark. H.influenzae type b aşılaması yapılan iki çocukta invaziv Haemophilus influenzae enfeksiyonları. Çocuk Enf Derg 2010; 4: 76-8.
  • Karademir F, Aydınöz S, Süleymanoğlu S, Meral C, Ataş E, Göçmen İ. Tiplendirilemeyen Haemophilus influenzae’ya bağlı neonatal sepsis. Nobel Med 2008; 4(3): 37-39.
  • Budak F, Ocak Z, Gür D. Prevalence and Genotypic Characteristics of β-Lactamase Negative-Ampicillin-Resistant Haemophilus influenzae in a Children’sHospital in Turkey. Turkiye Klinikleri J Med Sci 2016; 36(2).
  • Eşel D, Karaca N, Sümerkan B. Klinik örneklerden izole edilen Haemophilus influenzae kökenlerinde antibiyotiklere duyarlılık. ANKEM Der 2000; 14: 555-59.
  • Turnak MR, Bandak SI, Bouchillon SK, Allen BC, Hoban DC. Antimicrobial susceptibilities of clinical isolates of Haemophilus influenzae and Moraxella catarrhalis collected during 1999-2000 from 13 countries. Clin Microbiol Infect 2001; 7: 671-677
  • Tsang RSW, Shuel M, Whyte K, Hoang L, Tyrrell G, Horsman G, Wylie J, Jamieson F, Lefebvre B, Haldane D, Gad RR, German GJ, Needle R. Antibiotic susceptibility and molecular analysis of invasive Haemophilus influenzae in Canada, 2007 to 2014. J Antimicrob Chemother 2017; 72: 1314–1319. (doi: 10.1093/jac/dkw565).
  • Zhang Y, Zhang F, Wang H, ve ark. Antimicrobial susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolated from community-acquired respiratory tract infections in China: Results from the CARTIPS Antimicrobial Surveillance Program. J Glob Antimicrob Resist 2016 Jun;5:36-41. (doi: 10.1016/j.jgar.2016.03.002).
  • İlki A, Sağiroğlu P, Elgörmüş N, Söyletir G. Streptococcus pneumoniae ve Haemophilus influenzae izolatlarının antibiyotik duyarlılık paternlerindeki değişim: dört yıllık izlem. Mikrobiyol Bul 2010; 44: 169-175.
  • Şener B, Tunçkanat F, Ulusoy S, ve ark. A survey of antibiotic resistance in Streptococcus pneumoniae and Haemophilus influenzae in Turkey, 2004–2005. Journal of Antimicrobial Chemotherapy 2007; 60: 587–593. (doi: 10.1093/jac/dkm232).
  • Alışkan HA, Çolakoğlu Ş, Göçmen JS. Solunum yolu örneklerinden izole edilen Streptococcus pneumoniae ve Haemophilus influenzae suşlarının antibiyotiklere dirençlerinin belirlenmesi. Cukurova Med J 2016; 41(2): 201-20. (doi: 10.17826/cutf.196127).
  • Jones ME, Karlowsky JA, Blosser-Middleton R, Critchley IA, Thornsberry C, Sahm DF. Apparent plateau in -lactamase production among clinical isolates of Haemophilus influenzae and Moraxella catarrhalis in the United States: results from the LIBRA Surveillance initiative. Int J Antimicrob Agents 2002; 19: 119-123.
  • Reis JN, Lima JB, Ribeiro GS, ve ark. Antimicrobial resistance in Haemophilus influenzae isolated during population-based surveillance for meningitis in Salvador, Brazil. Antimicrobial Agents Chemother 2002; 46: 3641-43.
  • Beşli Y, Karatuna O, Akyar I. 2012-2014 Yıllarında alt solunum yolu örneklerinden izole edilen Streptococcus pneumoniae ve Haemophilus influenzae suşlarında antibiyotiklere duyarlılığın yıllara ve yaş gruplarına göre değerlendirilmesi. ANKEM Derg 2015;29 (3): 114-121. (doi: 10.5222/ankem.2015.0114).
  • Nilius AM, Beyer JM, Flamm RK, Tanaka SK. Variability in susceptibilities of Haemophilus influenzae to clarithromycin and azithromycin due to medium pH. J Clin Microbiol 1997; 35(6): 1311-1315.

Serotyping strains of Haemophilus influenzae isolated from clinical specimens and investigating their susceptibilities towards certain antimicrobials

Year 2019, Volume: 11 Issue: 4, 497 - 503, 01.12.2019
https://doi.org/10.21601/ortadogutipdergisi.544493

Abstract

Aim: Haemophilus influenzae is an agent of severe pediatric infections, and a significant cause of mortality and morbidity in children. Its capsulated strains are grouped from ‘a’ to ‘f’ in six groups, the most invasive among which is Type B. The other serotypes are also capable of causing severe infections and invasive diseases. Antibiotic sensitivity testing proves to be useful in directing course of treatment in view of the beta-lactamase-negative and ampicillin-resistant strains as well as the ever-increasing production of beta-lactamase.

In this study it has been aimed to serotype Haemophilus influenzae strains isolated from various clinical specimens, and to investigate their status of beta-lactamase production and susceptibilities towards antimicrobials.
Materials and Methods: 100 samples of H. influenzae proliferating in various clinical specimens were included in the study. The bacteria were identified according to their requirements of X and V factors, or through the usage of API NH. Detection of beta-lactamase production was made with nitrocefin disks. Serotyping was performed via slide agglutination method with specific antiserums. Susceptibilities towards various antimicrobials were specified with gradient test in Haemophilus Test Medium.
Results: 59 of the specimens were sputum, 23 were nasotracheal aspirates, 3 were bronchoalveolar lavages, 7 were middle ear fluids, 3 were cerebrospinal fluids, 2 were eye fluids, 2 were pleural fluids, and 1 was a blood sample. The ranking was made without keeping age groups in regard and turned out as a>b>d>THi>c>e. Serotype f was not found among the strains. Type b was isolated from all of sterile body cavity fluids. Beta-lactamase positivity was found as 2% and the BLNAR ratio was found as 2%. All were found as susceptible towards cefotaxime and siprofloxacin while 66.6% were susceptible towards azithromycin, and 93% were susceptible towards TMP-SMX.
Conclusion: It will be appropriate to perform standardized susceptibility tests in routine in order to monitor antimicrobial resistance. Serotyping is important as inclusion of H. influenzae type b in vaccination programs may cause an increase in infections with non-Hib isolates.

References

  • Jordens JZ, Slack MPE. Haemophilus influenzae: Then and Now. Eur. J. Clin. Microbiol. Infect. Dis 1995; 14: 935-48.
  • Gür D, Özalp M, Sümerkan B, ve ark. Prevalance of antimicrobial resistance in Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis and Streptococcus pyogenes: results of a multicentre study in Turkey. Int J Antimicrob Agents 2002; 19: 207-11.
  • Ubukata K, Shibasaki Y, Yamamoto K, ve ark. Association of amino acid substitution in Penicilin-Binding Protein 3 with -lactam resistance in -lactamase-negative ampicillin-resistant Haemophilus influenzae. Antimicrobial Agents Chemother 2001; 45: 1693-99.
  • CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty- Informational Supplement. CLSI Document M. Wayne, PA: Clinical Laboratory Standards Institute; 2011.
  • O’Neil MJ, St. Geme III JW, Cutter D, Adderson EE, Anyanwu J, ve ark. Invazive disease due to nontypeable Haemophilus influenzae among children in Arkansas. Journal of Clinical Microbiology 2003; 41: 3064-69.
  • Akçakaya N, Camcıoğlu Y, Belbek Ş, Eşkazan G, Çokuğraş H. Haemophilus influenzae type b colonization in children in a hospital-based day care center. European Journal of Epidemiology 2001; 17: 313-16.
  • Guilherme SR, Joice NR, Soraia MC, ve ark. Prevention of Haemophilus influenzae type b (Hib) meningitis and emergence of serotype replacement with type a strains after introduction of Hib immunization in Brazil. The Journal of Infectious Diseases 2003; 187: 109-16.
  • Luong DC, Ishiwada N, Takeda N, Kohno Y. Serotypes of Haemophilus influenzae strains isolated from pediatric patients with respiratory tract infections. Tohoku J. Exp. Med 2004; 202: 245-54.
  • Agrawal A, Murphy TF. Haemophilus influenzae infections in the H.influenzae type b conjugate vaccine era. J Clin Microbiol. 2011 Nov; (11): 3728-32. (doi: 10.1128/JCM.05476-11).
  • Mevsim V. H.influenzae type b aşısı. Türkiye Klinikleri J Fam Med-Special Topics 2011; 2(6): 82-6.
  • Rainbow J. H.influenzae Type b diseases in five young children-Minnesota. MMWR Weekly 2009; 58; 58-60).
  • Ödek Ç, Özdemir H, Tapısız A, ve ark. H.influenzae type b aşılaması yapılan iki çocukta invaziv Haemophilus influenzae enfeksiyonları. Çocuk Enf Derg 2010; 4: 76-8.
  • Karademir F, Aydınöz S, Süleymanoğlu S, Meral C, Ataş E, Göçmen İ. Tiplendirilemeyen Haemophilus influenzae’ya bağlı neonatal sepsis. Nobel Med 2008; 4(3): 37-39.
  • Budak F, Ocak Z, Gür D. Prevalence and Genotypic Characteristics of β-Lactamase Negative-Ampicillin-Resistant Haemophilus influenzae in a Children’sHospital in Turkey. Turkiye Klinikleri J Med Sci 2016; 36(2).
  • Eşel D, Karaca N, Sümerkan B. Klinik örneklerden izole edilen Haemophilus influenzae kökenlerinde antibiyotiklere duyarlılık. ANKEM Der 2000; 14: 555-59.
  • Turnak MR, Bandak SI, Bouchillon SK, Allen BC, Hoban DC. Antimicrobial susceptibilities of clinical isolates of Haemophilus influenzae and Moraxella catarrhalis collected during 1999-2000 from 13 countries. Clin Microbiol Infect 2001; 7: 671-677
  • Tsang RSW, Shuel M, Whyte K, Hoang L, Tyrrell G, Horsman G, Wylie J, Jamieson F, Lefebvre B, Haldane D, Gad RR, German GJ, Needle R. Antibiotic susceptibility and molecular analysis of invasive Haemophilus influenzae in Canada, 2007 to 2014. J Antimicrob Chemother 2017; 72: 1314–1319. (doi: 10.1093/jac/dkw565).
  • Zhang Y, Zhang F, Wang H, ve ark. Antimicrobial susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolated from community-acquired respiratory tract infections in China: Results from the CARTIPS Antimicrobial Surveillance Program. J Glob Antimicrob Resist 2016 Jun;5:36-41. (doi: 10.1016/j.jgar.2016.03.002).
  • İlki A, Sağiroğlu P, Elgörmüş N, Söyletir G. Streptococcus pneumoniae ve Haemophilus influenzae izolatlarının antibiyotik duyarlılık paternlerindeki değişim: dört yıllık izlem. Mikrobiyol Bul 2010; 44: 169-175.
  • Şener B, Tunçkanat F, Ulusoy S, ve ark. A survey of antibiotic resistance in Streptococcus pneumoniae and Haemophilus influenzae in Turkey, 2004–2005. Journal of Antimicrobial Chemotherapy 2007; 60: 587–593. (doi: 10.1093/jac/dkm232).
  • Alışkan HA, Çolakoğlu Ş, Göçmen JS. Solunum yolu örneklerinden izole edilen Streptococcus pneumoniae ve Haemophilus influenzae suşlarının antibiyotiklere dirençlerinin belirlenmesi. Cukurova Med J 2016; 41(2): 201-20. (doi: 10.17826/cutf.196127).
  • Jones ME, Karlowsky JA, Blosser-Middleton R, Critchley IA, Thornsberry C, Sahm DF. Apparent plateau in -lactamase production among clinical isolates of Haemophilus influenzae and Moraxella catarrhalis in the United States: results from the LIBRA Surveillance initiative. Int J Antimicrob Agents 2002; 19: 119-123.
  • Reis JN, Lima JB, Ribeiro GS, ve ark. Antimicrobial resistance in Haemophilus influenzae isolated during population-based surveillance for meningitis in Salvador, Brazil. Antimicrobial Agents Chemother 2002; 46: 3641-43.
  • Beşli Y, Karatuna O, Akyar I. 2012-2014 Yıllarında alt solunum yolu örneklerinden izole edilen Streptococcus pneumoniae ve Haemophilus influenzae suşlarında antibiyotiklere duyarlılığın yıllara ve yaş gruplarına göre değerlendirilmesi. ANKEM Derg 2015;29 (3): 114-121. (doi: 10.5222/ankem.2015.0114).
  • Nilius AM, Beyer JM, Flamm RK, Tanaka SK. Variability in susceptibilities of Haemophilus influenzae to clarithromycin and azithromycin due to medium pH. J Clin Microbiol 1997; 35(6): 1311-1315.
There are 25 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original article
Authors

Demet Hacıseyitoğlu 0000-0001-7404-8347

Bülent Sümerkan This is me 0000-0001-9690-807X

Publication Date December 1, 2019
Published in Issue Year 2019 Volume: 11 Issue: 4

Cite

Vancouver Hacıseyitoğlu D, Sümerkan B. Klinik örneklerden izole edilen Haemophilus influenzae suşlarının serotiplendirilmesi ve bazı antimikrobiyallere duyarlılık durumlarının araştırılması. omj. 2019;11(4):497-503.

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