Can non-typeable Haemophilus influenzae carriage surveillance data infer antimicrobial resistance associated with otitis media?  

作　　者：Sophia Bowman-Derrick Tegan M.Harris Jemima Beissbarth Mariana Kleinecke Katrina Lawrence Teresa M.Wozniak Amy Bleakley Angela Rumaseb Michael J.Binks Robyn L.Marsh Peter S.Morris Amanda J.Leach Heidi Smith-Vaughan 

机构地区：[1]Menzies School of Health Research,Charles Darwin University,Darwin,Australia [2]Australian e-Health Research Centre CSIRO,Brisbane,Australia [3]Royal Darwin Hospital,Darwin,Australia

出　　处：《Pediatric Investigation》2023年第1期13-22,共10页儿科学研究（英文）

基　　金：Centre of Research Excellence in Ear and Hearing Health of Aboriginal and Torres Strait Islander Children,National Health and Medical Research Council(CRE07)

摘　　要：Importance:In remote communities of the Northern Territory,Australia,children experience high rates of otitis media(OM),commonly caused by non-typeable Haemophilus influenzae(NTHi).Few data exist on antibiotic susceptibility of NTHi from OM.Objective:To determine whether population-level nasopharyngeal NTHi antibiotic susceptibility data could inform antibiotic treatment for OM.Methods:NTHi isolates(n=92)collected from ear discharge between 2003 and 2013 were selected to time-and age-match NTHi isolates from the nasopharyngeal carriage(n=95).Antimicrobial susceptibility were tested.Phylogenomic trees and a genome-wide association study(GWAS)were performed to determine the similarity of nasopharyngeal and ear isolates at a population level.Results:Among 174 NTHi isolates available for antimicrobial susceptibility testing,10.3%(18/174)were resistant to ampicillin and 9.2%(16/174)were resistant to trimethoprim-sulfamethoxazole.Small numbers of isolates(≤3)were resistant to tetracycline,chloramphenicol,or amoxicillin-clavulanic acid.There was no statistical difference in the proportion of ampicillin-resistant(P=0.11)or trimethoprim-sulfamethoxazole-resistant isolates(P=0.70)between ear discharge and nasopharynx-derived NTHi isolates.Three multi-drug resistant NTHi isolates were identified.Phylogenomic trees showed no clustering of 187 Haemophilus influenzae isolates based on anatomical niche(nasopharynx or ear discharge),and no genetic variations that distinguished NTHi derived from ear discharge and nasopharyngeal carriage were evident in the GWAS.Interpretation:In this population-level study,nasopharyngeal and ear discharge isolates did not represent distinct microbial populations.These results support tracking of population-level nasopharyngeal NTHi antibiotic resistance patterns to inform clinical management of OM in this population.

关 键 词：Haemophilus influenzae Otitis media Antimicrobial resistance 

分 类 号：R764.21[医药卫生—耳鼻咽喉科] R446.5[医药卫生—临床医学]