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Haemophilus influenzae: antibiotic susceptibility
1Department of Laboratory Medicine, Lahey Clinic Medical Center, Burlington, Massachusetts 01805.
Clinical Microbiology Reviews
|April 1, 1988
Summary
Antibiotic resistance in Haemophilus influenzae, particularly to ampicillin and chloramphenicol, emerged early due to plasmid-mediated enzymes. This necessitates reliable in vitro testing for effective treatment of invasive infections.
Area of Science:
- Microbiology
- Clinical Medicine
- Pharmacology
Background:
- Haemophilus influenzae infections pose a significant public health challenge.
- Early emergence of ampicillin and chloramphenicol resistance in H. influenzae compromised treatment options.
- Enzymatic inactivation, often plasmid-mediated, is the primary resistance mechanism.
Purpose of the Study:
- To review the historical development of antibiotic resistance in H. influenzae.
- To discuss the mechanisms of resistance and newer antimicrobial agents.
- To analyze in vitro testing methodologies for H. influenzae susceptibility.
Main Methods:
- Literature review of antibiotic resistance in H. influenzae.
- Analysis of resistance mechanisms, including enzymatic inactivation.
- Exploration of emerging antimicrobial therapies and diagnostic approaches.
Main Results:
- Ampicillin resistance in H. influenzae was noted by 1972, followed by chloramphenicol resistance.
- Plasmid-mediated enzymatic inactivation is the predominant resistance mechanism.
- Standardization of in vitro susceptibility testing remains challenging due to the organism's fastidious nature.
Conclusions:
- Antibiotic resistance in H. influenzae has significantly impacted clinical treatment strategies.
- Understanding resistance mechanisms is crucial for developing effective therapies.
- Advancements in in vitro testing are essential for guiding appropriate antimicrobial selection.