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Ampicillin-resistant Haemophilus influenzae. 1. Incidence, mechanism, and detection
Abstract:
Ampicillin resistance in Haemophilus influenzae, an organism once thought to be universally susceptible to ampicillin, is increasing. It varies from one institution or community to another, and rates of 6.6% to 48% have been reported. The vast majority of resistant strains produce beta-lactamase, an enzyme that hydrolyzes the beta-lactam ring of ampicillin and other susceptible beta-lactam antibiotics. The beta-lactamase production is mediated by a gene contained on a plasmid (piece of extrachromosomal DNA). It is important for physicians and microbiologists to be aware that an infection such as meningitis or otitis media could be caused by ampicillin-resistant strain of H influenzae. Knowledge of the incidence of resistance for the institution or community is particularly pertinent in selection of empiric therapy.
Insights
Ampicillin resistance in Haemophilus influenzae is rising, with rates varying by location. Most resistant strains produce beta-lactamase, an enzyme encoded on plasmids, necessitating awareness for effective treatment.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Haemophilus influenzae was historically susceptible to ampicillin.
- Increasing ampicillin resistance in H. influenzae is a growing concern.
- Reported resistance rates range from 6.6% to 48% across different settings.
Purpose of the Study:
- To highlight the increasing ampicillin resistance in Haemophilus influenzae.
- To inform healthcare professionals about the prevalence and mechanisms of resistance.
- To emphasize the importance of local resistance data for guiding treatment decisions.
Main Methods:
- The abstract does not detail specific experimental methods.
- It summarizes existing knowledge and reported resistance rates.
- Focuses on the mechanism of resistance (beta-lactamase production).
Main Results:
- Ampicillin resistance in H. influenzae is increasing globally.
- The primary mechanism of resistance is beta-lactamase production.
- Resistance rates vary significantly between institutions and communities.
Conclusions:
- Physicians and microbiologists must be aware of ampicillin-resistant H. influenzae strains.
- Beta-lactamase production, mediated by plasmids, is the main cause of resistance.
- Understanding local resistance incidence is crucial for selecting appropriate empiric therapy for infections like meningitis and otitis media.