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A total of 255 NPS specimens were collected from every seventh of 1786 children with meningitis (n = 293) and pneumonia (n = 1493). One hundred and twenty one (47.5%) H. influenzae were isolated from 255 NPS specimens. Among 121 isolates, 15 (38%) were recovered from meningitis compared to 106 (49%) from pneumonia cases (P < 0.3). Fifteen percent of isolates (18/121) were serotype b (Hib) and the rest were non-Hib. The rate of resistance to ampicillin, amoxicillin, chloramphenicol, azithromycin and cotrimoxazole revealed by E-test were; 17.3%, 17.3%, 22%, 1% and 55% respectively. All strains were susceptible to ciprofloxacin, moxifloxacin, gatifloxacin, levofloxacin and ceftriaxone. A significant difference in antimicrobial resistance between Hib and non-Hib was noted for ampicillin (67% vs 8.7%; P < 0.1), chloramphenicol (72.2% vs 12.6%; P < 0.1), and co-trimoxazole (88.9% vs 48.5%; P < 0.004). Seventeen percent (21/121) of H. influenzae were ampicillin resistant due to β-lactamase. All ampicillin resistant isolates were characterized as multi-drugs resistant (MDR). Of the 21 ampicillin-resistant H. influenzae, 57% (12/ 21) were Hib, followed by non-capsulated (28.6%), serotype d (9.5%) and serotype c (4.8%). MDR was significantly different (P < 0.1) between Hib (66.7%) and non-Hib (8.7%). Biotype II (38.8%), III (20.7%), and I (18.1%) comprise 78% of H. influenzae isolates. Ninety-five percent of Hib belong to biotype I. Thus, 67% of the Hib isolates represent β-lactamase mediated ampicillin and multi-drugs resistance which is a tremendous public health concern.

Prevalence of β-Lactamase Positive Ampicillin Resistant H. Influenzae from Children of Bangladesh