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ABS TRACT Objective: This study’s aim is to investigate the serotypes and ampicillin resistance mechanisms in Haemophilus influenzae pediatric isolates in several clinical samples. Material and Methods: One hundred thirty nine patients’ clinic samples were examined. Serotyping using slide agglutination and antimicrobial susceptibilitiy testing using microbroth dilution test methodology were performed. Strains for which ampicillin MICs were ≥0.5 μg/mL were indiscriminately selected, and penicillin binding protein (PBP) profiles were analyzed. The blaTEM-1, blaROB-1 genes and ftsI gene mutations were examined by polymerase chain reaction (PCR) and then sequenced. Results: The serotypes in 139 serial isolates of H. influenzae were detected as serotype b (n=19; 13.7%), serotype a (n=9; 6.4%), serotype d (n=2; 1.4%), serotype f (n=2; 1.4%) and serotype c (n=1; 0.7%), serotype e (n=1; 0.7%). One hundred and five (75.5%) strains were found as nontypeable. Ampicillin, cefaclor, amoxicillin-clavulanic acid and cefotaxime resistance rates were 4.3%, 11.5%, 0%, 0%, respectively. Resistance was not detected in serotype b and e. Ampicillin resistant, beta lactamase positive four isolates (two serotype a and two nontypeable) were positive for blaTEM-1. All strains were negative for blaROB-1. A total of 4 (11.1%) serotype a, 2 (5.5%) serotype b and 30 (83.3%) nontypeable H. influenzae strains were positive for low BLNAR. Conclusion: Among pediatric isolates nontypeable H. influenzae was found to be the most common serotype. Ampicillin resistant, TEM-1 beta lactamase positive strains still involve risk in our country. Significant rate of low BLNAR positive strains in nontypeable H. influenzae is considerable. This is the first investigation on the specific gene mutations that encode PBP-3 INT and their connection with TEM-1 in low BLNAR H. influenzae strains in Turkey.

türkiye klinikleri tıp bilimleri dergisi

Prevalence and Genotypic Characteristics of ß-lactamase Negative-Ampicillin-Resistant (BLNAR) Haemophilus Influenzae in a Children's Hospital in Turkey