Emerging fluoroquinolone and ketolide resistance in Haemophilus parainfluenzae in South Africa

Abotsi, Regina E.; Govinden, Usha; Moodley, K; Essack, Sabiha Y.

doi:10.3855/jidc.8241

Cited by 3 publications

(4 citation statements)

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“…Interestingly, for the isolates with a Ͼ4-fold increase in fluoroquinolone MIC values from both arms, 3 out of the 4 isolates were genetically unrelated. Previous studies from Spain and South Africa reported fluoroquinolone resistance arising from mutations in the QRDR as well as plasmid-mediated resistance (9,10). The mutations observed in H. parainfluenzae in this study were also observed in isolates reported in the Spanish and South African studies.…”

Section: Discussionsupporting

confidence: 75%

Efficacy of Delafloxacin versus Moxifloxacin against Bacterial Respiratory Pathogens in Adults with Community-Acquired Bacterial Pneumonia (CABP): Microbiology Results from the Delafloxacin Phase 3 CABP Trial

McCurdy

Keedy

Lawrence

et al. 2020

Antimicrob Agents Chemother

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Delafloxacin is a novel fluoroquinolone with activity against Grampositive, Gram-negative, and atypical pathogens, including fluoroquinolone-nonsusceptible methicillin-resistant Staphylococcus aureus (MRSA). The microbiological results of a phase 3 clinical trial in adults with community-acquired pneumonia (CAP) comparing delafloxacin (300 mg intravenously [i.v.] with the option to switch to 450 mg orally every 12 h) to moxifloxacin (400 mg i.v. with the option to switch to 400 mg orally once a day [QD]) were determined. Patients from 4 continents, predominately Europe but also South America and Asia, were enrolled. The microbiological intent-to-treat (MITT) population included 520 patients, and 60.5% of these patients had a bacterial pathogen identified. Multiple diagnostic methods were employed, including culture, serology, PCR, and urinary antigen tests. Based on baseline MIC 90 values, delafloxacin exhibited at least 16-fold greater activity than moxifloxacin for Gram-positive and fastidious Gram-negative pathogens. Delafloxacin retained activity against resistant phenotypes found in Streptococcus pneumoniae (penicillin-, macrolide-, and multiple-drug resistant), Haemophilus species (␤-lactamase producing and macrolide nonsusceptible), and S. aureus (MRSA and fluoroquinolonenonsusceptible methicillin-susceptible S. aureus [MSSA]). The microbiological success rates were 92.7% for S. pneumoniae (87.5% for penicillin-resistant S. pneumoniae [PRSP]), 92.6% for S. aureus (100% for MRSA), 100% for Escherichia coli, 82.4% for Klebsiella pneumoniae, 100% for Klebsiella oxytoca, 100% for Moraxella catarrhalis, 91.7% for Haemophilus influenzae, 88.6% for Haemophilus parainfluenzae, 96.7% for Mycoplasma pneumoniae, 93.1% for Legionella pneumophila, and 100% for Chlamydia pneumoniae. There was little correlation between MICs and outcomes, with a high proportion of favorable outcomes observed across all delafloxacin baseline MIC values. Delafloxacin may be considered a treatment option as monotherapy for CAP in adults, where broad-spectrum coverage including MRSA activity is desirable.

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Section: Discussionsupporting

confidence: 75%

Efficacy of Delafloxacin versus Moxifloxacin against Bacterial Respiratory Pathogens in Adults with Community-Acquired Bacterial Pneumonia (CABP): Microbiology Results from the Delafloxacin Phase 3 CABP Trial

McCurdy

Keedy

Lawrence

et al. 2020

Antimicrob Agents Chemother

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“…Levels of Haemophilus parainfluenzae , a commensal organism, were significantly higher in post‐treatment samples than in healthy sites, a finding also observed in chronic periodontitis volunteers treated with adjunctive MTZ and AMX 47 . This may be in part due to a transition to a healthy microbiome but also because this species is often resistant to β‐lactam antibiotics 48 . The same may be argued for Corynebacterium, especially C. durum , which was strikingly elevated post‐treatment to an abundance slightly higher than that observed in healthy samples.…”

Section: Discussionmentioning

confidence: 66%

Microbiome changes in young periodontitis patients treated with adjunctive metronidazole and amoxicillin

Feres

Retamal‐Valdes

Fermiano

et al. 2020

Journal of Periodontology

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Background To our knowledge, to date, no studies have comprehensively assessed the changes occurring in the subgingival microbiome of young patients with periodontitis treated by means of mechanical and antibiotic therapy. Thus, this study aimed to use next‐generation sequencing to evaluate the subgingival microbial composition of young patients with severe periodontitis treated with scaling and root planing and systemic metronidazole and amoxicillin. Methods Subgingival samples from healthy individuals and shallow and deep sites from periodontitis patients were individually collected at baseline and 90 days post‐treatment. The samples were analyzed using 16S rRNA‐gene sequencing (MiSeq‐Illumina) and QIIME pipeline. Differences between groups for the microbiological data were determined using principal coordinate analysis (PCoA), linear mixed models, and the PERMANOVA test. Results One hundred samples were collected from 10 periodontitis patients and seven healthy individuals. PCoA analysis revealed significant partitioning between pre‐and post‐treatment samples. No major differences in the composition of the subgingival microbiota were observed between shallow and deep sites, at baseline or at 90‐days post‐treatment, and the microbiome of both site categories after treatment moved closer in similarity to that observed in periodontal health. Treatment significantly improved all clinical parameters and reduced the relative abundance of classical periodontal pathogens and of Fretibacterium fastidiosum, Eubacterium saphenum, Porphyromonas endodontalis, Treponema medium, Synergistetes, TM7, and Treponema spp, and increased that of Actinomyces, Rothia, Haemophilus, Corynebacterium, and Streptococci spp. Conclusion Mechanical treatment associated with metronidazole and amoxicillin promoted a beneficial change in the microbiome of young individuals with severe periodontitis.

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“…The ErmB gene which codes for methylases has also been implicated in macrolide, azalide and ketolide resistance by H. parainfluenzae. 18 Substitutions in the L22 ribosomal protein and in the 23S rRNA have not yet been reported in macrolide resistant H. parainfluenzae. 15 However, the involvement of other resistance mechanisms of the bacteria to macrolides is still to be determined.…”

Section: Macrolides Azalides Ketolides Lincosamides and Streptograminsmentioning

confidence: 99%

“…Of the studies that investigated the involvement of plasmid mediated resistance genes (qnrA, qnrB, qnrS, qnrC, qnrD, qnrVC, qepA and aac(6′)-Ib-cr genes), 15,17,19,20,34 only one detected aac(6′)-Ib-cr in four isolates of H. parainfluenzae. 18…”

Section: Quinolonesmentioning

confidence: 99%

Mechanisms of antibiotic resistance in Haemophilus parainfluenzae

Abotsi

Govinden

Essack

2017

Southern African Journal of Infectious Diseases

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Haemophilus parainfluenzae is part of the HACEK group of fastidious bacteria commonly implicated in endocarditis and bacteremia. Previously considered as a normal respiratory, oral and sometimes genitourinary commensal, it has been recognised as a pathogen that can cause life-threatening infections in both immunocompromised and healthy individuals. It has also been reported as a bacterium that can harbor transferable antibiotic resistance genes. This paper presents a literature review on the molecular mechanisms of resistance of H. parainfluenzae to commonly prescribed antibiotics and discusses areas for further research.

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Emerging fluoroquinolone and ketolide resistance in Haemophilus parainfluenzae in South Africa

Abstract: This item has no abstract. Follow the links on the page to access the full text.

Cited by 3 publications

References 9 publications

Efficacy of Delafloxacin versus Moxifloxacin against Bacterial Respiratory Pathogens in Adults with Community-Acquired Bacterial Pneumonia (CABP): Microbiology Results from the Delafloxacin Phase 3 CABP Trial

Efficacy of Delafloxacin versus Moxifloxacin against Bacterial Respiratory Pathogens in Adults with Community-Acquired Bacterial Pneumonia (CABP): Microbiology Results from the Delafloxacin Phase 3 CABP Trial

Microbiome changes in young periodontitis patients treated with adjunctive metronidazole and amoxicillin

Mechanisms of antibiotic resistance in Haemophilus parainfluenzae

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