Antimicrobial susceptibility of 70 invasive <i>H. influenzae</i>.

a<p>β-lactamase production: 8.6% (n = 6).</p>b<p>The ratio of amoxicillin/clavulanic acid was 2∶1.</p>c<p>The ratio of cotrimoxazole was 1∶19.</p><p>Antimicrobial susceptibility of 70 invasive <i>H. influenzae</i>.</p

Demographic data, clinical characteristics, and underlying conditions of 82 patients with an invasive <i>H. influenzae</i> episode during the period 2008–2013.

a<p>Facial cellulites, endometritis, liver abscess, and urinary-tract infection (n = 1, 1.2% each), and peritonitis (n = 2, 2.4%).</p>b<p>Leukemia (n = 3, 3.6%), lymphoma (n = 1, 1.2%), and myeloma (n = 5, 6.1%).</p>c<p>Bone marrow transplant (n = 1, 1.2%), kidney transplant (n = 1, 1.2%), and liver transplantation (n = 2, 2.4%).</p>d<p>Cerebrospinal fluid fistula (n = 2, 2.4%), renal failure, autoimmune disease, and head trauma (n = 1, 1.2% each).</p><p>Demographic data, clinical characteristics, and underlying conditions of 82 patients with an invasive <i>H. influenzae</i> episode during the period 2008–2013.</p

Molecular Epidemiology of Nontypeable <i>Haemophilus influenzae</i> Causing Community-Acquired Pneumonia in Adults

<div><p>Nontypeable <i>Haemophilus influenzae</i> (NTHi) is an opportunistic pathogen which causes a variety of respiratory infections. The objectives of the study were to determine its antimicrobial susceptibility, to characterize the β-lactam resistance, and to establish a genetic characterization of NTHi isolates. Ninety-five NTHi isolates were analyzed by pulsed field gel electrophoresis (PFGE) and multi locus sequence typing (MLST). Antimicrobial susceptibility was determined by microdilution, and the <i>fts</i>I gene (encoding penicillin-binding protein 3, PBP3) was PCR amplified and sequenced. Thirty (31.6%) isolates were non-susceptible to ampicillin (MIC≥2 mg/L), with 10 of them producing β-lactamase type TEM-1 as a resistance mechanism. After <i>fts</i>I sequencing, 39 (41.1%) isolates showed amino acid substitutions in PBP3, with Asn526→ Lys being the most common (69.2%). Eighty-four patients were successfully treated with amoxicillin/clavulanic acid, ceftriaxone and levofloxacin. Eight patients died due either to aspiration or complication of their comorbidities. In conclusion, NTHi causing CAP in adults shows high genetic diversity and is associated with a high rate of reduced susceptibility to ampicillin due to alterations in PBP3. The analysis of treatment and outcomes demonstrated that NTHi strains with mutations in the <i>fts</i>I gene could be successfully treated with ceftriaxone or fluoroquinolones.</p></div

Amino acid substitutions in the transpeptidase domain of PBP3 identified in 95 NTHi isolates.

<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0082515#pone.0082515-Dabernat1" target="_blank">[24]</a>; the miscellaneous group was classified according to the criteria of García-Cobos et al. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0082515#pone.0082515-GarciaCobos1" target="_blank">[10]</a> and the data from this study.^a The isolates were classified into groups I, IIa, IIb and IIc, according to the criteria of Dabernat et al. </p><p>≤1 mg/L; AMC Resistant: ≥8/4 mg/L; AMC susceptible: ≤4/2 mg/L;^b AMP Resistant: >4 mg/L; AMP Intermediate: 2 mg/L; AMP Susceptible </p><p>+: positive; -: negative);^c BL: Beta-lactamase production (</p><p> = 3), ST36, ST98, ST103, ST139 (n = 2), ST145 (n = 3), ST159 (n = 3), ST183, ST203 (n = 3), ST241 (n = 2), ST245, ST266, ST270, ST272, ST385, ST408, ST414 (n = 2), ST519 (n = 4), ST582, ST679, ST714, ST974, ST989, ST990, ST992, ST995, ST1174, ST1176, ST1178, ST1179, ST1180, ST1181, ST1182, ST1183 and ST1184.^d ST11 (n</p

Amino acid substitutions in PBP3 among 70 invasive <i>H. influenzae</i> strains.

a<p>BL: Beta-lactamase production: + (positive); – (negative).</p>b<p>Isolates without amino acid changes in PBP3 (gBLNAS).</p>c<p>Isolates grouped in the miscellaneous group were not gBLNAR.</p><p>Amino acid substitutions in PBP3 among 70 invasive <i>H. influenzae</i> strains.</p

Minimal inhibitory concentrations (MIC) of 10 antimicrobials. MIC against 95 NTHi isolates using the microdilution method according to CLSI breakpoints.

<p>^a CLSI: Clinical and Laboratory Standards Institute. I: intermediate; R: resistant.</p><p>∶1.^b The ratio of amoxicillin/clavulanic acid was 2</p><p>∶19.^c The ratio of cotrimoxazole was 1</p

Tree diagram showing the genetic relatedness of 39 nontypeable <i>H. influenzae</i> isolates with mutations in the <i>fts</i>I gene (gBLNAR n = 36 and gBLPACR n = 3) obtained by PFGE according to Dice's similarity index.

<p>Dice coefficients are shown above the tree diagram. Isolates with ≥80% relatedness are considered highly genetically related.</p

Allergic rhinitis.

<p>Meta-analyses of the adjusted odds of <b>allergic rhinitis</b> (sensitized to at least 1 aero-allergen; secondary endpoint) in early school age and pet ownership in the first 2 years of life for: A), cat only vs. no pets; B), dog only vs. no pets; C) cat and dog only vs. no pets; D) bird only vs. no pets; E) rodents only vs. no pets.</p

Prevalence of current asthma, allergic asthma (sensitized to ≥1 aero-allergen), allergic rhinitis (sensitized to ≥1 aero-allergen) and allergic sensitization (≥1 aero-allergen >0.35 kU/L) at last follow-up assessment between 6 to 10 years in 11 European birth cohorts.

<p>n.a. = not assessed.</p>1<p>in DARC, AMICS-Barcelona and AMICS-Menorca, sensitization data were only available for the age of 4 years.</p

Allergic asthma.

<p>Meta-analyses of the adjusted odds of <b>allergic asthma</b> (sensitized to at least 1 aero-allergen; secondary endpoint) in early school age and ownership of pets in the first 2 years of life for: A), cat only vs. no pets; B), dog only vs. no pets; C) cat and dog only vs. no pets; D) bird only vs. no pets; E) rodents only vs. no pets.</p