ArticleJournal of clinical microbiology2015
Haemophilus influenzae with Non-Beta-Lactamase-Mediated Beta-Lactam Resistance: Easy To Find but Hard To Categorize.
Article in Journal of clinical microbiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Revisiting mutational resistance to ampicillin and cefotaxime in Haemophilus influenzae.Genome medicine · 2024Pooled it
- Haemophilus influenzae global epidemiology and antimicrobial susceptibility patterns including ampicillin and amoxicillin-clavulanate resistance based on β-lactamase production, 2013-2022.BMC infectious diseases · 2025Article
- Molecular and Drug Resistance Characteristics ofMicroorganisms · 2025Article
- Amino acid substitutions in PBP3 in Haemophilus influenzae strains, their phenotypic detection and impact on resistance to β-lactams.The Journal of antimicrobial chemotherapy · 2025Article
- Genomic profiling of cefotaxime-resistantFrontiers in microbiology · 2025Article
- Monitoring of Haemophilus influenzae isolated from carriage, lower respiratory tract infections and blood over a six-month period in Belgium.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Wild-type distributions of minimum inhibitory concentrations and epidemiological cut-off values-laboratory and clinical utility.Clinical microbiology reviews · 2023Review
- Short incubation of disc diffusion for Streptococcus pneumoniae and Haemophilus influenzae to reduce time to susceptibility report.The Journal of antimicrobial chemotherapy · 2023Article
- Molecular epidemiology and antibiotic resistance profiles of invasiveFrontiers in microbiology · 2022Article
- Haemophilus influenzae one day in Denmark: prevalence, circulating clones, and dismal resistance to aminopenicillins.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Article
- Phenotypic detection of clinical isolates of Haemophilus influenzae with altered penicillin-binding protein 3.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2018Article
- A novel PBP3 substitution in Haemophilus influenzae confers reduced aminopenicillin susceptibility.BMC microbiology · 2018Article
- Ampicillin resistance inInternational journal of chronic obstructive pulmonary disease · 2017Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Haemophilus influenzae is a major pathogen, and beta-lactams are first-line drugs. Resistance due to altered penicillin-binding protein 3 (rPBP3) is frequent, and susceptibility testing of such strains is challenging. A collection of 154 beta-lactamase-negative isolates with a large proportion of rPBP3 (67.5%) was used to evaluate and compare Etest (Haemophilus test medium [HTM]) and disk diffusion (EUCAST method) for categorization of susceptibility to aminopenicillins and cefuroxime, using MICs generated with broth (HTM) microdilution and clinical breakpoints from CLSI and EUCAST as the gold standards. In addition, the proficiency of nine disks in screening for the rPBP3 genotype (N526K positive) was evaluated. By Etest, both essential and categorical agreement were generally poor (<70%), with high very major errors (VME) (CLSI, 13.0%; EUCAST, 34.3%) and falsely susceptible rates (FSR) (CLSI, 87.0%; EUCAST, 88.3%) for ampicillin. Ampicillin (2 μg) with adjusted (+2 mm) zone breakpoints was superior to Etest for categorization of susceptibility to ampicillin (agreement, 74.0%; VME, 11.0%; FSR, 28.3%). Conversely, Etest was superior to 30 μg cefuroxime for categorization of susceptibility to cefuroxime (agreement, 57.1% versus 60.4%; VME, 2.6% versus 9.7%; FSR, 7.1% versus 26.8%). Benzylpenicillin (1 unit) (EUCAST screening disk) and cefuroxime (5 μg) identified rPBP3 isolates with highest accuracies (95.5% and 92.2%, respectively). In conclusion, disk screening reliably detects rPBP3 H. influenzae, but false ampicillin susceptibility is frequent with routine methods. We suggest adding a comment recommending high-dose aminopenicillin therapy or the use of other agents for severe infections with screening-positive isolates that are susceptible to aminopenicillins by gradient or disk diffusion.
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