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High prevalence of nasal carriage of β-lactamase-negative ampicillin-resistant Haemophilus influenzae in healthy children in Korea

  • S. M. BAE (a1), J. H. LEE (a1), S. K. LEE (a1), J. Y. YU (a1), S. H. LEE (a2) and Y. H. KANG (a1)...

This study investigated the carriage of antimicrobial resistant Haemophilus influenzae in 582 healthy children attending kindergarten or elementary school at four intervals over a 9-month period in Seoul, Korea. Diverse colonization patterns and a lower level of long-term persistent carriage by H. influenzae status were evident in this study. Colonizing H. influenzae isolates showed a high rate of resistance to β-lactams including ampicillin (51·9%), cefaclor (52·1%), and amoxicillin/clavulanate (16·3%). Based on the ampicillin resistance mechanism, H. influenzae isolates were categorized as β-lactamase-negative, ampicillin-susceptible (BLNAS) (48·1%), β-lactamase-positive, ampicillin-resistant (BLPAR) (22·6%), β-lactamase-negative, ampicillin-resistant (BLNAR) (22·8%), and β-lactamase-positive, amoxicillin/clavulanate-resistant (BLPACR) strains (6·5%). This study provides the first evidence of a high prevalence (22·8%) of BLNAR strains of H. influenzae nasal carriage in healthy children attending kindergarten or the first 2 years of elementary school in Korea. The high carriage of these resistant strains in overcrowded urban settings may create reservoirs for development of H. influenzae-resistant strains.

Corresponding author
*Author for correspondence: Y. H. Kang, Director, Division of Bacterial Respiratory Infections, Center for Infectious Diseases, National Institute of Health, Korea Centers for Disease Control and Prevention, Osong Health Technology Administration Complex, 643, Yeonje-ri, Gangoe-myeon, Cheongwon-gun, Chungcheongbuk-do, 363-951, Korea. (Email:
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1. MM Pettigrew , Microbial interactions during upper respiratory tract infections. Emerging Infectious Diseases 2008; 14: 15841591.

2. TF Murphy , LO Bakaletz , PR Smeesters . Microbial interactions in the respiratory tract. Pediatric Infectious Diseases Journal 2009; 28: S121126.

4. RP Rennie , KH Ibrahim . Antimicrobial resistance in Haemophilus influenzae: how can we prevent the inevitable? Commentary on antimicrobial resistance in H. influenzae based on data from the TARGETed surveillance program. Clinical Infectious Disease 2005; 41 (Suppl. 4): S234238.

5. S Bae , Antimicrobial resistance in Haemophilus influenzae respiratory tract isolates in Korea: results of a nationwide acute respiratory infections surveillance. Antimicrobial Agents and Chemotherapy 2010; 54: 6571.

6. R Dagan , Evidence to support the rationale that bacterial eradication in respiratory tract infection is an important aim of antimicrobial therapy. Journal of Antimicrobial Chemotherapy 2001; 47: 129140.

7. García-Rodríguez , MJ Frensnadillo Martínez . Dynamics of nasopharyngeal colonization by potential respiratory pathogens. Journal of Antimicrobial Chemotherapy 2002; 50: S2, 5973.

8. S Bae , Nasal colonization of four potential respiratory bacteria in healthy children attending kindergarten or elementary school in Seoul, Korea. Journal of Medical Microbiology 2012; 61: 678685.

12. D Fontanals , Prevalence of Haemophilus influenzae carriers in the Catalan preschool population. European Journal of Clinical Microbiology and Infectious Diseases 2000; 19: 301304.

14. N Principi , Risk factors for carriage of respiratory pathogens in the nasopharynx of healthy children. Ascanius Project Collaborative Group. Pediatric Infectious Diseases Journal 1999; 18: 517523.

16. S Shin , Y Shin , M Ki . Cost-benefit analysis of Haemophilus influenzae type b immunization in Korea. Journal of Korean Medical Science 2008; 23: 176184.

18. R Sá-Leão , High rates of transmission of and colonization by Streptococcus pneumoniae and Haemophilus influenzae within a day care center revealed in a longitudinal study. Journal of Clinical Microbiology 2008; 46: 225234.

19. K Hashida , Nasopharyngeal Haemophilus influenzae carriage in Japanese children attending day-care centers. Journal of Clinical Microbiology 2008; 46: 876881.

20. S Tristram , MR Jacobs , PC Appelbaum . Antimicrobial resistance in Haemophilus influenzae. Clinical Microbiology Reviews 2007; 20: 368389.

21. S García-Cobos , Ampicillin-resistant non-β-lactamase-producing Haemophilus influenzae in Spain: recent emergence of clonal isolates with increased resistance to cefotaxime and cefixime. Antimicrobial Agents and Chemotherapy 2007; 51: 25642573.

22. K Masuda , Incidences of nasopharyngeal colonization of respiratory bacterial pathogens in Japanese children attending day-care centers. Pediatrics International 2002; 44: 376380.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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