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Antimicrobial Agents and Chemotherapy, February 2007, p. 453-460, Vol. 51, No. 2
0066-4804/07/$08.00+0     doi:10.1128/AAC.00960-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Diversity of Ampicillin Resistance Genes and Antimicrobial Susceptibility Patterns in Haemophilus influenzae Strains Isolated in Korea{triangledown}

In-Suk Kim,1 Chang-Seok Ki,2 Sunjoo Kim,1 Won Sup Oh,3 Kyong Ran Peck,3 Jae-Hoon Song,3 Kyungwon Lee,4 and Nam Yong Lee2*

Department of Laboratory Medicine, Gyeong-Sang National University College of Medicine, Jinju, Korea,1 Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea,2 Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea,3 Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea4

Received 2 August 2006/ Returned for modification 17 October 2006/ Accepted 7 November 2006

By Etest determination of the susceptibilities of 229 Haemophilus influenzae strains isolated in Korea to 10 antibiotics, the isolates were found to be antibiotic nonsusceptible in the following order: ampicillin (58.1%), trimethoprim-sulfamethoxazole (52%), cefaclor (41.1%), clarithromycin (25.8%), chloramphenicol (14.0%), amoxicillin-clavulanic acid (13.5%), meropenem (11.7%), cefixime (10.9%), cefuroxime (9.2%), and levofloxacin (1.3%). The prevalences of each resistance class were 23.6% for ß-lactamase-negative ampicillin-susceptible (BLNAS) strains; 37.6% for strains with the TEM-1 type ß-lactamase gene; 1.3% for strains with the ROB-1 type ß-lactamase gene; 29.3% for the ß-lactamase-negative ampicillin-resistant (BLNAR) strains with a mutation in the ftsI gene, which encodes PBP 3; and 8.3% for ß-lactamase-positive amoxicillin-clavulanate-resistant (BLPACR) strains, which showed both resistance mechanisms (i.e., a ß-lactamase gene and a mutation in the ftsI gene). The MIC50s of all ß-lactams, including cephem and meropenem agents, for the BLNAR strains were two to three times higher than those for the BLNAS strains. This study confirms that the prevalence of BLNAR and BLPACR strains is relatively high and for the first time confirms the presence of H. influenzae strains carrying blaROB-1 in Korea. Even though mutations in another gene(s) might be involved in ß-lactam resistance, these results suggest that mutations in the ftsI gene are important for the development of resistance to ß-lactams in H. influenzae strains in Korea.

* Corresponding author. Mailing address: Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, Korea 135-710. Phone: 82-2-3410-2706. Fax: 82-2-3410-2719. E-mail: micro.lee{at}samsung.com.

{triangledown} Published ahead of print on 20 November 2006.

Antimicrobial Agents and Chemotherapy, February 2007, p. 453-460, Vol. 51, No. 2
0066-4804/07/$08.00+0     doi:10.1128/AAC.00960-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



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