Publication
Assessment of trimethoprim-sulfamethoxazole susceptibility testing methods for fastidious Haemophilus spp
| dc.contributor.author | Sierra, Y. | |
| dc.contributor.author | Tubau, F. | |
| dc.contributor.author | González-Díaz, A. | |
| dc.contributor.author | Carrera-Salinas, A. | |
| dc.contributor.author | Moleres, J. | |
| dc.contributor.author | Bajanca-Lavado, P. | |
| dc.contributor.author | Garmendia, J. | |
| dc.contributor.author | Domínguez, M. Ángeles | |
| dc.contributor.author | Ardanuy, C. | |
| dc.contributor.author | Martí, S. | |
| dc.date.accessioned | 2020-04-21T19:17:04Z | |
| dc.date.available | 2020-12-04T01:30:12Z | |
| dc.date.issued | 2019-12-04 | |
| dc.description.abstract | To compare the determinants of trimethoprim-sulfamethoxazole resistance with established susceptibility values for fastidious Haemophilus spp., to provide recommendations for optimal trimethoprim-sulfamethoxazole measurement. We collected 50 strains each of Haemophilus influenzae and Haemophilus parainfluenzae at Bellvitge University Hospital. Trimethoprim-sulfamethoxazole susceptibility was tested by microdilution, E-test and disc diffusion using both Mueller-Hinton fastidious (MH-F) medium and Haemophilus test medium (HTM) following EUCAST and CLSI criteria, respectively. Mutations in folA, folP and additional determinants of resistance were identified in whole-genome-sequenced isolates. Strains presented generally higher rates of trimethoprim-sulfamethoxazole resistance when grown on HTM than on MH-F, independent of the methodology used (average MIC 2.6-fold higher in H. influenzae and 1.2-fold higher in H. parainfluenzae). The main resistance-related determinants were as follows: I95L and F154S/V in folA; 3- and 15-bp insertions and substitutions in folP; acquisition of sul genes; and FolA overproduction potentially linked to mutations in -35 and -10 promoter motifs. Of note, 2 of 19 H. influenzae strains (10.5%) and 9 of 33 H. parainfluenzae strains (27.3%) with mutations and assigned as resistant by microdilution were inaccurately considered susceptible by disc diffusion. This misinterpretation was resolved by raising the clinical resistance breakpoint of the EUCAST guidelines to ≤30 mm. Given the routine use of disc diffusion, a significant number of strains could potentially be miscategorized as susceptible to trimethoprim-sulfamethoxazole despite having resistance-related mutations. A simple modification to the current clinical resistance breakpoint given by the EUCAST guideline for MH-F ensures correct interpretation and correlation with the reference standard method of microdilution. | pt_PT |
| dc.description.sponsorship | This study has been funded by Instituto de Salud Carlos III through the Projects from the Fondo de Investigaciones Sanitarias “PI16/00977” to SM, and CIBER de Enfermedades Respiratorias (CIBERES - CB06/06/0037), co-funded by the European Regional Development Fund/European Social Fund (ERDF/ESF, “Investing in your future”), and the Ministerio de Ciencia, Innovación y Universidades through the Projects SAF2015-66520-R and RTI2018-096369-B-I00 to JG. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Clin Microbiol Infect. 2019 Dec 4;S1198-743X(19)30624-X. doi: 10.1016/j.cmi.2019.11.022. Online ahead of print. | pt_PT |
| dc.identifier.doi | 10.1016/j.cmi.2019.11.022 | pt_PT |
| dc.identifier.issn | 1198-743X | |
| dc.identifier.uri | http://hdl.handle.net/10400.18/6475 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier/ European Society of Clinical Microbiology and Infectious Diseases | pt_PT |
| dc.relation.publisherversion | https://linkinghub.elsevier.com/retrieve/pii/S1198-743X(19)30624-X | pt_PT |
| dc.subject | Antimicrobial Susceptibility Testing Methods | pt_PT |
| dc.subject | Trimethoprim-sulfamethoxazole | pt_PT |
| dc.subject | Haemophilus Parainfluenzae | pt_PT |
| dc.subject | Eucast Breakpoints | pt_PT |
| dc.subject | Resistance-related Determinants | pt_PT |
| dc.subject | Haemophilus Influenzae | pt_PT |
| dc.subject | Clinical Resistance Breakpoint | pt_PT |
| dc.subject | Infecções Respiratórias | pt_PT |
| dc.title | Assessment of trimethoprim-sulfamethoxazole susceptibility testing methods for fastidious Haemophilus spp | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.title | Clinical Microbiology and Infection | pt_PT |
| rcaap.embargofct | De acordo com política editorial da revista. | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |