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The aim of this study was to assess the antimicrobial susceptibility of 1370 Haemophilus spp. (1051 H. influenzae and 319 H. parainfluenzae) isolated during a 4-year period (July 2000 to June 2004) and to compare the results with other nationwide Spanish surveillance studies. The rate of isolation of H. parainfluenzae was significantly higher in clinical samples from the genitourinary tract (p <0.00001) and skin and soft tissues (p <0.00001), whereas H. influenzae was significantly more frequent in clinical respiratory tract samples (p <0.00001). A total of 46.2% and 31.8% of H. influenzae were isolated in infants and children of 2-6 years old, respectively; whereas 73.3% of H. parainfluenzae was isolated in patients older than age 14. Overall, 22.2% and 18.5% of the H. influenzae and H. parainfluenzae, respectively, were found to produce betalactamase. A total of 1.9% of betalactamase-negative H. influenzae were found to be resistant to ampicillin. Four strains (0.4%) of betalactamase-producing H. influenzae were resistant to amoxicillin-clavulanic acid, all isolated from infants. The rate of ampicillin susceptibility was significantly higher (p <0.01) in H. parainfluenzae than in H. influenzae. All of the 1370 strains of Haemophilus spp. were susceptible to cefotaxime and ciprofloxacin. The susceptibility to clarithromycin, trimethoprim-sulfamethoxazole, tetracycline, chloramphenicol and rifampin were 86.9%, 61.5%, 96.7%, 99.1% and 95.2% for H. influenzae versus 81.2%, 55.8%, 76.5%, 90,9% and 733% for H. parainfluenzae. In conclusion, H. influenzae is more resistant to ampicillin and H. parainfluenzae to non-betalactam antimicrobials. All isolates were susceptible to cefotaxime and ciprofloxacin.

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El objetivo de este estudio retrospectivo fue evaluar la sensibilidad antibiótica de 1370 cepas de Haemophilus spp. (1051 H. influenzae y319 H. parainfluenzae) aisladas durante cuatro años (julio de 2000 a junio de 2004), y comparar estos datos entre sí y con los resultadosobtenidos en otras zonas de España. En las muestras del aparato genitourinario (p <0.00001) y de piel y tejidos blandos (p <0.00001) seaisló con más frecuencia H. parainfluenzae, mientras que en las procedentes del aparato respiratorio y anejos predominó H. influenzae(p <0.00001). El 46,2% y el 31,8% de H. influenzae se aislaron en lactantes y niños de 2 a 6 años, respectivamente, mientras que el 73,3%de H. parainfluenzae se aisló en pacientes mayores de 14 años. La prevalencia de la producción de betalactamasas fue del 22,2% en H. influenzaey el 18,5% en H. parainfluenzae. La resistencia a la ampicilina sin producción de betalactamasas se encontró en el 1,9% de H. influenzae.Cuatro cepas (0,4%) de H. influenzae productoras de betalactamasas fueron resistentes a amoxicilina-ácido clavulánico, todas aisladas de lactantes.La sensibilidad a la ampicilina es mayor (p <0.01) en H. parainfluenzae que en H. influenzae. Las 1370 cepas de Haemophilus spp.fueron sensibles a cefotaxima y ciprofloxacino. La sensibilidad a claritromicina, cotrimoxazol, tetraciclina, cloranfenicol y rifampicina fue del86,9%, 61,5%, 96,7%, 99,1% y 95,2% en H. influenzae, y del 81,2%, 55,8%, 76,5%, 90,9% y 73,3% en H. parainfluenzae, respectivamente.En conclusión, H. influenzae es más resistente a la ampicilina y H. parainfluenzae es más resistente a los antimicrobianos no betalactámicos.Todas las cepas de Haemophilus spp. fueron sensibles a cefotaxima y ciprofloxacino

The aim of this study was to assess the antimicrobial susceptibility of 1370 Haemophilus spp. (1051 H. influenzae and 319 H. parainfluenzae)isolated during a 4-year period (July 2000 to June 2004) and to compare the results with other nationwide Spanish surveillance studies. Therate of isolation of H. parainfluenzae was significantly higher in clinical samples from the genitourinary tract (p <0.00001) and skin and softtissues (p <0.00001), whereas H. influenzae was significantly more frequent in clinical respiratory tract samples (p <0.00001). A total of46.2% and 31.8% of H. influenzae were isolated in infants and children of 2-6 years old, respectively; whereas 73.3% of H. parainfluenzaewas isolated in patients older than age 14. Overall, 22.2% and 18.5% of the H. influenzae and H. parainfluenzae, respectively, were foundto produce betalactamase. A total of 1.9% of betalactamase-negative H. influenzae were found to be resistant to ampicillin. Four strains(0.4%) of betalactamase-producing H. influenzae were resistant to amoxicillin-clavulanic acid, all isolated from infants. The rate of ampicillinsusceptibility was significantly higher (p <0.01) in H. parainfluenzae than in H. influenzae. All of the 1370 strains of Haemophilus spp.were susceptible to cefotaxime and ciprofloxacin. The susceptibility to clarithromycin, trimethoprim-sulfamethoxazole, tetracycline, chloramphenicoland rifampin were 86.9%, 61.5%, 96.7%, 99.1% and 95.2% for H. influenzae versus 81.2%, 55.8%, 76.5%, 90,9% and 733%for H. parainfluenzae. In conclusion, H. influenzae is more resistant to ampicillin and H. parainfluenzae to non-betalactam antimicrobials.All isolates were susceptible to cefotaxime and ciprofloxacin

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INTRODUCTION: Bacterial conjunctivitis is a self-limiting process, but topical antibiotic treatment is recommended to eradicate the pathogen and reduce symptom duration. Since this treatment is usually empirical and prior cultures are not normally taken, the etiological agents involved in the process are unknown. PATIENTS AND METHODS: A total of 596 conjunctival exudates from pediatric outpatients with a diagnosis of acute conjunctivitis in Medical Area 6 of Madrid, Spain, were studied over 3 years (from 2000 to 2002 inclusive). The patients were divided into three age groups: group 1 (infants), group 2 (2- to 6-year-olds) and group 3 (7- to 14-year-olds). RESULTS: A total of 428 bacteria were isolated. The most prevalent bacteria were Haemophilus influenzae (44.8 %) and Streptococcus pneumoniae (30.6 %) followed by Staphylococcus aureus (7.5 %), S. viridans (7.2 %), Moraxella catarrhalis (6.8 %) and Enterobacteriaceae (4.2 %). In 56 exudates (15.1 %), two or more bacteria were isolated and S. pneumoniae 1 H. influenzae were found in 8.1 % of the cases. By age group, S. aureus was significantly more prevalent (p < 0.0001) in group 3 than in groups 1 and 2. Isolation of Enterobacteriaceae, S. viridans and non-fermentative Gram negative bacilli was significantly more frequent (p < 0.05) in group 1 and isolation of S. pneumoniae (p < 0.05) was significantly more frequent in group 2. S. pneumoniae showed the greatest level of resistance to antibiotics used in eye drops and ophthalmic ointments. Ciprofloxacin, chloramphenicol and rifampin were active in the most prevalent pathogens. CONCLUSIONS: The most prevalent bacteria were H. influenzae and S. pneumoniae. The most active antibiotics in these pathogens were ciprofloxacin, chloramphenicol and rifampin.

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Introducción. La conjuntivitis bacteriana es un proceso autolimitado, pero se recomienda antibioticoterapia tópica para erradicar el patógeno y acortar la duración de los síntomas. Este tratamiento habitualmente es empírico, sin cultivo previo y por lo tanto sin conocer los agentes etiológicos implicados en el proceso. Pacientes y métodos. Se revisaron los aislamientos de 596 exudados conjuntivales de los últimos 3 años (2000-2002), procedentes de pacientes pediátricos extrahospitalarios del área 6 de Madrid, con diagnóstico de conjuntivitis aguda. Los pacientes se dividieron en tres grupos de edades: grupo 1, lactantes; grupo 2, entre 2 y 6 años, y grupo 3, entre 7 y 14 años. Resultados. Se aislaron un total de 428 bacterias: Haemophilus influenzae (44,8 por ciento) y Streptococcus pneumoniae (30,6 por ciento) fueron las bacterias más prevalentes, seguidas por Staphylococcus aureus (7,5 por ciento), Streptococcus grupo viridans (7,2 por ciento), Moraxella catarrhalis (6,8 por ciento) y Enterobacteriaceae (4,2 por ciento). En 56 exudados (15,1 por ciento) se aislaron dos o más bacterias, siendo en el 8,1 por ciento de los casos S. pneumoniae + H. influenzae. Por grupos de edades se encontró que S. aureus fue significativamente más frecuente (p < 0,0001) en los niños del grupo 3 que en los de los grupos 1 y 2. Enterobacteriaceae, Streptococcus grupo viridans y los bacilos gramnegativos no fermentadores (BGNNF) se aíslan significativamente con más frecuencia (p < 0,05) en el grupo 1 y S. pneumoniae (p < 0,05) en el grupo 2. S. pneumoniae ha sido la bacteria que ha presentado un mayor nivel de resistencia a los antimicrobianos de uso en colirios o pomadas oftálmicas. Ciprofloxacino, cloranfenicol y rifampicina fueron activos en la mayoría de los patógenos más prevalentes. Conclusiones. H. influenzae y S. pneumoniae fueron las bacterias más prevalentes. Ciprofloxacino, cloranfenicol y rifampicina fueron los antibióticos más activos frente a estos patógenos (AU)

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