The prevalence and antimicrobial resistance of Haemophilus influenzae in prepubertal girls with vulvovaginitis release_pgxmotc525esvmpm3ubrasl5sa

Abstract

<jats:title>Abstract</jats:title> <jats:bold>Background: </jats:bold>To determine the prevalence of <jats:italic>Haemophilus influenzae</jats:italic> vulvovaginitis in prepubertal girls and the antimicrobial resistance of <jats:italic>H.influenzae </jats:italic>strains isolated from vulval specimens.<jats:bold>Methods:</jats:bold> Isolates of <jats:italic>H.influenzae</jats:italic> from vulval swabs of prepubertal girls with vulvovaginitis received at The Children's Hospital, Zhejiang University School of Medicine during 2016-2019 were studied. Vulval specimens were inoculated on <jats:italic>Haemophilus</jats:italic> selective chocolate agar. Antimicrobial susceptibility tests were performed using the disk diffusion method. A cefinase disk was used to detect <jats:italic>β</jats:italic>-lactamase. <jats:bold>Results</jats:bold>: A total of 4142 vulval specimens were received during the 4 years, 649 isolates of <jats:italic>H. influenzae </jats:italic>were isolated from 642 girls aged 6 months to 13 years, with a median of 5y. There were peaks of isolates from April to July seen in the vulval isolates. In total, the ampicillin resistance rate was 39.1% (250/640); 33.2% strains (211/636) were for <jats:italic>β</jats:italic>-lactamase-positive isolates, 6.6% strains (42/635) were <jats:italic>β</jats:italic>-lactamase-negative and ampicillin-resistant (BLNAR) isolates. The resistance rates of <jats:italic>H. influenzae</jats:italic> isolates to amoxycillin-clavulanic acid, ampicillin-sulbactam, cefuroxime, ceftriaxone, cefotaxime, meropenem, levofloxacin, sulfamethoxazole-trimethoprim, azithromycin, and chloramphenicol were 26.4%, 21.8%, 24.8%, 1.7%, 1.0%, 0.2%, 0%, 47.7%, 10.2%, and 1.1%, respectively. MDR was present in 41 (6.4%) of the 642 <jats:italic>H. influenzae</jats:italic> isolates, with the most prevalent MDR phenotype of ampicillin-sulfamethoxazole-trimethoprim-azithromycin resistance. <jats:bold>Conclusions</jats:bold>:<jats:italic> H. influenzae </jats:italic>is a common cause of vulvovaginitis in prepubertal girls. Laboratories should ensure that they include media appropriate for the isolation of <jats:italic>H. influenzae</jats:italic>. It's worth noting of ampicillin resistance of <jats:italic>H. influenzae </jats:italic>in clinical management.
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