Microbiologic and virulence characteristics of Moraxella catarrhalis isolates from Zambian children presenting with acute pneumonia.
Moraxella catarrhalis
antimicrobial resistance
induced sputum
pneumonia
virulence genes
Journal
Pediatric pulmonology
ISSN: 1099-0496
Titre abrégé: Pediatr Pulmonol
Pays: United States
ID NLM: 8510590
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
revised:
18
07
2022
received:
05
12
2021
accepted:
27
08
2022
pubmed:
4
9
2022
medline:
22
11
2022
entrez:
3
9
2022
Statut:
ppublish
Résumé
Moraxella catarrhalis is one of the bacterial pathogens associated with childhood pneumonia, but its clinical importance is not clearly defined. This study aimed to investigate the microbiologic and virulence characteristics of M. catarrhalis isolates obtained from children with pneumonia in Lusaka, Zambia. This retrospective, cross-sectional study analyzed 91 M. catarrhalis isolates from induced sputum samples of children less than 5 years of age with pneumonia enrolled in the Pneumonia Etiology Research for Child Health study in Lusaka, Zambia between 2011 and 2014. Bacteria identification and virulence genes detection were performed by PCR and DNA sequencing, while antimicrobial susceptibility testing was determined by the Kirby-Bauer method. All the M. catarrhalis isolates were obtained from good-quality sputum samples and were the predominant bacteria. These isolates harbored virulence genes copB (100%), ompE (69.2%), ompCD (71.4%), uspA1 (92.3%), and uspA2 (69.2%) and were all β-lactamase producers. They showed resistance to ampicillin (100%), amoxicillin (100%), trimethoprim-sulfamethoxazole (92.3%), ciprofloxacin (46.2%), chloramphenicol (45.1%), erythromycin (36.3%), tetracycline (25.3%), cefuroxime (11.0%), and amoxicillin-clavulanate (2.2%), with 71.4% displaying multi-drug resistant phenotype but all susceptible to imipenem (100%). This study showed that M. catarrhalis isolates were the predominant or only bacterial isolates from the sputum samples analyzed. The findings provide supportive evidence for the pathogenic potential role of this bacterium in pediatric pneumonia. High multidrug resistance was also observed amongst the isolates, which can result in affected patients not responding to standard treatment, leading to prolonged illness, increased healthcare costs, and risk of death.
Sections du résumé
BACKGROUND
Moraxella catarrhalis is one of the bacterial pathogens associated with childhood pneumonia, but its clinical importance is not clearly defined.
OBJECTIVE
This study aimed to investigate the microbiologic and virulence characteristics of M. catarrhalis isolates obtained from children with pneumonia in Lusaka, Zambia.
METHODS
This retrospective, cross-sectional study analyzed 91 M. catarrhalis isolates from induced sputum samples of children less than 5 years of age with pneumonia enrolled in the Pneumonia Etiology Research for Child Health study in Lusaka, Zambia between 2011 and 2014. Bacteria identification and virulence genes detection were performed by PCR and DNA sequencing, while antimicrobial susceptibility testing was determined by the Kirby-Bauer method.
RESULTS
All the M. catarrhalis isolates were obtained from good-quality sputum samples and were the predominant bacteria. These isolates harbored virulence genes copB (100%), ompE (69.2%), ompCD (71.4%), uspA1 (92.3%), and uspA2 (69.2%) and were all β-lactamase producers. They showed resistance to ampicillin (100%), amoxicillin (100%), trimethoprim-sulfamethoxazole (92.3%), ciprofloxacin (46.2%), chloramphenicol (45.1%), erythromycin (36.3%), tetracycline (25.3%), cefuroxime (11.0%), and amoxicillin-clavulanate (2.2%), with 71.4% displaying multi-drug resistant phenotype but all susceptible to imipenem (100%).
CONCLUSION
This study showed that M. catarrhalis isolates were the predominant or only bacterial isolates from the sputum samples analyzed. The findings provide supportive evidence for the pathogenic potential role of this bacterium in pediatric pneumonia. High multidrug resistance was also observed amongst the isolates, which can result in affected patients not responding to standard treatment, leading to prolonged illness, increased healthcare costs, and risk of death.
Substances chimiques
Anti-Bacterial Agents
0
Amoxicillin
804826J2HU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3084-3093Informations de copyright
© 2022 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.
Références
Mikula KM, Kolodziejczyk R, Goldman A. Structure of the uspa1 protein fragment from Moraxella catarrhalis responsible for c3d binding. J Struct Biol. 2019;208:77-85.
Sy MG, Robinson JL. Community-acquired Moraxella catarrhalis pneumonia in previously healthy children. Pediatr Pulmonol. 2010;45:674-678.
Chochua S, D'Acremont V, Hanke C, et al. Increased nasopharyngeal density and concurrent carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are associated with pneumonia in febrile children. PLoS One. 2016;11:e0167725.
Bernhard S, Spaniol V, Aebi C. Molecular pathogenesis of infections caused by moraxella catarrhalis in children. Swiss Med Wkly. 2012;142:w13694.
Shi W, Wen D, Chen C, et al. Β-lactamase production and antibiotic susceptibility pattern of Moraxella catarrhalis isolates collected from two county hospitals in China. BMC Microbiol. 2018;18:1-6.
Saito R, Nonaka S, Fujinami Y, et al. The frequency of bro β-lactamase and its relationship to antimicrobial susceptibility and serum resistance in Moraxella catarrhalis. J Infect Chemother. 2014;20:6-8.
Du Y, Zhou H, Wang F, et al. Multilocus sequence typing-based analysis of Moraxella catarrhalis population structure reveals clonal spreading of drug-resistant strains isolated from childhood pneumonia. Infect Genet Evol. 2017;56:117-124.
Mulu W, Yizengaw E, Alemu M, et al. Pharyngeal colonization and drug resistance profiles of Moraxella catarrrhalis, Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae among HIV infected children attending art clinic of Felege Hiwot referral hospital, Ethiopia. PLoS One. 2018;13:e0196722.
Weimer KE, Juneau RA, Murrah KA, et al. Divergent mechanisms for passive pneumococcal resistance to β-lactam antibiotics in the presence of Haemophilus influenzae. J Infect Dis. 2011;203:549-555.
Perez AC, Pang B, King LB, et al. Residence of Streptococcus pneumoniae and Moraxella catarrhalis within polymicrobial biofilm promotes antibiotic resistance and bacterial persistence in vivo. Pathog Dis. 2014;70:280-288.
Simusika P, Bateman AC, Theo A, et al. Identification of viral and bacterial pathogens from hospitalized children with severe acute respiratory illness in Lusaka, Zambia, 2011-2012: a cross-sectional study. BMC Infect Dis. 2015;15:1-10.
O'Brien KL, Baggett HC, Brooks WA, et al. Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the perch multi-country case-control study. Lancet. 2019;394:757-779.
Popova G, Boskovska K, Arnaudova-Danevska I, Smilevska-Spasova O, Jakovska T. Sputum quality assessment regarding sputum culture for diagnosing lower respiratory tract infections in children. Open Access Maced J Med Sci. 2019;7:1926-1930.
Sethi S, Surface J, Murphy T. Antigenic heterogeneity and molecular analysis of CopB of Moraxella (Branhamella) catarrhalis. Infect Immun. 1997;65:3666-3671.
Magiorakos A-P, Srinivasan A, Carey Rt, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18:268-281.
Clinical and Laboratory Standards Institute (CLSI). Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria; Approved Guideline. M45-A. 2014; 26:28-29.
Aebi C. Moraxella catarrhalis-pathogen or commensal? Adv Exp Med Biol. 2011;697:107-116.
Mitov IG, Gergova RT, Ouzounova-Raykova VV. Distribution of genes encoding virulence factors ompb2, ompcd, ompe, β-lactamase and serotype in pathogenic and colonizing strains of Moraxella catarrhalis. Arch Med Res. 2010;41:530-535.
Kumar S, Stecher G, Li M, Knyaz C, Tamura K. Mega X: molecular evolutionary genetics analysis across computing platforms. Mol Biol Evol. 2018;35:1547-1549.
The European Committee on Antimicrobial Susceptibility Testing. Breakpoint Tables for Interpretation of MICs and Zone Diameters, Version 11.0. 2021. Accessed July 7, 2021. http://www.eucast.org
Verduin CM, Hol C, Fleer A, van Dijk H, van Belkum A. Moraxella catarrhalis: from emerging to established pathogen. Clin Microbiol Rev. 2002;15:125-144.
Prashanth H, Saldanha R, Shenoy S. Moraxella catarrhalis-a rediscovered pathogen. Int J Biol Med Res. 2011;2:979-981.
Vaneechoutte M, Verschraegen G, Claeys G, Weise B, Van den Abeele AM. Respiratory tract carrier rates of Moraxella (Branhamella) catarrhalis in adults and children and interpretation of the isolation of M. catarrhalis from sputum. J Clin Microbiol. 1990;28:2674-2680.
Anezaki H, Terada N, Kawamura T, Kurai H. Moraxella catarrhalis bacteremic pneumonia. IDCases. 2020;19:e00712.
Tsitsiklis A, Osborne CM, Kamm J, et al. Lower respiratory tract infections in children requiring mechanical ventilation: a multicentre prospective surveillance study incorporating airway metagenomics. Lancet Microbe. 2022;3:e284-e293.
Verhaegh SJ, Streefland A, Dewnarain JK, Farrell DJ, van Belkum A, Hays JP. Age-related genotypic and phenotypic differences in Moraxella catarrhalis isolates from children and adults presenting with respiratory disease in 2001-2002. Microbiology. 2008;154(4):1178-1184.
Hallström T, Nordström T, Tan TT, et al. Immune evasion of Moraxella catarrhalis involves ubiquitous surface protein a-dependent c3d binding. J Immunol. 2011;186:3120-3129.
Verhaegh SJ, Snippe ML, Levy F, et al. Colonization of healthy children by Moraxella catarrhalis is characterized by genotype heterogeneity, virulence gene diversity and co-colonization with Haemophilus influenzae. Microbiology. 2011;157:169-178.
Leung AK, Wong AH, Hon KL. Community-acquired pneumonia in children. Recent Pat Inflamm Allergy Drug Discov. 2018;12:136-144.
Schaar V, Nordström T, Mörgelin M, Riesbeck K. Moraxella catarrhalis outer membrane vesicles carry β-lactamase and promote survival of Streptococcus pneumoniae and Haemophilus influenzae by inactivating amoxicillin. Antimicrob Agents Chemother. 2011;55:3845-3853.
Pfaller MA, Farrell DJ, Sader HS, Jones RN. Aware ceftaroline surveillance program (2008-2010): trends in resistance patterns among Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in the United States. Clin Infect Dis. 2012;55:S187-S193.
Raveendran S, Kumar G, Sivanandan R, Dias M. Moraxella catarrhalis: a cause of concern with emerging resistance and presence of bro beta-lactamase gene-report from a tertiary care hospital in South India. Int J Microbiol. 2020;2020(4):1-5.
Bandet T, Whitehead S, Blondel-Hill E, Wagner K, Cheeptham N. Susceptibility of clinical Moraxella catarrhalis isolates in British Columbia to six empirically prescribed antibiotic agents. Can J Infect Dis Med Microbiol. 2014;25:4-8.
Abdullah FE, Ahuja KR, Kumar H. Prevalence and emerging resistance of Moraxella catarrhalis in lower respiratory tract infections in Karachi. J Pak Med Assoc. 2013;63:1342-1344.
Hamze M, Osman M, Mallat H, El Achkar M. First data on antimicrobial susceptibility patterns of Moraxella catarrhalis isolates in Lebanon. Int Arab J Antimicrob Agents. 2019;9:3.
Samuel S, Noyar T, Ahmed G, Rudrapathy P, Murugesan S. Prevalence and resistance pattern of Moraxella catarrhalis causing respiratory tract infections in cancer patients. Online J Health Allied Scs. 2019;18:10.
Król-Turmińska K, Olender A, Bogut A. Tetracycline resistance in Moraxella catarrhalis clinical strains isolated in Poland. New Microbiol. 2020;43:103-106.
Guitor AK, Wright GD. Antimicrobial resistance and respiratory infections. Chest. 2018;154:1202-1212.
Gupta N, Arora S, Kundra S. Moraxella catarrhalis as a respiratory pathogen. Indian J Pathol and Microbiol. 2011;54:769-771.
Mathur S, Fuchs A, Bielicki J, Van Den Anker J, Sharland M. Antibiotic use for community-acquired pneumonia in neonates and children: who evidence review. Paediatr Int Child Health. 2018;38:S66-S75.