Authors: Helena Žemličková; Vladislav Jakubů; Lucia Mališová; Iveta Vrbová; Markéta Čechová Authors‘ workplace: Národní referenční laboratoř pro antibiotika, Státní zdravotní ústav, Praha ; Ústav mikrobiologie, 3. lékařská fakulta, Univerzita Karlova, Fakultní nemocnice Královské Vinohrady a Státní zdravotní ústav, Praha Published in: Čes-slov Pediat 2026; 81 (2): 88-93. Category: doi: https://doi.org/10.55095/CSPediatrie2026/012
Žemličková H, Jakubů V, Mališová L, Vrbová I, Čechová M. Factors influencing antibiotic resistance in Haemophilus influenzae
Haemophilus influenzae is a common part of the microflora of the upper respiratory tract, and is also one of the main causative agents of a wide range of diseases from uncomplicated respiratory tract infections to life-threatening infections. Traditional drugs for the treatment of hemophilic infections are beta-lactam antibiotics. Resistance to beta-lactams in hemophili is caused by the production of beta-lactamase or arises on the basis of mutations in the ftsI gene encoding penicillin-binding protein 3. These strains are referred to as rPBP3 (genotype showing a mutation in the ftsI transpeptidase region). According to the results of antibiotic resistance surveillance, the proportion of H. influenzae strains of the rPBP3 genotype is increasing in the Czech Republic. There is an assumption that cefuroxime stimulates the formation of rPBP3 H. influenzae more than aminopenicillins. In the Czech Republic, the proportion of rPBP3 strains increased during the same period when the consumption of cefuroxime increased twofold.
The aim of the project NU21-09-00028, Characterization of Haemophilus influenzae strains with non-enzymatic resistance to beta-lactam antibiotics in the Czech Republic (2020–2024), was to assess possible risk factors associated with the development of non-enzymatic resistance in H. influenzae. Phylogenetic analysis did not demonstrate the spread of a specific clone. In vitro investigation of the effect of ampicillin and cefuroxime on the selection of mutations in the ftsI gene revealed differences in the selection potential of both antibiotics. It was shown that both antibiotics have the potential to cause mutations in PBP3, but exposure to cefuroxime tends to generate mutations more frequently compared to ampicillin. Also, in H. influenzae strains passaged in increasing concentrations of cefuroxime, there was a greater increase in the minimum inhibitory concentration compared to ampicillin. The increase in the prevalence of non-enzymatic resistance to beta-lactams in the Czech Republic was therefore probably more related to the increasing consumption of cefuroxime and increased selection pressure.
Antibiotic resistance – Haemophilus influenzae – cefuroxim
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