Antimicrobial susceptibility and impact of macrolide antibiotics on Moraxella catarrhalis in the upper and lower airways of children with chronic endobronchial suppuration

Kim Hare, Kate Seib, Anne Chang, Tegan Harris, Jessie Spargo, Heidi Smith-Vaughan

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Introduction: Moraxella catarrhalis is an important but insufficiently studied respiratory pathogen.

Aim: To determine antibiotic susceptibility and impact of recent antibiotics on M. catarrhalis from children with chronic endobronchial suppuration.

Methodology: We cultured nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL) fluids collected from children who were prospectively enrolled in studies of chronic cough and had flexible bronchoscopy performed. Recent β-lactam or macrolide antibiotic use was recorded. M. catarrhalis isolates stored at −80 °C were re-cultured and susceptibility determined to a range of antibiotics including the macrolide antibiotic erythromycin.
Results: Data from concurrently collected NP and BAL specimens were available from 547 children (median age 2.4 years) enrolled from 2007 to 2016. M. catarrhalis NP carriage was detected in 149 (27  %) children and lower airway infection (≥104 c.f.u. ml−1 BAL) in 67 (12  %) children. In total, 91  % of 222 M. catarrhalis isolates were β-lactamase producers, and non-susceptibility was high to benzylpenicillin (98 %), cefaclor (39 %) and cotrimoxazole (38 %). Overall, >97  % isolates were susceptible to cefuroxime, chloramphenicol, erythromycin and tetracycline; three isolates were erythromycin-resistant (MIC >0.5 mg l−1). Recent macrolide antibiotics (n=152 children, 28 %) were associated with significantly reduced M. catarrhalis carriage and lower airway infection episodes compared to children who did not receive macrolides; odds ratios 0.19 (95  % CI 0.10–0.35) and 0.15 (0.04–0.41), respectively.

Conclusion: Despite the frequent use of macrolides, few macrolide-resistant isolates were detected. This suggests a fitness cost associated with macrolide resistance in M. catarrhalis. Macrolide antibiotics remain an effective choice for treating M. catarrhalis lower airway infection in children with chronic endobronchial suppuration.
Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalJournal of Medical Microbiology
Volume68
Issue number8
DOIs
Publication statusE-pub ahead of print - 5 Jul 2019

Fingerprint

Moraxella (Branhamella) catarrhalis
Suppuration
Macrolides
Anti-Bacterial Agents
Erythromycin
Bronchoalveolar Lavage
Infection
Cefaclor
Lactams
Cefuroxime
Penicillin G
Sulfamethoxazole Drug Combination Trimethoprim
Bronchoalveolar Lavage Fluid
Bronchoscopy
Chloramphenicol
Tetracycline
Cough
Odds Ratio
Costs and Cost Analysis

Cite this

@article{9cbfe6c25df2484582749f6bab20b5bc,
title = "Antimicrobial susceptibility and impact of macrolide antibiotics on Moraxella catarrhalis in the upper and lower airways of children with chronic endobronchial suppuration",
abstract = "Introduction: Moraxella catarrhalis is an important but insufficiently studied respiratory pathogen.Aim: To determine antibiotic susceptibility and impact of recent antibiotics on M. catarrhalis from children with chronic endobronchial suppuration.Methodology: We cultured nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL) fluids collected from children who were prospectively enrolled in studies of chronic cough and had flexible bronchoscopy performed. Recent β-lactam or macrolide antibiotic use was recorded. M. catarrhalis isolates stored at −80 °C were re-cultured and susceptibility determined to a range of antibiotics including the macrolide antibiotic erythromycin.Results: Data from concurrently collected NP and BAL specimens were available from 547 children (median age 2.4 years) enrolled from 2007 to 2016. M. catarrhalis NP carriage was detected in 149 (27  {\%}) children and lower airway infection (≥104 c.f.u. ml−1 BAL) in 67 (12  {\%}) children. In total, 91  {\%} of 222 M. catarrhalis isolates were β-lactamase producers, and non-susceptibility was high to benzylpenicillin (98 {\%}), cefaclor (39 {\%}) and cotrimoxazole (38 {\%}). Overall, >97  {\%} isolates were susceptible to cefuroxime, chloramphenicol, erythromycin and tetracycline; three isolates were erythromycin-resistant (MIC >0.5 mg l−1). Recent macrolide antibiotics (n=152 children, 28 {\%}) were associated with significantly reduced M. catarrhalis carriage and lower airway infection episodes compared to children who did not receive macrolides; odds ratios 0.19 (95  {\%} CI 0.10–0.35) and 0.15 (0.04–0.41), respectively.Conclusion: Despite the frequent use of macrolides, few macrolide-resistant isolates were detected. This suggests a fitness cost associated with macrolide resistance in M. catarrhalis. Macrolide antibiotics remain an effective choice for treating M. catarrhalis lower airway infection in children with chronic endobronchial suppuration.",
author = "Kim Hare and Kate Seib and Anne Chang and Tegan Harris and Jessie Spargo and Heidi Smith-Vaughan",
year = "2019",
month = "7",
day = "5",
doi = "10.1099/jmm.0.001033",
language = "English",
volume = "68",
pages = "1--8",
journal = "Journal of Medical Microbiology",
issn = "0022-2615",
publisher = "Society for General Microbiology",
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Antimicrobial susceptibility and impact of macrolide antibiotics on Moraxella catarrhalis in the upper and lower airways of children with chronic endobronchial suppuration. / Hare, Kim; Seib, Kate; Chang, Anne; Harris, Tegan ; Spargo, Jessie; Smith-Vaughan, Heidi.

In: Journal of Medical Microbiology, Vol. 68, No. 8, 05.07.2019, p. 1-8.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Antimicrobial susceptibility and impact of macrolide antibiotics on Moraxella catarrhalis in the upper and lower airways of children with chronic endobronchial suppuration

AU - Hare, Kim

AU - Seib, Kate

AU - Chang, Anne

AU - Harris, Tegan

AU - Spargo, Jessie

AU - Smith-Vaughan, Heidi

PY - 2019/7/5

Y1 - 2019/7/5

N2 - Introduction: Moraxella catarrhalis is an important but insufficiently studied respiratory pathogen.Aim: To determine antibiotic susceptibility and impact of recent antibiotics on M. catarrhalis from children with chronic endobronchial suppuration.Methodology: We cultured nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL) fluids collected from children who were prospectively enrolled in studies of chronic cough and had flexible bronchoscopy performed. Recent β-lactam or macrolide antibiotic use was recorded. M. catarrhalis isolates stored at −80 °C were re-cultured and susceptibility determined to a range of antibiotics including the macrolide antibiotic erythromycin.Results: Data from concurrently collected NP and BAL specimens were available from 547 children (median age 2.4 years) enrolled from 2007 to 2016. M. catarrhalis NP carriage was detected in 149 (27  %) children and lower airway infection (≥104 c.f.u. ml−1 BAL) in 67 (12  %) children. In total, 91  % of 222 M. catarrhalis isolates were β-lactamase producers, and non-susceptibility was high to benzylpenicillin (98 %), cefaclor (39 %) and cotrimoxazole (38 %). Overall, >97  % isolates were susceptible to cefuroxime, chloramphenicol, erythromycin and tetracycline; three isolates were erythromycin-resistant (MIC >0.5 mg l−1). Recent macrolide antibiotics (n=152 children, 28 %) were associated with significantly reduced M. catarrhalis carriage and lower airway infection episodes compared to children who did not receive macrolides; odds ratios 0.19 (95  % CI 0.10–0.35) and 0.15 (0.04–0.41), respectively.Conclusion: Despite the frequent use of macrolides, few macrolide-resistant isolates were detected. This suggests a fitness cost associated with macrolide resistance in M. catarrhalis. Macrolide antibiotics remain an effective choice for treating M. catarrhalis lower airway infection in children with chronic endobronchial suppuration.

AB - Introduction: Moraxella catarrhalis is an important but insufficiently studied respiratory pathogen.Aim: To determine antibiotic susceptibility and impact of recent antibiotics on M. catarrhalis from children with chronic endobronchial suppuration.Methodology: We cultured nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL) fluids collected from children who were prospectively enrolled in studies of chronic cough and had flexible bronchoscopy performed. Recent β-lactam or macrolide antibiotic use was recorded. M. catarrhalis isolates stored at −80 °C were re-cultured and susceptibility determined to a range of antibiotics including the macrolide antibiotic erythromycin.Results: Data from concurrently collected NP and BAL specimens were available from 547 children (median age 2.4 years) enrolled from 2007 to 2016. M. catarrhalis NP carriage was detected in 149 (27  %) children and lower airway infection (≥104 c.f.u. ml−1 BAL) in 67 (12  %) children. In total, 91  % of 222 M. catarrhalis isolates were β-lactamase producers, and non-susceptibility was high to benzylpenicillin (98 %), cefaclor (39 %) and cotrimoxazole (38 %). Overall, >97  % isolates were susceptible to cefuroxime, chloramphenicol, erythromycin and tetracycline; three isolates were erythromycin-resistant (MIC >0.5 mg l−1). Recent macrolide antibiotics (n=152 children, 28 %) were associated with significantly reduced M. catarrhalis carriage and lower airway infection episodes compared to children who did not receive macrolides; odds ratios 0.19 (95  % CI 0.10–0.35) and 0.15 (0.04–0.41), respectively.Conclusion: Despite the frequent use of macrolides, few macrolide-resistant isolates were detected. This suggests a fitness cost associated with macrolide resistance in M. catarrhalis. Macrolide antibiotics remain an effective choice for treating M. catarrhalis lower airway infection in children with chronic endobronchial suppuration.

U2 - 10.1099/jmm.0.001033

DO - 10.1099/jmm.0.001033

M3 - Article

VL - 68

SP - 1

EP - 8

JO - Journal of Medical Microbiology

JF - Journal of Medical Microbiology

SN - 0022-2615

IS - 8

ER -