Journal Article

Quinolone-Resistant <i>Haemophilus influenzae</i> in a Long-Term Care Facility: Clinical and Molecular Epidemiology

Jawad Nazir, Carl Urban, Noriel Mariano, Janice Burns, Barbara Tommasulo, Carl Rosenberg, Sorana Segal-Maurer and James J. Rahal

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 11, pages 1564-1569
Published in print June 2004 | ISSN: 1058-4838
Published online June 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/420820
Quinolone-Resistant Haemophilus influenzae in a Long-Term Care Facility: Clinical and Molecular Epidemiology

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We describe a clonal outbreak of quinolone-resistant Haemophilus influenzae (QRHI) from an affiliated long-term care facility (LTCF-A); the outbreak was associated with the clinical use of levofloxacin, which was determined to be a risk factor for acquisition of QRHI. The minimum inhibitory concentration to which 90% of isolates were susceptible (MIC90), as determined by broth microdilution, was >4 µg/mL for levofloxacin, >2 µg/mL for moxifloxacin, >2 µg/mL for gatifloxacin, and 8 µg/mL for gemifloxacin. The MIC90, as determined by Etest (AB Biodisk), was >32 µg/mL for levofloxacin, ciprofloxacin, moxifloxacin, and gatifloxacin. Having been a resident at LTCF-A and having chronic obstructive pulmonary disease were significant risk factors for acquisition of QRHI at our 500-bed hospital (New York Hospital Queens). All QRHI isolates were found to be genetically related by pulsed-field gel electrophoresis, were nontypeable, were susceptible to ceftriaxone and azithromycin, and were negative for β-lactamase production. Emphasis on patient contact and respiratory isolation and placing colonized or infected patients in cohorts yielded a marked reduction in the prevalence of QRHI at LTCF-A.

Journal Article.  3121 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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