Journal Article

High levels of multiple antibiotic resistance among 938 <i> Haemophilus influenzae</i> type b meningitis isolates from Cuba (1990–2002)

Isis Tamargo, Kiomy Fuentes, Alina Llop, Jesús Oteo and José Campos

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 52, issue 4, pages 695-698
Published in print October 2003 | ISSN: 0305-7453
Published online October 2003 | e-ISSN: 1460-2091 | DOI:
High levels of multiple antibiotic resistance among 938  Haemophilus influenzae type b meningitis isolates from Cuba (1990–2002)

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  • Medical Oncology
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Objectives: A national surveillance study to determine antimicrobial susceptibility in Haemophilus influenzae type b isolated from cerebrospinal fluid was carried out in Cuba from 1990 to 2002.

Methods: Susceptibility to ampicillin, co-amoxiclav, cefotaxime, ceftriaxone, co-trimoxazole, tetracycline, chloramphenicol and rifampicin was tested by the microdilution method according to the NCCLS guidelines.

Results: The 34 participating laboratories recovered 938 consecutive, non-identical isolates. All the isolates were retrieved from children aged <5 years. The mean number of isolates collected by year in the pre-vaccination era (1990–1998) was 93; after vaccination, 57 isolates were reported in 1999, 31 in 2000, four in 2001 and five in 2002. Resistance to ampicillin, co-trimoxazole, tetracycline and chloramphenicol was 46.3% (all β-lactamase-positive), 51.3%, 33.2% and 44.0%, respectively. Ampicillin-resistant β-lactamase-negative strains were not detected. All strains were susceptible to co-amoxiclav, cefotaxime, ceftriaxone and rifampicin. Ampicillin resistance was strongly associated with resistance to tetracycline, co-trimoxazole and chloramphenicol (P < 0.001). Multidrug resistance was present in 43.8% of isolates. The most prevalent phenotype was resistance to ampicillin/chloramphenicol/tetracycline/co-trimoxazole, which was detected in 29.2% of strains overall. An increase in the prevalence of resistance to these antibiotics was observed from 1990 to 2000 in the range 40.7%–54.8% for ampicillin, 40.1%–51.6% for chloramphenicol, 45.4%–58.1% for co-trimoxazole and 23%–45.2% for tetracycline.

Conclusions: In Cuba, the widespread vaccination against Haemophilus influenzae type b prevented a large number of meningitis cases in children caused by strains resistant to multiple antibiotics.

Keywords: Keywords: Haemophilus influenzae type b, antimicrobial resistance, meningitis, conjugate vaccines

Journal Article.  1899 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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