Genital carriage of the genus Haemophilus in pregnancy: Species distribution and antibiotic susceptibility

Rita Cardines, Laura Daprai, Maria Giufrè, Erminio Torresani, Maria Laura Garlaschi, Marina Cerquetti

Research output: Contribution to journalArticle

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Abstract

Recent reports have hypothesized that colonization of the maternal genital tract with noncapsulated Haemophilus influenzae could result in neonatal invasive disease. In this study, genital carriage of the genus Haemophilus was investigated in 510 pregnant women attending an Italian hospital for routine controls. Overall, vaginal carriage of the genus Haemophilus was 9.0% (46/510). A high colonization rate with Haemophilus parainfluenzae (37/510, 7.3%) was found; other species, such as Haemophilus pittmaniae (7/510, 1.4%) and Haemophilus haemolyticus (2/510, 0.4%), were detected for the first time in the genital flora by 16S rRNA gene sequencing. Notably, no H. influenzae was identified, in agreement with previous investigations indicating that this species is rarely isolated from the genito-urinary tract of pregnant women. No antibiotic resistance was detected in H. pittmaniae and H. haemolyticus, but quite a high degree of ampicillin (10/37, 27%) and ciprofloxacin (3/37, 8.1 %) resistance was observed in H. parainfluenzae. Five ampicillin-resistant isolates were β lactamase producers, whereas five isolates exhibited β lactamase-negative ampicillin-resistant (BLNAR) phenotype. Sequencing of penicillin-binding protein 3 revealed that Val511Ala, Asn526Ser, Ala530Ser and Thr574Ala changes were associated with BLNAR phenotypes. Two ciprofloxacin-resistant isolates carried substitutions in both GyrA (Ser84Phe and Asp88Tyr) and ParC (Ser84Tyr and Met198Leu); the other ciprofloxacin-resistant isolate had substitutions in ParC, only (Ser138Thr and Met198Leu). In conclusion, ~10% of pregnant women carried a species of Haemophilus in their genital tract. The emergence of non-/ -lactamase-mediated resistance in genital H. parainfluenzae is a matter of concern because of the risk of mother-to-baby transmission.

Original languageEnglish
Pages (from-to)724-730
Number of pages7
JournalJournal of Medical Microbiology
Volume64
Issue number7
DOIs
Publication statusPublished - Jul 1 2015

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Haemophilus
Haemophilus parainfluenzae
Anti-Bacterial Agents
Pregnancy
Ampicillin
Ciprofloxacin
Pregnant Women
Haemophilus influenzae
Infant, Newborn, Diseases
Mothers
Penicillin-Binding Proteins
Phenotype
Microbial Drug Resistance
Urinary Tract
rRNA Genes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Microbiology
  • Medicine(all)

Cite this

Genital carriage of the genus Haemophilus in pregnancy : Species distribution and antibiotic susceptibility. / Cardines, Rita; Daprai, Laura; Giufrè, Maria; Torresani, Erminio; Garlaschi, Maria Laura; Cerquetti, Marina.

In: Journal of Medical Microbiology, Vol. 64, No. 7, 01.07.2015, p. 724-730.

Research output: Contribution to journalArticle

Cardines, Rita ; Daprai, Laura ; Giufrè, Maria ; Torresani, Erminio ; Garlaschi, Maria Laura ; Cerquetti, Marina. / Genital carriage of the genus Haemophilus in pregnancy : Species distribution and antibiotic susceptibility. In: Journal of Medical Microbiology. 2015 ; Vol. 64, No. 7. pp. 724-730.
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abstract = "Recent reports have hypothesized that colonization of the maternal genital tract with noncapsulated Haemophilus influenzae could result in neonatal invasive disease. In this study, genital carriage of the genus Haemophilus was investigated in 510 pregnant women attending an Italian hospital for routine controls. Overall, vaginal carriage of the genus Haemophilus was 9.0{\%} (46/510). A high colonization rate with Haemophilus parainfluenzae (37/510, 7.3{\%}) was found; other species, such as Haemophilus pittmaniae (7/510, 1.4{\%}) and Haemophilus haemolyticus (2/510, 0.4{\%}), were detected for the first time in the genital flora by 16S rRNA gene sequencing. Notably, no H. influenzae was identified, in agreement with previous investigations indicating that this species is rarely isolated from the genito-urinary tract of pregnant women. No antibiotic resistance was detected in H. pittmaniae and H. haemolyticus, but quite a high degree of ampicillin (10/37, 27{\%}) and ciprofloxacin (3/37, 8.1 {\%}) resistance was observed in H. parainfluenzae. Five ampicillin-resistant isolates were β lactamase producers, whereas five isolates exhibited β lactamase-negative ampicillin-resistant (BLNAR) phenotype. Sequencing of penicillin-binding protein 3 revealed that Val511Ala, Asn526Ser, Ala530Ser and Thr574Ala changes were associated with BLNAR phenotypes. Two ciprofloxacin-resistant isolates carried substitutions in both GyrA (Ser84Phe and Asp88Tyr) and ParC (Ser84Tyr and Met198Leu); the other ciprofloxacin-resistant isolate had substitutions in ParC, only (Ser138Thr and Met198Leu). In conclusion, ~10{\%} of pregnant women carried a species of Haemophilus in their genital tract. The emergence of non-/ -lactamase-mediated resistance in genital H. parainfluenzae is a matter of concern because of the risk of mother-to-baby transmission.",
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AU - Cardines, Rita

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AU - Garlaschi, Maria Laura

AU - Cerquetti, Marina

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AB - Recent reports have hypothesized that colonization of the maternal genital tract with noncapsulated Haemophilus influenzae could result in neonatal invasive disease. In this study, genital carriage of the genus Haemophilus was investigated in 510 pregnant women attending an Italian hospital for routine controls. Overall, vaginal carriage of the genus Haemophilus was 9.0% (46/510). A high colonization rate with Haemophilus parainfluenzae (37/510, 7.3%) was found; other species, such as Haemophilus pittmaniae (7/510, 1.4%) and Haemophilus haemolyticus (2/510, 0.4%), were detected for the first time in the genital flora by 16S rRNA gene sequencing. Notably, no H. influenzae was identified, in agreement with previous investigations indicating that this species is rarely isolated from the genito-urinary tract of pregnant women. No antibiotic resistance was detected in H. pittmaniae and H. haemolyticus, but quite a high degree of ampicillin (10/37, 27%) and ciprofloxacin (3/37, 8.1 %) resistance was observed in H. parainfluenzae. Five ampicillin-resistant isolates were β lactamase producers, whereas five isolates exhibited β lactamase-negative ampicillin-resistant (BLNAR) phenotype. Sequencing of penicillin-binding protein 3 revealed that Val511Ala, Asn526Ser, Ala530Ser and Thr574Ala changes were associated with BLNAR phenotypes. Two ciprofloxacin-resistant isolates carried substitutions in both GyrA (Ser84Phe and Asp88Tyr) and ParC (Ser84Tyr and Met198Leu); the other ciprofloxacin-resistant isolate had substitutions in ParC, only (Ser138Thr and Met198Leu). In conclusion, ~10% of pregnant women carried a species of Haemophilus in their genital tract. The emergence of non-/ -lactamase-mediated resistance in genital H. parainfluenzae is a matter of concern because of the risk of mother-to-baby transmission.

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