No development of ciprofloxacin resistance in the Haemophilus species associated with pneumonia over a 10-year study

BACKGROUND The widespread overuse of antibiotics promotes the development of antibiotic resistance in bacteria, which can cause severe illness and constitutes a major public health concern. Haemophilus species are a common cause of community- and nosocomial-acquired pneumonia. The antibiotic resistance of these Gram-negative bacteria can be prevented through the reduction of unnecessary antibiotic prescriptions, the correct use of antibiotics, and good hygiene and infection control. This article examines, retrospectively, antibiotic resistance in patients with community- and nosocomial-acquired pneumonia caused by Haemophilus species. METHODS The demographic, clinical, and laboratory data of all patients with community- and nosocomial-acquired pneumonia caused by Haemophilus species were collected from the hospital charts at the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, within a study period from 2004 to 2014. Antimicrobial susceptibility testing was performed for the different antibiotics that have been consistently used in the treatment of patients with pneumonia caused by Haemophilus species. RESULTS During the study period of January 1, 2004, to August 12, 2014, 82 patients were identified with community- and nosocomial-acquired pneumonia affected by Haemophilus species. These patients had a mean age of 63.8 ± 15.5 (60 [73.2%, 95% CI 63.6%-82.8%] males and 22 [26.8%, 95% CI 17.2%-36.4%] females). Haemophilus species had a high resistance rate to erythromycin (38.3%), ampicillin (24.4%), piperacillin (20.8%), cefuroxime (8.5%), ampicillin-sulbactam (7.3%), piperacillin-sulbactam (4.3%), piperacillin-tazobactam (2.5%), cefotaxime (2.5%), and levofloxacin (1.6%). In contrast, they were not resistant to ciprofloxacin in patients with pneumonia (P = 0.016). CONCLUSION Haemophilus species were resistant to many of the typically used antibiotics. Resistance toward ciprofloxacin was not detected in patients with pneumonia caused by Haemophilus species.