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Nosocomial Outbreak of Upper Respiratory Tract Infection With β-Lactamase-Negative Ampicillin-Resistant Nontypeable Haemophilus influenzae

Published online by Cambridge University Press:  03 April 2018

Reiko Miyahara
Affiliation:
Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Motoi Suzuki*
Affiliation:
Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
Konosuke Morimoto
Affiliation:
Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
Bin Chang
Affiliation:
National Institute of Infectious Diseases, Tokyo, Japan
Sayaka Yoshida
Affiliation:
Chikamori Hospital, Kochi, Japan
Shiori Yoshinaga
Affiliation:
Chikamori Hospital, Kochi, Japan
Miki Kitamura
Affiliation:
Chikamori Hospital, Kochi, Japan
Mikiko Chikamori
Affiliation:
Chikamori Hospital, Kochi, Japan
Kazunori Oishi
Affiliation:
National Institute of Infectious Diseases, Tokyo, Japan
Tatsuhiko Kitamura
Affiliation:
Chikamori Hospital, Kochi, Japan
Masayuki Ishida
Affiliation:
Chikamori Hospital, Kochi, Japan
*
Address correspondence to Motoi Suzuki, MD, PhD, Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Japan, 852-852 (mosuzuki@nagasaki-u.ac.jp).

Abstract

OBJECTIVE

To describe the epidemiologic features of an outbreak of an acute respiratory tract infection (ARI) caused by β-lactamase-negative ampicillin-resistant (BLNAR) nontypeable Haemophilus influenzae (NTHi) in an acute-care ward.

DESIGN

Cross-sectional case-control study.

SETTING

An acute-care ward (ward A) in a general hospital of Kochi in western Japan.

METHODS

Patients who shared a room with an index patient and all staff in ward A were screened and followed from July 1 to August 31, 2015. Sputum or throat swab samples were collected from participants and tested by culture and polymerase chain reaction (PCR). The association between detected pathogens and ARI development among all participants was examined. A case-control study was conducted to identify risk factors for disease.

RESULTS

In total, 78 participants, including the index patient, were enrolled. Of all participants, 27 (34.6%) developed mild respiratory symptoms during a 3-week period: 24 were diagnosed as upper respiratory tract infections, and 3 were diagnosed as lower respiratory tract infections. The presence of BLNAR NTHi was confirmed in 13 participants, and multilocus sequence typing demonstrated that these isolates belonged to sequence type 159. All isolates showed identical pulsed-field gel electrophoresis patterns. The presence of BLNAR NTHi was strongly associated with ARI development, whereas viruses were not associated with the disease. Multivariate analyses demonstrated that a history of contact with the index patient was independently associated with ARI caused by BLNAR NTHi.

CONCLUSIONS

BLNAR NTHi has the potential to cause upper respiratory tract infections among adults and to spread rapidly in hospital settings.

Infect Control Hosp Epidemiol 2018;39:652–659

Type
Original Articles
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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