Surveillance and whole genome sequencing of Ceftriaxone resistant Haemophilus influenzae in Scotland.
PHE ePoster Library. Smith A. Apr 9, 2019; 259619; 15621
Prof. Andrew Smith
Prof. Andrew Smith
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Abstract Background

The monitoring of antimicrobial resistance early warning system (AMR-EWS) generates alerts associated with unusual antibiotic resistance reported in the Electronic Communication of Surveillance in Scotland (ECOSS) system. The aim of this presentation is to provide background epidemiology of ceftriaxone (CRO) resistant H. influenzae and preliminary characterisation using whole genome sequencing in Scotland.


Isolates referred to Scottish Microbiology Reference Laboratory (SMiRL), Glasgow (respiratory bacteria section) were re-tested for antimicrobial susceptibility using E-test methodology and if confirmed were whole genome sequenced (Illumina platform). Reads were assembled de novo and put through ParSNP, as well as mapped to a reference sequence and analysed by SnapperDB to generate single nucleotide polymorphism (SNP) phylogenies


During period 2016-2018 CRO susceptibility was tested in 21,287 isolates with 69 reported as CRO resistant (2016 0.45% R; 2017 0.51% R; 2018 0.13% R). For the period 2016 to-date (2019), SMiRL received 13 isolates of CRO resistant H. influenza (12 sputum and 1 eye swab), sensitive to meropenem and pheno-/geno-typically non-typeable. Sequence types (STs) comprised 107 (n=5), 143 (n=2) and n= 1 of 142, 388, 422, 1002, 1218, 2016. Only the two ST143 isolates demonstrated a 5 SNP difference between isolates. Analysis of the ftsI gene revealed a new allelic type (107) for ST143. The remaining ftsl alleles comprised16, 26, 40 and 107. A number of Penicillin Binding Protein 3 (PBP3) profiles such as Group III+: S385T, L389F and N526K were detected in 6 isolates. The virulent clone ST14CC was not detected in our CRO resistant strains.


Surveillance of isolates referred to SMiRL indicates that strains belonging to ST14CC appear sporadically and at very low levels in the Scottish population. The presence of various substitutions in the PBP3 proteins of isolates merits careful surveillance to ascertain clinical impact and emergence of these strains.
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