Table 5.

MIC and susceptibility data for H. influenzae isolates collected during 2009–11 and 2013–14

Years/antimicrobial agentIsolate groupNSusceptibility
MIC (mg/L)
CLSI
PK/PD
EUCAST
50%90%min.max.%S%I%R%S%S%I%R
2009–11
 AMCa,ball307120.0651298.4 (97.4)c1.6 (2.6)c93.5 (98.4)93.5 (85.0)c6.5 (15.0)c
BL−2570.520.06898.81.294.2 (98.8)94.25.8
BL+50120.1251296.04.090.0 (96.0)90.010.0
 ampicillindall3070.5640.06>25671.39.519.2NA71.328.7
BL−2570.520.06>25684.411.34.3NA84.415.6
BL+5064>2560.5>2564.00.096.0NA4.096.0
 azithromycineall10424≤0.015>25691.4NANANANA
BL−8544≤0.015892.9NANANANA
BL+192>256≤0.015>25684.2NANANANA
 cefaclorball3072320.25>25678.5 (77.5)c7.8 (7.2)c13.7 (15.3)c2.0NANANA
BL−2572320.25>25679.47.812.82.3NANANA
BL+504321>25674.08.018.00.0NANANA
 cefuroximeb,fall307140.066494.8 (92.8)c2.9 (2.0)c2.3 (5.2)c65.51.0 (1.0)c64.5 (62.9)c34.5 (36.2)c
BL−257140.066494.63.12.366.91.265.833.1
BL+50140.253296.02.02.058.00.058.042.0
 levofloxacinall3070.0640.008>3278.278.271.728.3
BL−2570.0640.008>3279.820.279.872.427.6
BL+500.0380.008>3270.003070.068.032.0
 chloramphenicolgall307NANANANA90.61.38.1NA91.58.5
BL−257NANANANA96.11.22.7NA96.93.1
BL+50NANANANA62.02.036.0NA64.036.0
 tetracyclinegall292NANANANA74.39.915.8NA85.32.712.0
BL−242NANANANA79.810.39.9NA90.92.56.6
BL+50NANANANA48.08.044.0NA58.04.038.0
 SXTgall307NANANANA41.02.656.4NA34.24.661.2
BL−257NANANANA46.33.150.6NA38.55.156.4
BL+50NANANANA14.00.086.0NA12.02.086.0
2013–14
 AMCa,ball185140.121695.7 (89.1)c4.3 (10.9)c78.4 (95.7)78.4 (73.0)c21.6 (27.0)c
BL−138120.12897.82.281.9 (97.8)81.918.1
BL+47280.51689.410.668.1 (89.4)68.131.9
 ampicillindall1851>2560.12>25658.49.731.9NA58.441.6
BL−138120.12>25677.513.19.4NA77.522.5
BL+47256>2561>2562.10.097.9NA2.197.9
 ampicillin/sulbactamball97140.12886.6 (80.4)c13.4 (19.6)cNA63.9 (58.9)c36.1 (41.1)c
BL−73120.12893.26.8NA82.217.8
BL+24280.25866.733.3NA8.391.7
 azithromycineall185216≤0.015>25689.7NANANANA
BL−13824≤0.015>25697.8NANANANA
BL+474>256≤0.015>25666.0NANANANA
 cefaclorball18516>2561>25649.2 (47.6)c13.0 (13.0)c37.8 (39.5)c0.0NANANA
BL−1388>2561>25652.910.936.20.0NANANA
BL+4716>2561>25638.319.242.50.0NANANA
 cefuroximeb,fall1852320.25>25675.1 (73.0)c7.1 (7.0)c17.8 (20.0)c43.80.0 (0.0)c43.8 (42.2)c56.2 (57.8)c
BL−1382320.25>25676.87.315.946.40.046.453.6
BL+472640.25>25670.26.423.436.20.036.263.8
 levofloxacinall1850.01540.008>3289.289.282.717.3
BL−1380.01520.008890.690.683.316.7
BL+470.0340.008>3285.185.180.919.2
 chloramphenicolgall185NANANANA91.42.16.5NA91.98.1
BL−138NANANANA96.41.42.2NA97.12.9
BL+47NANANANA76.64.319.1NA76.623.4
 tetracyclinegall185NANANANA86.53.89.7NA90.31.68.1
BL−138NANANANA92.02.95.1NA94.90.05.1
BL+47NANANANA70.26.423.4NA76.66.417.0
 SXTgall185NANANANA41.13.255.7NA38.91.659.5
BL−138NANANANA45.72.951.4NA42.82.155.1
BL+47NANANANA27.74.268.1NA27.70.072.3
Years/antimicrobial agentIsolate groupNSusceptibility
MIC (mg/L)
CLSI
PK/PD
EUCAST
50%90%min.max.%S%I%R%S%S%I%R
2009–11
 AMCa,ball307120.0651298.4 (97.4)c1.6 (2.6)c93.5 (98.4)93.5 (85.0)c6.5 (15.0)c
BL−2570.520.06898.81.294.2 (98.8)94.25.8
BL+50120.1251296.04.090.0 (96.0)90.010.0
 ampicillindall3070.5640.06>25671.39.519.2NA71.328.7
BL−2570.520.06>25684.411.34.3NA84.415.6
BL+5064>2560.5>2564.00.096.0NA4.096.0
 azithromycineall10424≤0.015>25691.4NANANANA
BL−8544≤0.015892.9NANANANA
BL+192>256≤0.015>25684.2NANANANA
 cefaclorball3072320.25>25678.5 (77.5)c7.8 (7.2)c13.7 (15.3)c2.0NANANA
BL−2572320.25>25679.47.812.82.3NANANA
BL+504321>25674.08.018.00.0NANANA
 cefuroximeb,fall307140.066494.8 (92.8)c2.9 (2.0)c2.3 (5.2)c65.51.0 (1.0)c64.5 (62.9)c34.5 (36.2)c
BL−257140.066494.63.12.366.91.265.833.1
BL+50140.253296.02.02.058.00.058.042.0
 levofloxacinall3070.0640.008>3278.278.271.728.3
BL−2570.0640.008>3279.820.279.872.427.6
BL+500.0380.008>3270.003070.068.032.0
 chloramphenicolgall307NANANANA90.61.38.1NA91.58.5
BL−257NANANANA96.11.22.7NA96.93.1
BL+50NANANANA62.02.036.0NA64.036.0
 tetracyclinegall292NANANANA74.39.915.8NA85.32.712.0
BL−242NANANANA79.810.39.9NA90.92.56.6
BL+50NANANANA48.08.044.0NA58.04.038.0
 SXTgall307NANANANA41.02.656.4NA34.24.661.2
BL−257NANANANA46.33.150.6NA38.55.156.4
BL+50NANANANA14.00.086.0NA12.02.086.0
2013–14
 AMCa,ball185140.121695.7 (89.1)c4.3 (10.9)c78.4 (95.7)78.4 (73.0)c21.6 (27.0)c
BL−138120.12897.82.281.9 (97.8)81.918.1
BL+47280.51689.410.668.1 (89.4)68.131.9
 ampicillindall1851>2560.12>25658.49.731.9NA58.441.6
BL−138120.12>25677.513.19.4NA77.522.5
BL+47256>2561>2562.10.097.9NA2.197.9
 ampicillin/sulbactamball97140.12886.6 (80.4)c13.4 (19.6)cNA63.9 (58.9)c36.1 (41.1)c
BL−73120.12893.26.8NA82.217.8
BL+24280.25866.733.3NA8.391.7
 azithromycineall185216≤0.015>25689.7NANANANA
BL−13824≤0.015>25697.8NANANANA
BL+474>256≤0.015>25666.0NANANANA
 cefaclorball18516>2561>25649.2 (47.6)c13.0 (13.0)c37.8 (39.5)c0.0NANANA
BL−1388>2561>25652.910.936.20.0NANANA
BL+4716>2561>25638.319.242.50.0NANANA
 cefuroximeb,fall1852320.25>25675.1 (73.0)c7.1 (7.0)c17.8 (20.0)c43.80.0 (0.0)c43.8 (42.2)c56.2 (57.8)c
BL−1382320.25>25676.87.315.946.40.046.453.6
BL+472640.25>25670.26.423.436.20.036.263.8
 levofloxacinall1850.01540.008>3289.289.282.717.3
BL−1380.01520.008890.690.683.316.7
BL+470.0340.008>3285.185.180.919.2
 chloramphenicolgall185NANANANA91.42.16.5NA91.98.1
BL−138NANANANA96.41.42.2NA97.12.9
BL+47NANANANA76.64.319.1NA76.623.4
 tetracyclinegall185NANANANA86.53.89.7NA90.31.68.1
BL−138NANANANA92.02.95.1NA94.90.05.1
BL+47NANANANA70.26.423.4NA76.66.417.0
 SXTgall185NANANANA41.13.255.7NA38.91.659.5
BL−138NANANANA45.72.951.4NA42.82.155.1
BL+47NANANANA27.74.268.1NA27.70.072.3

NA, no breakpoint data available; BL−, β-lactamase negative; BL+, β-lactamase positive; AMC, amoxicillin/clavulanic acid; SXT, trimethoprim/sulfamethoxazole.

aAmoxicillin/clavulanic acid PK/PD susceptibility at high dose is shown in parentheses.

bIn the clinical setting, isolates of BLNAR are considered resistant to amoxicillin/clavulanic acid, ampicillin/sulbactam, cefaclor and cefuroxime (see main text).

cClinical susceptibility to amoxicillin/clavulanic acid ampicillin/sulbactam, cefaclor and cefuroxime reduced (data in parentheses) due to corrections according to BLNAR (see main text).

dIn clinical setting, all β-lactamase-positive H. influenzae should be considered resistant.

ebioMérieux Etest® breakpoints for incubation in CO2.

fBreakpoints used are for cefuroxime axetil.

gCLSI disc diffusion testing method used.

Table 5.

MIC and susceptibility data for H. influenzae isolates collected during 2009–11 and 2013–14

Years/antimicrobial agentIsolate groupNSusceptibility
MIC (mg/L)
CLSI
PK/PD
EUCAST
50%90%min.max.%S%I%R%S%S%I%R
2009–11
 AMCa,ball307120.0651298.4 (97.4)c1.6 (2.6)c93.5 (98.4)93.5 (85.0)c6.5 (15.0)c
BL−2570.520.06898.81.294.2 (98.8)94.25.8
BL+50120.1251296.04.090.0 (96.0)90.010.0
 ampicillindall3070.5640.06>25671.39.519.2NA71.328.7
BL−2570.520.06>25684.411.34.3NA84.415.6
BL+5064>2560.5>2564.00.096.0NA4.096.0
 azithromycineall10424≤0.015>25691.4NANANANA
BL−8544≤0.015892.9NANANANA
BL+192>256≤0.015>25684.2NANANANA
 cefaclorball3072320.25>25678.5 (77.5)c7.8 (7.2)c13.7 (15.3)c2.0NANANA
BL−2572320.25>25679.47.812.82.3NANANA
BL+504321>25674.08.018.00.0NANANA
 cefuroximeb,fall307140.066494.8 (92.8)c2.9 (2.0)c2.3 (5.2)c65.51.0 (1.0)c64.5 (62.9)c34.5 (36.2)c
BL−257140.066494.63.12.366.91.265.833.1
BL+50140.253296.02.02.058.00.058.042.0
 levofloxacinall3070.0640.008>3278.278.271.728.3
BL−2570.0640.008>3279.820.279.872.427.6
BL+500.0380.008>3270.003070.068.032.0
 chloramphenicolgall307NANANANA90.61.38.1NA91.58.5
BL−257NANANANA96.11.22.7NA96.93.1
BL+50NANANANA62.02.036.0NA64.036.0
 tetracyclinegall292NANANANA74.39.915.8NA85.32.712.0
BL−242NANANANA79.810.39.9NA90.92.56.6
BL+50NANANANA48.08.044.0NA58.04.038.0
 SXTgall307NANANANA41.02.656.4NA34.24.661.2
BL−257NANANANA46.33.150.6NA38.55.156.4
BL+50NANANANA14.00.086.0NA12.02.086.0
2013–14
 AMCa,ball185140.121695.7 (89.1)c4.3 (10.9)c78.4 (95.7)78.4 (73.0)c21.6 (27.0)c
BL−138120.12897.82.281.9 (97.8)81.918.1
BL+47280.51689.410.668.1 (89.4)68.131.9
 ampicillindall1851>2560.12>25658.49.731.9NA58.441.6
BL−138120.12>25677.513.19.4NA77.522.5
BL+47256>2561>2562.10.097.9NA2.197.9
 ampicillin/sulbactamball97140.12886.6 (80.4)c13.4 (19.6)cNA63.9 (58.9)c36.1 (41.1)c
BL−73120.12893.26.8NA82.217.8
BL+24280.25866.733.3NA8.391.7
 azithromycineall185216≤0.015>25689.7NANANANA
BL−13824≤0.015>25697.8NANANANA
BL+474>256≤0.015>25666.0NANANANA
 cefaclorball18516>2561>25649.2 (47.6)c13.0 (13.0)c37.8 (39.5)c0.0NANANA
BL−1388>2561>25652.910.936.20.0NANANA
BL+4716>2561>25638.319.242.50.0NANANA
 cefuroximeb,fall1852320.25>25675.1 (73.0)c7.1 (7.0)c17.8 (20.0)c43.80.0 (0.0)c43.8 (42.2)c56.2 (57.8)c
BL−1382320.25>25676.87.315.946.40.046.453.6
BL+472640.25>25670.26.423.436.20.036.263.8
 levofloxacinall1850.01540.008>3289.289.282.717.3
BL−1380.01520.008890.690.683.316.7
BL+470.0340.008>3285.185.180.919.2
 chloramphenicolgall185NANANANA91.42.16.5NA91.98.1
BL−138NANANANA96.41.42.2NA97.12.9
BL+47NANANANA76.64.319.1NA76.623.4
 tetracyclinegall185NANANANA86.53.89.7NA90.31.68.1
BL−138NANANANA92.02.95.1NA94.90.05.1
BL+47NANANANA70.26.423.4NA76.66.417.0
 SXTgall185NANANANA41.13.255.7NA38.91.659.5
BL−138NANANANA45.72.951.4NA42.82.155.1
BL+47NANANANA27.74.268.1NA27.70.072.3
Years/antimicrobial agentIsolate groupNSusceptibility
MIC (mg/L)
CLSI
PK/PD
EUCAST
50%90%min.max.%S%I%R%S%S%I%R
2009–11
 AMCa,ball307120.0651298.4 (97.4)c1.6 (2.6)c93.5 (98.4)93.5 (85.0)c6.5 (15.0)c
BL−2570.520.06898.81.294.2 (98.8)94.25.8
BL+50120.1251296.04.090.0 (96.0)90.010.0
 ampicillindall3070.5640.06>25671.39.519.2NA71.328.7
BL−2570.520.06>25684.411.34.3NA84.415.6
BL+5064>2560.5>2564.00.096.0NA4.096.0
 azithromycineall10424≤0.015>25691.4NANANANA
BL−8544≤0.015892.9NANANANA
BL+192>256≤0.015>25684.2NANANANA
 cefaclorball3072320.25>25678.5 (77.5)c7.8 (7.2)c13.7 (15.3)c2.0NANANA
BL−2572320.25>25679.47.812.82.3NANANA
BL+504321>25674.08.018.00.0NANANA
 cefuroximeb,fall307140.066494.8 (92.8)c2.9 (2.0)c2.3 (5.2)c65.51.0 (1.0)c64.5 (62.9)c34.5 (36.2)c
BL−257140.066494.63.12.366.91.265.833.1
BL+50140.253296.02.02.058.00.058.042.0
 levofloxacinall3070.0640.008>3278.278.271.728.3
BL−2570.0640.008>3279.820.279.872.427.6
BL+500.0380.008>3270.003070.068.032.0
 chloramphenicolgall307NANANANA90.61.38.1NA91.58.5
BL−257NANANANA96.11.22.7NA96.93.1
BL+50NANANANA62.02.036.0NA64.036.0
 tetracyclinegall292NANANANA74.39.915.8NA85.32.712.0
BL−242NANANANA79.810.39.9NA90.92.56.6
BL+50NANANANA48.08.044.0NA58.04.038.0
 SXTgall307NANANANA41.02.656.4NA34.24.661.2
BL−257NANANANA46.33.150.6NA38.55.156.4
BL+50NANANANA14.00.086.0NA12.02.086.0
2013–14
 AMCa,ball185140.121695.7 (89.1)c4.3 (10.9)c78.4 (95.7)78.4 (73.0)c21.6 (27.0)c
BL−138120.12897.82.281.9 (97.8)81.918.1
BL+47280.51689.410.668.1 (89.4)68.131.9
 ampicillindall1851>2560.12>25658.49.731.9NA58.441.6
BL−138120.12>25677.513.19.4NA77.522.5
BL+47256>2561>2562.10.097.9NA2.197.9
 ampicillin/sulbactamball97140.12886.6 (80.4)c13.4 (19.6)cNA63.9 (58.9)c36.1 (41.1)c
BL−73120.12893.26.8NA82.217.8
BL+24280.25866.733.3NA8.391.7
 azithromycineall185216≤0.015>25689.7NANANANA
BL−13824≤0.015>25697.8NANANANA
BL+474>256≤0.015>25666.0NANANANA
 cefaclorball18516>2561>25649.2 (47.6)c13.0 (13.0)c37.8 (39.5)c0.0NANANA
BL−1388>2561>25652.910.936.20.0NANANA
BL+4716>2561>25638.319.242.50.0NANANA
 cefuroximeb,fall1852320.25>25675.1 (73.0)c7.1 (7.0)c17.8 (20.0)c43.80.0 (0.0)c43.8 (42.2)c56.2 (57.8)c
BL−1382320.25>25676.87.315.946.40.046.453.6
BL+472640.25>25670.26.423.436.20.036.263.8
 levofloxacinall1850.01540.008>3289.289.282.717.3
BL−1380.01520.008890.690.683.316.7
BL+470.0340.008>3285.185.180.919.2
 chloramphenicolgall185NANANANA91.42.16.5NA91.98.1
BL−138NANANANA96.41.42.2NA97.12.9
BL+47NANANANA76.64.319.1NA76.623.4
 tetracyclinegall185NANANANA86.53.89.7NA90.31.68.1
BL−138NANANANA92.02.95.1NA94.90.05.1
BL+47NANANANA70.26.423.4NA76.66.417.0
 SXTgall185NANANANA41.13.255.7NA38.91.659.5
BL−138NANANANA45.72.951.4NA42.82.155.1
BL+47NANANANA27.74.268.1NA27.70.072.3

NA, no breakpoint data available; BL−, β-lactamase negative; BL+, β-lactamase positive; AMC, amoxicillin/clavulanic acid; SXT, trimethoprim/sulfamethoxazole.

aAmoxicillin/clavulanic acid PK/PD susceptibility at high dose is shown in parentheses.

bIn the clinical setting, isolates of BLNAR are considered resistant to amoxicillin/clavulanic acid, ampicillin/sulbactam, cefaclor and cefuroxime (see main text).

cClinical susceptibility to amoxicillin/clavulanic acid ampicillin/sulbactam, cefaclor and cefuroxime reduced (data in parentheses) due to corrections according to BLNAR (see main text).

dIn clinical setting, all β-lactamase-positive H. influenzae should be considered resistant.

ebioMérieux Etest® breakpoints for incubation in CO2.

fBreakpoints used are for cefuroxime axetil.

gCLSI disc diffusion testing method used.

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