Introduction. Treatment of Haemophilus influenzae (Hi) pneumonia is on concern because resistance to amoxicillin is largely diffused. This study describes the evolution of resistance to amoxicillin and amoxicillin/clavulanic acid (AMC) in Hi isolates and characteristics of patients with Hi severe pneumonia. Methods. A monocentric retrospective observational study including patients from 2008 to 2017 with severe pneumonia hospitalized in ICU. Evolution of amoxicillin and AMC susceptibility was showed. Characteristics of patients with Hi pneumonia were compared to characteristics of patients with Streptococcus pneumoniae (Sp) pneumonia, as reference. Risk factors for amoxicillin resistance in Hi were investigated. Results. Overall, 113 patients with Hi and 132 with Sp pneumonia were included. The percentages of AMC resistance among Hi strains decreased over the years (from 10% in 2008-2009 to 0% in 2016-2017) while resistance to amoxicillin remained stable at 20%. Also, percentages of Sp resistant strains for amoxicillin decreased over years (from 25% to 3%). Patients with Hi pneumonia experienced higher prevalence of bronchitis (18% vs. 8%, , chronic obstructive pulmonary disease (43% vs. 30% ), HAP (18% vs. 7%, , ventilator-associated pneumonia (27% vs. 17%, , and longer duration of mechanical ventilation (8 days vs. 6 days, ) than patients with Sp pneumonia. Patients with Sp pneumonia had more frequently local complications than patients with Hi pneumonia (17% vs. 7%, ). De-escalation of antibiotics was more frequent in patients with Sp than in patients with Hi (67% vs. 53%, ). No risk factors were associated with amoxicillin resistance among patients with Hi pneumonia. Conclusions. Amoxicillin resistance was stable over time, but no risk factors were detected. AMC resistance was extremely low, suggesting that AMC could be used for empiric treatment of Hi pneumonia, as well as other molecules, namely, cephalosporins. Patients with Hi pneumonia had more pulmonary comorbidities and severe diseases than patients with Sp pneumonia.

中文翻译：

---

重症流感嗜血杆菌肺炎阿莫西林敏感性的回顾性研究。

简介。流感嗜血杆菌(Hi) 肺炎的治疗受到关注，因为对阿莫西林的耐药性在很大程度上是扩散的。本研究描述了 Hi 分离株对阿莫西林和阿莫西林/克拉维酸 (AMC) 耐药性的演变以及 Hi 重症肺炎患者的特征。方法。一项单中心回顾性观察研究，包括 2008 年至 2017 年在 ICU 住院的重症肺炎患者。显示了阿莫西林和 AMC 敏感性的演变。将 Hi 肺炎患者的特征与肺炎链球菌(Sp) 肺炎患者的特征进行比较，作为参考。研究了Hi中阿莫西林耐药的危险因素。结果. 总体而言，纳入了 113 名 Hi 患者和 132 名 Sp 肺炎患者。Hi 菌株中 AMC 耐药率逐年下降（从 2008-2009 年的 10% 降至 2016-2017 年的 0%），而对阿莫西林的耐药性则稳定在 20%。此外，对阿莫西林的 Sp 耐药菌株的百分比逐年下降（从 25% 降至 3%）。Hi 肺炎患者的支气管炎患病率较高（18% 对 8%，,慢性阻塞性肺病 (43% vs. 30%), HAP (18% 对 7%,,呼吸机相关性肺炎 (27% vs. 17%,，以及更长的机械通气时间（8 天 vs. 6 天，)比 Sp 肺炎患者。Sp 肺炎患者比 Hi 肺炎患者更常出现局部并发症（17% vs. 7%，）。Sp 患者的抗生素降级比 Hi 患者更频繁（67% 对 53%，）。在 Hi 肺炎患者中，没有与阿莫西林耐药相关的危险因素。结论。随着时间的推移，阿莫西林耐药性稳定，但未检测到危险因素。AMC 耐药性极低，表明 AMC 可用于 Hi 肺炎的经验性治疗，以及其他分子，即头孢菌素。Hi 型肺炎患者的肺部合并症和严重疾病多于 Sp 型肺炎患者。