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Abstract

This study provides an update on invasive disease in Bellvitge University Hospital (2014–2019), reporting its evolution from a previous period (2008–2013) and analysing the non-typeable (NTHi) population structure using a clade-related classification. Clinical data, antimicrobial susceptibility and serotyping were studied and compared with those of the previous period. Population structure was assessed by multilocus sequence typing (MLST), SNP-based phylogenetic analysis and clade-related classification. The incidence of invasive disease remained constant between the two periods (average 2.07 cases per 100 000 population), while the 30 day mortality rate decreased (20.7–14.7 %, respectively). Immunosuppressive therapy (40 %) and malignancy (36 %) were the most frequent comorbidities. Ampicillin and fluoroquinolone resistance rates had increased between the two periods (10–17.6 % and 0–4.4 %, respectively). NTHi was the main cause of invasive disease in both periods (84.3 and 85.3 %), followed by serotype f (12.9 and 8.8 %). NTHi displayed high genetic diversity. However, two clusters of 13 (=20) and 5 sequence types (STs) (=10) associated with clade V included NTHi strains of the most prevalent STs (ST3 and ST103), many of which showed increased frequency over time. Moreover, ST103 and ST160 from clade V were associated with β-lactam resistance. Invasive disease is uncommon, but can be severe, especially in the elderly with comorbidities. NTHi remains the main cause of invasive disease, with ST103 and ST160 (clade V) responsible for increasing β-lactam resistance over time.

Funding
This study was supported by the:
  • instituto de salud carlos iii (Award CP19/00096)
    • Principle Award Recipient: SaraMartí
  • ministerio de ciencia, innovación y universidades (Award FPU16/02202)
    • Principle Award Recipient: AnnaCarrera-Salinas
  • amazon web services
    • Principle Award Recipient: SaraMartí
  • centro de investigación biomédica en red de enfermedades respiratorias (es) (Award CB06/06/0037)
    • Principle Award Recipient: CarmenArdanuy
  • instituto de salud carlos iii (Award PI16/00977)
    • Principle Award Recipient: SaraMartí
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
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2021-12-13
2022-01-27
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