{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T18:30:03Z","timestamp":1787941803318,"version":"build-2784847793"},"reference-count":36,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2012,8,1]],"date-time":"2012-08-01T00:00:00Z","timestamp":1343779200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The proportions of\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Haemophilus influenzae<\/jats:named-content>\n            resistant to ampicillin and other \u03b2-lactam antibiotics have been low in Sweden compared to other countries in the Western world. However, a near-doubled proportion of nasopharyngeal Swedish\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">H. influenzae<\/jats:named-content>\n            isolates with resistance to \u03b2-lactams has been observed in the last decade. In the present study, the epidemiology and mechanisms of antimicrobial resistance of\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">H. influenzae<\/jats:named-content>\n            isolates from blood and cerebrospinal fluid in southern Sweden from 1997 to 2010 (\n            <jats:italic>n<\/jats:italic>\n            = 465) were studied. Antimicrobial susceptibility testing was performed using disk diffusion, and isolates with resistance to any tested \u03b2-lactam were further analyzed in detail. We identified a significantly increased (\n            <jats:italic>P<\/jats:italic>\n            = 0.03) proportion of \u03b2-lactam-resistant invasive\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">H. influenzae<\/jats:named-content>\n            during the study period, which was mainly attributed to a significant recent increase of \u03b2-lactamase-negative \u03b2-lactam-resistant isolates (\n            <jats:italic>P<\/jats:italic>\n            = 0.04). Furthermore, invasive \u03b2-lactamase-negative \u03b2-lactam-resistant\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">H. influenzae<\/jats:named-content>\n            isolates from 2007 and onwards were found in higher proportions than the corresponding proportions of nasopharyngeal isolates in a national survey. Multiple-locus sequence typing (MLST) of this group of isolates did not completely separate isolates with different resistance phenotypes. However, one cluster of \u03b2-lactamase-negative ampicillin-resistant (BLNAR) isolates was identified, and it included isolates from all geographical areas. A truncated variant of a \u03b2-lactamase gene with a promoter deletion,\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>TEM-1<\/jats:sub>\n            -P\u0394 dominated among the \u03b2-lactamase-positive\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">H. influenzae<\/jats:named-content>\n            isolates. Our results show that the proportions of \u03b2-lactam-resistant invasive\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">H. influenzae<\/jats:named-content>\n            have increased in Sweden in the last decade.\n          <\/jats:p>","DOI":"10.1128\/aac.00415-12","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T05:39:27Z","timestamp":1339479567000},"page":"4408-4415","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":55,"title":["Increase of \u03b2-Lactam-Resistant Invasive Haemophilus influenzae in Sweden, 1997 to 2010"],"prefix":"10.1128","volume":"56","author":[{"given":"Fredrik","family":"Resman","sequence":"first","affiliation":[{"name":"Medical Microbiology, Department of Laboratory Medicine Malm\u00f6, Lund University, Sweden"},{"name":"Infectious Diseases Unit, Department of Clinical Sciences Malm\u00f6, Lund University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Ristovski","sequence":"additional","affiliation":[{"name":"Medical Microbiology, Department of Laboratory Medicine Malm\u00f6, Lund University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne","family":"Forsgren","sequence":"additional","affiliation":[{"name":"Medical Microbiology, Department of Laboratory Medicine Malm\u00f6, Lund University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertil","family":"Kaijser","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine, Deptartment of Clinical Bacteriology, Gothenburg University, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6ran","family":"Kronvall","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, MTC, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Medstrand","sequence":"additional","affiliation":[{"name":"Medical Microbiology, Department of Laboratory Medicine Malm\u00f6, Lund University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Melander","sequence":"additional","affiliation":[{"name":"Infection Control, Laboratory Medicine, Sk\u00e5ne County, Sk\u00e5ne, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga","family":"Odenholt","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Clinical Sciences Malm\u00f6, Lund University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Riesbeck","sequence":"additional","affiliation":[{"name":"Medical Microbiology, Department of Laboratory Medicine Malm\u00f6, Lund University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/605671"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.7.2208-2218.2002"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1086\/511861"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","first-page":"408","DOI":"10.3109\/00365516009065405","article-title":"The paper disc method for determination of bacterial sensitivity to antibiotics. 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