Emergence of extensively drug-resistant Haemophilus parainfluenzae in Switzerland.

Two homosexual men were colonized in the urethra with Haemophilus parainfluenzae nonsusceptible to ampicillin (MIC, 8 µg/ml), amoxicillin-clavulanate (MIC, 4 µg/ml), cefotaxime (MIC, 1.5 µg/ml), cefepime (MIC, 3 µg/ml), meropenem (MIC, 0.5 µg/ml), cefuroxime, azithromycin, ciprofloxacin, tetracycline, and chloramphenicol (all MICs, ≥ 32 µg/ml). Repetitive extragenic palindromic PCR (rep-PCR) showed that the strains were indistinguishable. The isolates had amino acid substitutions in PBP3, L4, GyrA, and ParC and possessed Mef(A), Tet(M), and CatS resistance mechanisms. This is the first report of extensively drug-resistant (XDR) H. parainfluenzae.