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Yamba Yamba L, Hansen K, Wasserstrom L, Su YC, Ahl J, Riesbeck K. The importance of Haemophilus influenzae in community-acquired pneumonia: an emerging pathogen in the elderly regardless of comorbidities compared to Streptococcus pneumoniae. Pneumonia (Nathan) 2024; 16:15. [PMID: 39182132 PMCID: PMC11344911 DOI: 10.1186/s41479-024-00136-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 06/19/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Haemophilus influenzae community-acquired pneumonia (CAP) is common, and it is equally common to Streptococcus pneumoniae in some settings. The purpose of this study was to provide additional data on patients affected by H. influenzae CAP and their outcomes. METHODS Streptococcus pneumoniae-caused CAP (111 cases) was compared to CAP with H. influenzae (53 cases). Patients were adults (≥ 18 years) from the prospective study "Etiology of community acquired pneumonia in Sweden" (ECAPS), which was established during the years 2016-2018. RESULTS Cases with H. influenzae CAP were significantly older compared to S. pneumoniae CAP (median 77 vs 70 years, p = 0.037) albeit similar comorbidities. Haemophilus influenzae was generally absent in the bloodstream compared to S. pneumoniae (18% vs 2%, p = 0.01) but clinical presentations were comparable. Only a minority of patients, 34% with H. influenzae and 41% with S. pneumoniae CAP had underlying lung disease. CONCLUSION In the light of childhood immunization campaigns against S. pneumoniae and the increasing numbers of pneumococcal vaccinations among the elderly, coupled with an aging population, the incidence of CAP caused by H. influenzae may increase. Further research is needed to understand the impact of H. influenzae CAP and to a development of a vaccine against this emerging microbe.
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Affiliation(s)
- Linda Yamba Yamba
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Jan Waldenströms Gata 59, 205 02, Malmö, Sweden
| | - Karin Hansen
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Jan Waldenströms Gata 59, 205 02, Malmö, Sweden
- Infectious Diseases, Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Lisa Wasserstrom
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Jan Waldenströms Gata 59, 205 02, Malmö, Sweden
- Clinical Microbiology, Laboratory Medicine Skåne, Infection Control and Prevention, Lund, Sweden
| | - Yu-Ching Su
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Jan Waldenströms Gata 59, 205 02, Malmö, Sweden
| | - Jonas Ahl
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Jan Waldenströms Gata 59, 205 02, Malmö, Sweden
- Infectious Diseases, Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Kristian Riesbeck
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Jan Waldenströms Gata 59, 205 02, Malmö, Sweden.
- Clinical Microbiology, Laboratory Medicine Skåne, Infection Control and Prevention, Lund, Sweden.
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2
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Tanousian A, Bajwa MR, Aghakhani N. Haemophilus influenzae Bacteremia and Pneumonia: A Case Report. Cureus 2023; 15:e49395. [PMID: 38146569 PMCID: PMC10749693 DOI: 10.7759/cureus.49395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2023] [Indexed: 12/27/2023] Open
Abstract
This study reports a case of respiratory failure and pneumonia attributed to infection from a confirmed case of Haemophilus influenzae in a patient with past medical history of interstitial lung disease following a COVID-19 infection. An 88-year-old man with significant past medical history of interstitial lung disease (ILD) and self-catheterization due to benign prostatic hyperplasia (BPH) presented to the ED with shortness of breath and cough. Examination revealed reduced respiratory effort and scattered rhonchi throughout the lung fields. Urine cultures were positive for extended spectrum beta-lactamase (ESBL) Escherichia coli. In addition, blood cultures and chest X-ray findings confirmed a case of H. influenzae bacteremia and pneumonia. The following case highlights the unusual finding of invasive H. influenzae disease and corresponds with the data provided by the Active Bacterial Core surveillance supported by the Centers for Disease Control and Prevention (CDC).
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Affiliation(s)
- Abraham Tanousian
- Internal Medicine, California Health Sciences University College of Osteopathic Medicine, Clovis, USA
- Internal Medicine, Kaiser Permanente Fresno Medical Center, Fresno, USA
| | - Muhammad R Bajwa
- Internal Medicine, Kaiser Permanente Fresno Medical Center, Fresno, USA
| | - Nina Aghakhani
- Internal Medicine, California Health Sciences University College of Osteopathic Medicine, Clovis, USA
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3
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Kwok M, Sheikh W, Lima FV, Russell R. A Rare Case of Haemophilus Influenzae Serotype F Endocarditis Complicated by Concurrent Cardiogenic and Septic Shock: A Case of Challenging Management. J Cardiovasc Dev Dis 2022; 9:jcdd9110384. [PMID: 36354783 PMCID: PMC9693515 DOI: 10.3390/jcdd9110384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
H. Influenza is a rare cause of endocarditis. We report a case of H. Influenza endocarditis that was complicated by cardiogenic and septic shock, active myocardial ischemia and aortic insufficiency. The goal of this report is to help recognize the signs and symptoms of endocarditis and to discuss management strategies in patients with concomitant cardiogenic and septic shock complicated by aortic insufficiency.
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Affiliation(s)
- Michael Kwok
- Divison of Biology and Medicine, Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, USA
- Correspondence:
| | - Wasiq Sheikh
- Cardiovascular Institute, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Fabio V. Lima
- Cardiovascular Institute, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Raymond Russell
- Cardiovascular Institute, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
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4
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Gan MY, Lee WL, Yap BJ, Seethor STT, Greenberg RG, Pek JH, Tan B, Hornik CPV, Lee JH, Chong SL. Contemporary Trends in Global Mortality of Sepsis Among Young Infants Less Than 90 Days: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:890767. [PMID: 35722477 PMCID: PMC9204066 DOI: 10.3389/fped.2022.890767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Current knowledge on the global burden of infant sepsis is limited to population-level data. We aimed to summarize global case fatality rates (CFRs) of young infants with sepsis, stratified by gross national income (GNI) status and patient-level risk factors. Methods We performed a systematic review and meta-analysis on CFRs among young infants < 90 days with sepsis. We searched PubMed, Cochrane Central, Embase, and Web of Science for studies published between January 2010 and September 2019. We obtained pooled CFRs estimates using the random effects model. We performed a univariate analysis at patient-level and a meta-regression to study the associations of gestational age, birth weight, onset of sepsis, GNI, age group and culture-proven sepsis with CFRs. Results The search yielded 6314 publications, of which 240 studies (N = 437,796 patients) from 77 countries were included. Of 240 studies, 99 were conducted in high-income countries, 44 in upper-middle-income countries, 82 in lower-middle-income countries, 6 in low-income countries and 9 in multiple income-level countries. Overall pooled CFR was 18% (95% CI, 17-19%). The CFR was highest for low-income countries [25% (95% CI, 7-43%)], followed by lower-middle [25% (95% CI, 7-43%)], upper-middle [21% (95% CI, 18-24%)] and lowest for high-income countries [12% (95% CI, 11-13%)]. Factors associated with high CFRs included prematurity, low birth weight, age less than 28 days, early onset sepsis, hospital acquired infections and sepsis in middle- and low-income countries. Study setting in middle-income countries was an independent predictor of high CFRs. We found a widening disparity in CFRs between countries of different GNI over time. Conclusion Young infant sepsis remains a major global health challenge. The widening disparity in young infant sepsis CFRs between GNI groups underscore the need to channel greater resources especially to the lower income regions. Systematic Review Registration [www.crd.york.ac.uk/prospero], identifier [CRD42020164321].
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Affiliation(s)
- Ming Ying Gan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wen Li Lee
- Duke-NUS Medical School, Singapore, Singapore
| | - Bei Jun Yap
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Rachel G Greenberg
- Department of Paediatrics, Duke University School of Medicine, Durham, NC, United States
| | - Jen Heng Pek
- Emergency Medicine, Sengkang General Hospital, Singapore, Singapore
| | - Bobby Tan
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Christoph Paul Vincent Hornik
- Division of Critical Care Medicine, Department of Paediatrics, Duke University School of Medicine, Durham, NC, United States
| | - Jan Hau Lee
- Duke-NUS Medical School, Singapore, Singapore
- Children's Intensive Care Unit, KK Women's and Children's Hospital, Singapore, Singapore
| | - Shu-Ling Chong
- Duke-NUS Medical School, Singapore, Singapore
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore, Singapore
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5
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Yee ME, Lai KW, Bakshi N, Grossman JK, Jaggi P, Mallis A, Wang YF, Jerris RC, Lane PA, Yildirim I. Bloodstream Infections in Children With Sickle Cell Disease: 2010-2019. Pediatrics 2022; 149:183842. [PMID: 34913059 PMCID: PMC8959248 DOI: 10.1542/peds.2021-051892] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Children with sickle cell disease (SCD) are at increased risk for bloodstream infections (BSIs), mainly because of functional asplenia. Immunizations and antibiotic prophylaxis have reduced the prevalence of invasive bacterial infections, but contemporary analysis of BSI in children with SCD is limited. METHODS We conducted a retrospective cohort study of children aged <18 years with SCD who had blood cultures collected at our institution from 2010 to 2019 to identify BSI. Probable contaminant organisms were identified and not included as BSI. We calculated the annual incidence of BSI at our institution with 95% confidence intervals (CIs) and used multivariate logistic regression to evaluate associations. RESULTS There were 2694 eligible patients with 19 902 blood cultures. Excluding repeated cultures and contaminant cultures, there were 156 BSI episodes in 144 patients. The median age at BSI was 7.5 years. The average incidence rate of BSI was 0.89 per 100 person-years (95% CI 0.45-1.32). The most common pathogens were Streptococcus pneumoniae (16.0%), Streptococcus viridans group (9.0%), Escherichia coli (9.0%), Staphylococcus aureus (7.7%), Bordetella holmesii (7.7%), Haemophilus influenzae (7.1%), and Salmonella species (6.4%). Odds of BSI were higher with sickle cell anemia genotypes (odds ratio [OR] 1.88; 95% CI 1.20-2.94) and chronic transfusions (OR 2.66; 95% CI 1.51-4.69) and lower with hydroxyurea (OR 0.57; 95% CI 0.39-0.84). CONCLUSIONS BSI remains a risk for children with SCD. Overall incidence, risk factors, and spectrum of pathogens are important considerations to guide prevention and empirical treatment of suspected infection in SCD.
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Affiliation(s)
- Marianne E. Yee
- Aflac Cancer and Blood Disorders Center,Departments of Pediatrics,Address correspondence to Marianne E. Yee, MD, MSc, Pediatric Hematology/Oncology, Emory University and Children’s Healthcare of Atlanta, 2015 Uppergate Rd, NE, Atlanta, GA 30322. E-mail:
| | | | - Nitya Bakshi
- Aflac Cancer and Blood Disorders Center,Departments of Pediatrics
| | | | | | | | - Yun F. Wang
- Pathology and Laboratory Medicine, School of Medicine,Department of Pathology and Laboratory Medicine, Grady Health System, Atlanta, Georgia
| | - Robert C. Jerris
- Department of Pathology and Laboratory Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia,Pathology and Laboratory Medicine, School of Medicine
| | - Peter A. Lane
- Aflac Cancer and Blood Disorders Center,Departments of Pediatrics
| | - Inci Yildirim
- Departments of Pediatrics,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia,Center for Childhood Infections and Vaccines, Emory University and Children’s Healthcare of Atlanta, Atlanta, Georgia
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6
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Soeters HM, Oliver SE, Plumb ID, Blain AE, Zulz T, Simons BC, Barnes M, Farley MM, Harrison LH, Lynfield R, Massay S, McLaughlin J, Muse AG, Petit S, Schaffner W, Thomas A, Torres S, Watt J, Pondo T, Whaley MJ, Hu F, Wang X, Briere EC, Bruce MG. Epidemiology of Invasive Haemophilus influenzae Serotype a Disease-United States, 2008-2017. Clin Infect Dis 2021; 73:e371-e379. [PMID: 32589699 PMCID: PMC9628811 DOI: 10.1093/cid/ciaa875] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/19/2020] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Haemophilus influenzae serotype a (Hia) can cause invasive disease similar to serotype b; no Hia vaccine is available. We describe the epidemiology of invasive Hia disease in the United States overall and specifically in Alaska during 2008-2017. METHODS Active population- and laboratory-based surveillance for invasive Hia disease was conducted through Active Bacterial Core surveillance sites and from Alaska statewide invasive bacterial disease surveillance. Sterile-site isolates were serotyped via slide agglutination or real-time polymerase chain reaction. Incidences in cases per 100 000 were calculated. RESULTS From 2008 to 2017, an estimated average of 306 invasive Hia disease cases occurred annually in the United States (estimated annual incidence: 0.10); incidence increased by an average of 11.1% annually. Overall, 42.7% of cases were in children aged <5 years (incidence: 0.64), with highest incidence among children aged <1 year (1.60). Case fatality was 7.8% overall and was highest among adults aged ≥65 years (15.1%). Among children aged <5 years, the incidence was 17 times higher among American Indian and Alaska Native (AI/AN) children (8.29) than among children of all other races combined (0.49). In Alaska, incidences among all ages (0.68) and among children aged <1 year (24.73) were nearly 6 and 14 times higher, respectively, than corresponding US incidences. Case fatality in Alaska was 10.2%, and the vast majority (93.9%) of cases occurred among AI/AN. CONCLUSIONS Incidence of invasive Hia disease has increased since 2008, with the highest burden among AI/AN children. These data can inform prevention strategies, including Hia vaccine development.
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Affiliation(s)
- Heidi M. Soeters
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Sara E. Oliver
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Ian D. Plumb
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Amy E. Blain
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Tammy Zulz
- Arctic Investigations Program, CDC, Anchorage, AK, USA
| | | | - Meghan Barnes
- Colorado Department of Public Health and Environment, Denver, CO, USA
| | - Monica M. Farley
- Emory University School of Medicine and The Atlanta VA Medical Center, Atlanta, GA, USA
| | - Lee H. Harrison
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | - Susan Petit
- Connecticut Department of Public Health, Hartford, CT, USA
| | | | - Ann Thomas
- Oregon Health Authority, Portland, OR, USA
| | | | - James Watt
- California Department of Public Health, Richmond, CA, USA
| | - Tracy Pondo
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Fang Hu
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Xin Wang
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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7
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Burzyńska P, Sobala ŁF, Mikołajczyk K, Jodłowska M, Jaśkiewicz E. Sialic Acids as Receptors for Pathogens. Biomolecules 2021; 11:831. [PMID: 34199560 PMCID: PMC8227644 DOI: 10.3390/biom11060831] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/28/2021] [Accepted: 05/29/2021] [Indexed: 12/17/2022] Open
Abstract
Carbohydrates have long been known to mediate intracellular interactions, whether within one organism or between different organisms. Sialic acids (Sias) are carbohydrates that usually occupy the terminal positions in longer carbohydrate chains, which makes them common recognition targets mediating these interactions. In this review, we summarize the knowledge about animal disease-causing agents such as viruses, bacteria and protozoa (including the malaria parasite Plasmodium falciparum) in which Sias play a role in infection biology. While Sias may promote binding of, e.g., influenza viruses and SV40, they act as decoys for betacoronaviruses. The presence of two common forms of Sias, Neu5Ac and Neu5Gc, is species-specific, and in humans, the enzyme converting Neu5Ac to Neu5Gc (CMAH, CMP-Neu5Ac hydroxylase) is lost, most likely due to adaptation to pathogen regimes; we discuss the research about the influence of malaria on this trait. In addition, we present data suggesting the CMAH gene was probably present in the ancestor of animals, shedding light on its glycobiology. We predict that a better understanding of the role of Sias in disease vectors would lead to more effective clinical interventions.
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Affiliation(s)
| | | | | | | | - Ewa Jaśkiewicz
- Laboratory of Glycobiology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, R. Weigla 12, 53-114 Wroclaw, Poland; (P.B.); (Ł.F.S.); (K.M.); (M.J.)
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8
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Haemophilus Species, a Rare Cause of Vertebral Osteomyelitis. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2020. [DOI: 10.1097/ipc.0000000000000847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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9
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A Cross-Reactive Protein Vaccine Combined with PCV-13 Prevents Streptococcus pneumoniae- and Haemophilus influenzae-Mediated Acute Otitis Media. Infect Immun 2019; 87:IAI.00253-19. [PMID: 31308088 DOI: 10.1128/iai.00253-19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/11/2019] [Indexed: 11/20/2022] Open
Abstract
Acute otitis media is one of the most common childhood infections worldwide. Currently licensed vaccines against the common otopathogen Streptococcus pneumoniae target the bacterial capsular polysaccharide and confer no protection against nonencapsulated strains or capsular types outside vaccine coverage. Mucosal infections such as acute otitis media remain prevalent, even those caused by vaccine-covered serotypes. Here, we report that a protein-based vaccine, a fusion construct of epitopes of CbpA to pneumolysin toxoid, confers effective protection against pneumococcal acute otitis media for non-PCV-13 serotypes and enhances protection for PCV-13 serotypes when coadministered with PCV-13. Having cross-reactive epitopes, the fusion protein also induces potent antibody responses against nontypeable Haemophilus influenzae and S. pneumoniae, engendering protection against acute otitis media caused by emerging unencapsulated otopathogens. These data suggest that augmenting capsule-based vaccination with conserved, cross-reactive protein-based vaccines broadens and enhances protection against acute otitis media.
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10
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Bouza E, Ancochea-Bermúdez J, Campins M, Eirós-Bouza JM, Fargas J, García Rojas A, Gracia D, Gutiérrez Sánchez A, Limia A, López JA, Magro MC, Mirada G, Muñoz P, Olier E, Ortiz de Lejarazu R, Urbiztondo L, Palomo E. The situation of vaccines for the prevention of infections in adults: An opinion paper on the situation in Spain. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2019; 32:333-364. [PMID: 31345005 PMCID: PMC6719651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 03/23/2019] [Accepted: 05/07/2019] [Indexed: 11/17/2022]
Abstract
The childhood immunization schedule is well known and generally well implemented in developed countries. For various reasons, the same is not true of vaccines aimed at preventing infections in adults, in which vaccination coverage is incomplete and generally very deficient. In order to assess the situation of adult vaccination in Spain, the Fundación de Ciencias de la Salud has brought together a series of experts in different fields, including doctors, nurses, representatives of patient associations, health managers and economists, health authorities and journalists to deal with this issue. The format was that of a round table in which a series of questions previously formulated by the coordinators were to be answered and debated. The document presented is not an exhaustive review of the topic, nor is it intended to make recommendations, but only to give a multidisciplinary opinion on topics that could be particularly debatable or controversial. The paper reviews the main vaccine-preventable adult diseases, their clinical and economic impact, the possibilities of reducing them with vaccination programmes and the difficulties in carrying them out. The role of nursing, pharmacy services, patient associations and the health administration itself in changing the current situation was discussed. Prospects for new vaccines were discussed and we speculated on the future in this field. Finally, particularly relevant ethical aspects in decision-making regarding vaccination were discussed, which must be faced by both individuals and states. We have tried to summarize, at the end of the presentation of each question, the environment of opinion that was agreed with all the members of the table.
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Affiliation(s)
- E Bouza
- Emilio Bouza, Instituto de Investigación Sanitaria Gregorio Marañón. C/ Dr. Esquerdo, 46, 28007 Madrid, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - E Palomo
- Esteban Palomo. Director. Fundación de Ciencias de la Salud. C/ Severo Ochoa, 2, 28760 Tres Cantos. Madrid, Spain. Phone +34 91 3530150
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11
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Yee M, Bakshi N, Graciaa SH, Lane PA, Jerris RC, Wang YF, Yildirim I. Incidence of invasive Haemophilus influenzae infections in children with sickle cell disease. Pediatr Blood Cancer 2019; 66:e27642. [PMID: 30724001 PMCID: PMC6472970 DOI: 10.1002/pbc.27642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Children with sickle cell disease (SCD) are at increased risk for invasive infection with encapsulated bacteria. Antibiotic prophylaxis and immunizations against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) have decreased the overall incidence of invasive infections and have shifted distribution of serotypes causing disease toward those not covered by immunizations. We sought to determine the current incidence of invasive H. influenzae infections in children with SCD and to describe the clinical features and management of these infections. METHODS Microbiology reports of a large pediatric tertiary care center were reviewed to identify all isolates of H. influenzae detected in sterile body fluid cultures from January 1, 2010 to December 31, 2017. Results were compared with the center's comprehensive clinical database of all children with SCD to identify all cases of children ages 0 to18 years with SCD with invasive H. influenzae disease for the same time period. RESULTS We captured 2444 patients with SCD, with 14,336 person-years. There were eight episodes of H. influenzae bacteremia in seven children with SCD (five type f, two non-typable, one type a). Most episodes (7 of 8) were in children < 5 years. The incidence rate of invasive H. influenzae in SCD was 0.58/1000 person-years for ages 0 to 18 years and 1.60/1000 person-years for children age < 5 years. There were no deaths from H. influenzae infection. CONCLUSIONS In the era of universal antibiotic prophylaxis and immunization against Hib, invasive H. influenzae disease due to nonvaccine serotypes remains a risk for children with SCD, particularly those under five years of age.
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Affiliation(s)
- Marianne Yee
- Department of Pediatrics, Division of Hematology/Oncology, Emory University, Atlanta, GA.,Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Nitya Bakshi
- Department of Pediatrics, Division of Hematology/Oncology, Emory University, Atlanta, GA.,Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Sara H. Graciaa
- Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Peter A. Lane
- Department of Pediatrics, Division of Hematology/Oncology, Emory University, Atlanta, GA.,Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Robert C. Jerris
- Department of Pathology and Laboratory Medicine, Children’s Healthcare of Atlanta, Atlanta, GA.,Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA
| | - Yun F. Wang
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA
| | - Inci Yildirim
- Department of Pediatrics, Division of Infectious Diseases, Emory University, Atlanta, GA.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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12
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Romaneli MTDN, Tresoldi AT, Pereira RM, Garcia MT, Hofling CC, Resende MR. INVASIVE NON-TYPE B HAEMOPHILUS INFLUENZAE DISEASE: REPORT OF EIGHT CASES. ACTA ACUST UNITED AC 2019; 37:156-160. [PMID: 30624539 PMCID: PMC6651304 DOI: 10.1590/1984-0462/;2019;37;2;00006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/06/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe eight cases of invasive non-type b Haemophilus influenzae disease in children admitted to Hospital de Clínicas of Universidade Estadual de Campinas. CASES DESCRIPTION In 2015, there were eight cases of invasive non-type b H. influenzae disease. We tested the ampicillin sensitivity and beta-lactamase production of the strains identified and performed the genotyping. Molecular typing was determined by Pulsed-Field Gel Electrophoresis. Four patients were diagnosed with bacteremia; in two cases, H. influenzae was detected in the pleural fluid, and two patients had meningitis. Patients with comorbidities represented 37.5% of cases. Except for the strain of one patient - not sent to the reference laboratory -, all were ampicillin-sensitive and non-beta-lactamase-producing. Genotyping identified four non-capsular, one type c, and two type a strains. Molecular typing ruled out nosocomial transmission since all serotypes were distinct regarding genotype. COMMENTS The rise in cases of invasive non-type b H. influenzae infection was real. There was no nosocomial transmission, and we found no justification for the increase. These data indicate the need for surveillance to correctly diagnose, monitor, and understand the spectrum of non-type b H. influenzae disease.
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Sayed-Hassan A, Hermann R, Chidiac F, Truy E, Guevara N, Bailleux S, Deguine O, Baladi B, Gallois Y, Bozorg-Grayeli A, Lerosey Y, Godey B, Parietti-Winkler C, Pereira B, Mom T. Association of the Duration of Antibiotic Therapy With Major Surgical Site Infection in Cochlear Implantation. JAMA Otolaryngol Head Neck Surg 2019; 145:14-20. [PMID: 30325991 DOI: 10.1001/jamaoto.2018.1998] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Infection after cochlear implantation is a rare but serious event that can lead to meningitis. There is no consensus on prevention of infection in these patients, and each center applies its own strategy. Objective To describe the rates of major surgical site infection for patients undergoing cochlear implantation who receive prolonged antibiotic treatment compared with those who receive a single perioperative dose of antibiotic prophylaxis. Design, Setting, and Participants Retrospective cohort study of patients who underwent cochlear implantation between January 1, 2011, and July 8, 2015, with a postoperative follow-up of 1 to 3 years. In this multicenter study at 8 French university centers, 1180 patients (509 children and 671 adults) who underwent cochlear implantation during this period were included. Interventions Prolonged antibiotic treatment vs single-dose antibiotic prophylaxis. Main Outcomes and Measures Major infection and explantation. Results Among 1180 patients (509 children [51.7% female] with a mean [SD] age of 4.6 [3.8] years and 671 adults [54.9% female] with a mean [SD] age of 54.8 [17.0] years), 12 patients (1.0%) developed a major infection, with 4 infections occurring in the prolonged antibiotic treatment group and 8 infections occurring in the antibiotic prophylaxis group (odds ratio, 2.45; 95% CI, 0.73-8.17). Children (9 of 509 [1.8%]) were more likely to develop infection than adults (3 of 671 [0.4%]). Among children, 4 infections occurred in the prolonged antibiotic group (n = 344), and 5 infections occurred in the antibiotic prophylaxis group (n = 158) (odds ratio, 2.78; 95% CI, 0.74-10.49). Among adults, 3 infections occurred in the antibiotic prophylaxis group (n = 365), whereas no infections occurred in the prolonged antibiotic treatment group (n = 290). Conclusions and Relevance After cochlear implantation, infection was rare, was less common among those who received prolonged antibiotic treatment, and was less likely to occur in adults than in children.
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Affiliation(s)
- Achraf Sayed-Hassan
- Otorhinolaryngology and Head and Neck Surgery, Gabriel Montpied University Hospital, Clermont-Ferrand, France
| | - Ruben Hermann
- Otorhinolaryngology, Head and Neck Surgery and Speech and Hearing, Edouard Herriot Hospital, Lyon, France
| | - Frédéric Chidiac
- Otorhinolaryngology, Head and Neck Surgery and Speech and Hearing, Edouard Herriot Hospital, Lyon, France
| | - Eric Truy
- Otorhinolaryngology, Head and Neck Surgery and Speech and Hearing, Edouard Herriot Hospital, Lyon, France
| | - Nicolas Guevara
- University Institute of the Head and Neck, Nice University Hospital, Nice, France
| | | | - Olivier Deguine
- Otorhinolaryngology, Otoneurology and Pediatric Otorhinolaryngology, Pierre-Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - Blandine Baladi
- Otorhinolaryngology, Otoneurology and Pediatric Otorhinolaryngology, Pierre-Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - Yohan Gallois
- Otorhinolaryngology, Otoneurology and Pediatric Otorhinolaryngology, Pierre-Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - Alexis Bozorg-Grayeli
- Otorhinolaryngology and Head and Neck Surgery, Dijon Bourgogne University Hospital, Dijon, France
| | - Yannick Lerosey
- Otorhinolaryngology and Head and Neck Surgery, Rouen University Hospital, Rouen, France
| | - Benoit Godey
- Otorhinolaryngology and Oral and Maxillofacial Surgery, Pontchaillou Hospital, Rennes University Hospital, Rennes, France
| | | | - Bruno Pereira
- Department of Statistics, Gabriel Montpied University Hospital, Clermont-Ferrand, France
| | - Thierry Mom
- Otorhinolaryngology and Head and Neck Surgery, Gabriel Montpied University Hospital, Clermont-Ferrand, France.,Laboratory of Biophysics of Sensory Handicaps, Unité Mixte de Recherche Institut National de la Santé et de la Recherche Médicale 1107, University of Clermont Auvergne, Clermont-Ferrand, France
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14
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Soeters HM, Blain A, Pondo T, Doman B, Farley MM, Harrison LH, Lynfield R, Miller L, Petit S, Reingold A, Schaffner W, Thomas A, Zansky SM, Wang X, Briere EC. Current Epidemiology and Trends in Invasive Haemophilus influenzae Disease-United States, 2009-2015. Clin Infect Dis 2018; 67:881-889. [PMID: 29509834 PMCID: PMC6181225 DOI: 10.1093/cid/ciy187] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/01/2018] [Indexed: 01/15/2023] Open
Abstract
Background Following Haemophilus influenzae serotype b (Hib) conjugate vaccine introduction in the 1980s, Hib disease in young children dramatically decreased, and epidemiology of invasive H. influenzae changed. Methods Active surveillance for invasive H. influenzae disease was conducted through Active Bacterial Core surveillance sites. Incidence rates were directly standardized to the age and race distribution of the US population. Results During 2009-2015, the estimated mean annual incidence of invasive H. influenzae disease was 1.70 cases per 100000 population. Incidence was highest among adults aged ≥65 years (6.30) and children aged <1 year (8.45); many cases in infants aged <1 year occurred during the first month of life in preterm or low-birth-weight infants. Among children aged <5 years (incidence: 2.84), incidence was substantially higher in American Indian and Alaska Natives AI/AN (15.19) than in all other races (2.62). Overall, 14.5% of cases were fatal; case fatality was highest among adults aged ≥65 years (20%). Nontypeable H. influenzae had the highest incidence (1.22) and case fatality (16%), as compared with Hib (0.03; 4%) and non-b encapsulated serotypes (0.45; 11%). Compared with 2002-2008, the estimated incidence of invasive H. influenzae disease increased by 16%, driven by increases in disease caused by serotype a and nontypeable strains. Conclusions Invasive H. influenzae disease has increased, particularly due to nontypeable strains and serotype a. A considerable burden of invasive H. influenzae disease affects the oldest and youngest age groups, particularly AI/AN children. These data can inform prevention strategies, including vaccine development.
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Affiliation(s)
- Heidi M Soeters
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amy Blain
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tracy Pondo
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Monica M Farley
- Emory University School of Medicine, Georgia
- Atlanta Veterans Affairs Medical Center, Georgia
| | - Lee H Harrison
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Lisa Miller
- University of Colorado School of Public Health, Denver
| | - Susan Petit
- Connecticut Department of Public Health, Hartford
| | | | | | | | | | - Xin Wang
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth C Briere
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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15
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Whittaker R, Economopoulou A, Dias JG, Bancroft E, Ramliden M, Celentano LP. Epidemiology of Invasive Haemophilus influenzae Disease, Europe, 2007-2014. Emerg Infect Dis 2018; 23:396-404. [PMID: 28220749 PMCID: PMC5382729 DOI: 10.3201/eid2303.161552] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe the epidemiology of invasive Haemophilus influenzae disease during 2007-2014 in 12 European countries and assess overall H. influenzae disease trends by serotype and patient age. Mean annual notification rate was 0.6 cases/100,000 population, with an increasing annual trend of 3.3% (95% CI 2.3% to 4.3%). The notification rate was highest for patients <1 month of age (23.4 cases/100,000 population). Nontypeable H. influenzae (NTHi) caused 78% of all cases and showed increasing trends among persons <1 month and >20 years of age. Serotype f cases showed an increasing trend among persons >60 years of age. Serotype b cases showed decreasing trends among persons 1-5 months, 1-4 years, and >40 years of age. Sustained success of routine H. influenzae serotype b vaccination is evident. Surveillance systems must adopt a broad focus for invasive H. influenzae disease. Increasing reports of NTHi, particularly among neonates, highlight the potential benefit of a vaccine against NTHi.
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16
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Kong M, Yang B, Gong C, Wang H, Li X, Zhao K, Li J, Wu F, Liu X, Hu Z. Development of immunochromatographic colloidal gold test strip for rapid detection ofHaemophilus influenzaein clinical specimens. J Appl Microbiol 2017; 123:287-294. [DOI: 10.1111/jam.13489] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/14/2017] [Accepted: 03/24/2017] [Indexed: 10/19/2022]
Affiliation(s)
- M.M. Kong
- Key Laboratory of Fermentation Engineering (Ministry of Education); Hubei Provincial Cooperative Innovation Center of Industrial Fermentation; Hubei Key Laboratory of Industrial Microbiology; Hubei University of Technology; Wuhan China
| | - B. Yang
- Key Laboratory of Fermentation Engineering (Ministry of Education); Hubei Provincial Cooperative Innovation Center of Industrial Fermentation; Hubei Key Laboratory of Industrial Microbiology; Hubei University of Technology; Wuhan China
| | - C.J. Gong
- Key Laboratory of Fermentation Engineering (Ministry of Education); Hubei Provincial Cooperative Innovation Center of Industrial Fermentation; Hubei Key Laboratory of Industrial Microbiology; Hubei University of Technology; Wuhan China
| | - H. Wang
- Key Laboratory of Fermentation Engineering (Ministry of Education); Hubei Provincial Cooperative Innovation Center of Industrial Fermentation; Hubei Key Laboratory of Industrial Microbiology; Hubei University of Technology; Wuhan China
| | - X. Li
- Key Laboratory of Fermentation Engineering (Ministry of Education); Hubei Provincial Cooperative Innovation Center of Industrial Fermentation; Hubei Key Laboratory of Industrial Microbiology; Hubei University of Technology; Wuhan China
| | - K.S. Zhao
- Key Laboratory of Fermentation Engineering (Ministry of Education); Hubei Provincial Cooperative Innovation Center of Industrial Fermentation; Hubei Key Laboratory of Industrial Microbiology; Hubei University of Technology; Wuhan China
| | - J.J. Li
- Key Laboratory of Fermentation Engineering (Ministry of Education); Hubei Provincial Cooperative Innovation Center of Industrial Fermentation; Hubei Key Laboratory of Industrial Microbiology; Hubei University of Technology; Wuhan China
| | - F. Wu
- Key Laboratory of Fermentation Engineering (Ministry of Education); Hubei Provincial Cooperative Innovation Center of Industrial Fermentation; Hubei Key Laboratory of Industrial Microbiology; Hubei University of Technology; Wuhan China
| | - X. Liu
- Key Laboratory of Fermentation Engineering (Ministry of Education); Hubei Provincial Cooperative Innovation Center of Industrial Fermentation; Hubei Key Laboratory of Industrial Microbiology; Hubei University of Technology; Wuhan China
| | - Z. Hu
- Key Laboratory of Fermentation Engineering (Ministry of Education); Hubei Provincial Cooperative Innovation Center of Industrial Fermentation; Hubei Key Laboratory of Industrial Microbiology; Hubei University of Technology; Wuhan China
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18
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Singh V, Nanjappa S, Pabbathi S, Greene JN. Invasive Haemophilus influenzae Infection in Patients With Cancer. Cancer Control 2017; 24:66-71. [PMID: 28178716 DOI: 10.1177/107327481702400111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A major cause of morbidity and mortality in patients with cancer is infection. Since the introduction of the Haemophilus influenzae type b (Hib) vaccine in the United States in the 1990s, invasive H influenzae infection has become less common. We report on 5 patients with cancer and invasive H influenzae infection. A literature review was also performed of the dominant Haemophilus subtype and the clinical features associated with the infection and concomitant cancer. Of the 17 cases found in the literature, had hematological malignancies and 1 case each had thymoma, schwannoma, teratoma, and pancreatic, Merkel cell, pharyngeal, laryngeal, and rectal carcinomas. Two cases occurred with AIDS and Kaposi sarcoma. Pneumonia with bacteremia was seen in 8 cases, whereas pleuritis, neck cellulitis, septic arthritis, meningitis, and mediastinitis were diagnosed in the others. No focus of infection was identified in 2 cases. Nontypable H influenzae (NTHi) occurred in 4 cases, and Hib was isolated in 2 cases; serotyping was not reported in the others. Leukocytosis occurred in 7 cases and lymphopenia in 3; no cases presented with neutropenia. Four isolates were positive for beta-lactamase. Susceptibility data were unavailable in 5 case patients. Among serotyped cases, 67% were of the NTHi strain - a finding consistent with the change in the epidemiology of H influenzae since the introduction of the Hib vaccine.
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Affiliation(s)
| | - Sowmya Nanjappa
- Department of Internal Hospital Medicine, Moffitt Cancer Center and University of South Florida Morsani College of Medicine, Tampa, FL
| | - Smitha Pabbathi
- Department of Internal Hospital Medicine, Moffitt Cancer Center, Tampa, FL
| | - John N Greene
- Department of Infectious Diseases, Moffitt Cancer Center, Tampa, FL.
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Tuyama M, Corrêa-Antônio J, Schlackman J, Marsh JW, Rebelo MC, Cerqueira EO, Nehab M, Kegele F, Carmo GF, Thielmann DC, Barroso PF, Harrison LH, Barroso DE. Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil. Mem Inst Oswaldo Cruz 2017; 112:196-202. [PMID: 28225904 PMCID: PMC5319370 DOI: 10.1590/0074-02760160391] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/23/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Haemophilus influenzae (Hi) serotype b (Hib) conjugate vaccine was incorporated into the infant immunisation schedule in Brazil in 1999, where Hib was one of the major etiologic sources of community-acquired bacterial meningitis. OBJECTIVES The purpose of this study is to describe the molecular epidemiology of invasive Hi disease in Rio de Janeiro state, Brazil, before and after vaccine introduction. METHODS Surveillance data from 1986 to 2014 were analysed. Hi isolates recovered from cerebrospinal fluid (CSF) or blood from 1993 to 2014 were serotyped by slide agglutination, genotyped by multilocus sequence typing (MLST), and the capsule type evaluation, differentiation of serologically non-typeable isolates, and characterisation of the capsule (cap) locus was done by polymerase chain reaction. Antimicrobial susceptibility testing was performed using E-test. FINDINGS From 1986 to 1999 and from 2000 to 2014, 2580 and 197 (42% without serotype information) confirmed cases were reported, respectively. The case fatality rate was 17% and did not correlate with the strain. Hib and b- variant isolates belonged to ST-6, whereas serotype a isolates belonged to the ST-23 clonal complex. Serotype a appeared to emerge during the 2000s. Non-encapsulated isolates were non-clonal and distinct from the encapsulated isolates. Ampicillin-resistant isolates were either of serotype b or were non-encapsulated, and all of them were β-lactamase-positive but amoxicillin-clavulanic acid susceptible. MAIN CONCLUSIONS Although Hi meningitis became a relatively rare disease in Rio de Janeiro after the introduction of the Hib conjugate vaccine, the isolates recovered from patients have become more diverse. These results indicate the need to implement an enhanced surveillance system to continue monitoring the impact of the Hib conjugate vaccine.
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Affiliation(s)
- Mari Tuyama
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, RJ, Brasil.,Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brasil
| | - Jessica Corrêa-Antônio
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, RJ, Brasil
| | - Jessica Schlackman
- University of Pittsburgh, School of Medicine and Graduate School of Public Health, Infectious Diseases Epidemiology Research Unit, Pittsburgh, PA, United States of America
| | - Jane W Marsh
- University of Pittsburgh, School of Medicine and Graduate School of Public Health, Infectious Diseases Epidemiology Research Unit, Pittsburgh, PA, United States of America
| | - Maria C Rebelo
- Secretaria de Estado de Saúde do Rio de Janeiro, Assessoria de Meningites, Rio de Janeiro, RJ, Brasil
| | - Elaine O Cerqueira
- Secretaria de Estado de Saúde do Rio de Janeiro, Assessoria de Meningites, Rio de Janeiro, RJ, Brasil
| | - Márcio Nehab
- Fundação Oswaldo Cruz-Fiocruz, Instituto Fernandes Figueira, Rio de Janeiro, RJ, Brasil
| | - Fabíola Kegele
- Fundação Oswaldo Cruz-Fiocruz, Instituto Fernandes Figueira, Rio de Janeiro, RJ, Brasil
| | | | | | - Paulo F Barroso
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brasil
| | - Lee H Harrison
- University of Pittsburgh, School of Medicine and Graduate School of Public Health, Infectious Diseases Epidemiology Research Unit, Pittsburgh, PA, United States of America
| | - David E Barroso
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, RJ, Brasil
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20
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Kress-Bennett JM, Hiller NL, Eutsey RA, Powell E, Longwell MJ, Hillman T, Blackwell T, Byers B, Mell JC, Post JC, Hu FZ, Ehrlich GD, Janto BA. Identification and Characterization of msf, a Novel Virulence Factor in Haemophilus influenzae. PLoS One 2016; 11:e0149891. [PMID: 26977929 PMCID: PMC4792463 DOI: 10.1371/journal.pone.0149891] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 02/05/2016] [Indexed: 12/11/2022] Open
Abstract
Haemophilus influenzae is an opportunistic pathogen. The emergence of virulent, non-typeable strains (NTHi) emphasizes the importance of developing new interventional targets. We screened the NTHi supragenome for genes encoding surface-exposed proteins suggestive of immune evasion, identifying a large family containing Sel1-like repeats (SLRs). Clustering identified ten SLR-containing gene subfamilies, each with various numbers of SLRs per gene. Individual strains also had varying numbers of SLR-containing genes from one or more of the subfamilies. Statistical genetic analyses of gene possession among 210 NTHi strains typed as either disease or carriage found a significant association between possession of the SlrVA subfamily (which we have termed, macrophage survival factor, msf) and the disease isolates. The PittII strain contains four chromosomally contiguous msf genes. Deleting all four of these genes (msfA1-4) (KO) resulted in a highly significant decrease in phagocytosis and survival in macrophages; which was fully complemented by a single copy of the msfA1 gene. Using the chinchilla model of otitis media and invasive disease, the KO strain displayed a significant decrease in fitness compared to the WT in co-infections; and in single infections, the KO lost its ability to invade the brain. The singly complemented strain showed only a partial ability to compete with the WT suggesting gene dosage is important in vivo. The transcriptional profiles of the KO and WT in planktonic growth were compared using the NTHi supragenome array, which revealed highly significant changes in the expression of operons involved in virulence and anaerobiosis. These findings demonstrate that the msfA1-4 genes are virulence factors for phagocytosis, persistence, and trafficking to non-mucosal sites.
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Affiliation(s)
- Jennifer M. Kress-Bennett
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - N. Luisa Hiller
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
- Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania, United States of America
| | - Rory A. Eutsey
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
| | - Evan Powell
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
| | - Mark J. Longwell
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
| | - Todd Hillman
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
| | - Tenisha Blackwell
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
| | - Barbara Byers
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
| | - Joshua C. Mell
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
- Center for Genomic Sciences, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - J. Christopher Post
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
- Department of Otolaryngology, Head and Neck Surgery, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, Pennsylvania, United States of America
| | - Fen Z. Hu
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
- Department of Otolaryngology, Head and Neck Surgery, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, Pennsylvania, United States of America
| | - Garth D. Ehrlich
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
- Center for Genomic Sciences, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
- Department of Otolaryngology, Head and Neck Surgery, Drexel University College of Medicine, Allegheny Campus, Pittsburgh, Pennsylvania, United States of America
| | - Benjamin A. Janto
- Center for Genomic Sciences, Allegheny Singer Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States of America
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
- Center for Genomic Sciences, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
- * E-mail:
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Porter M, Charles AK, Nathan EA, French NP, Dickinson JE, Darragh H, Keil AD. Haemophilus influenzae: a potent perinatal pathogen disproportionately isolated from Indigenous women and their neonates. Aust N Z J Obstet Gynaecol 2015; 56:75-81. [DOI: 10.1111/ajo.12413] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 09/06/2015] [Indexed: 12/26/2022]
Affiliation(s)
- Michelle Porter
- PathWest Laboratory Medicine; Microbiology Department; Princess Margaret Hospital; Perth Western Australia Australia
| | - Adrian K. Charles
- Department of Pathology; Sidra Medical and Research Centre; Doha Qatar
| | | | - Noel P. French
- Neonatal Clinical Care Unit; King Edward Memorial Hospital; Perth Western Australia Australia
| | - Jan E. Dickinson
- Women and Infants Research Foundation; Perth Western Australia Australia
- School of Women's and Infants' Health; The University of Western Australia; Perth Western Australia Australia
| | - Helen Darragh
- PathWest Laboratory Medicine; Microbiology Department; Princess Margaret Hospital; Perth Western Australia Australia
| | - Anthony D. Keil
- PathWest Laboratory Medicine; Microbiology Department; Princess Margaret Hospital; Perth Western Australia Australia
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Chen Y, Guo J, Qian G, Fang D, Shi D, Guo L, Li L. Gut dysbiosis in acute-on-chronic liver failure and its predictive value for mortality. J Gastroenterol Hepatol 2015; 30:1429-37. [PMID: 25711972 DOI: 10.1111/jgh.12932] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Bacterial translocation from the gut plays an important role in the pathophysiology of acute-on-chronic liver failure (ACLF). However, gut dysbiosis in ACLF was not widely documented in previous studies. AIM This research characterized the fecal microbiota in patients with ACLF and analyzed the temporal stability of gut microbiota during illness. METHODS Fecal microbiota of 79 ACLF patients (42 patients were followed in the next 4 weeks after the first visit for longitudinal study) and 50 healthy controls was analyzed by 16S ribosomal DNA pyrosequencing. RESULTS There was a marked difference between the ACLF group and the control group. The overall microbial diversity and richness were significantly lower in ACLF than in controls. ACLF patients had lower abundance of Bacteroidaceae, Ruminococcaceae, and Lanchnospiraceae, but higher abundance of Pasteurellaceae, Streptococcaceae, and Enterecoccaceae. The relative abundance of Lachnospiraceae was obviously decreased in ACLF patients with hepatic encephalopathy. The gut microbiota kept relatively stable in a short term after the onset of ACLF. The use of antibiotics only showed moderate impacts on the gut microbiota. The relative abundance of Pasteurellaceae and Model of End Stage Liver Disease score were independent factors predicting mortality rate. Network analysis comparison showed robust correlations between specific bacterial families (Ruminococcaceae and Lachnospiraceae) and inflammatory cytokines (interleukin [IL]-6, tumor necrosis factor alpha, IL-2) in ACLF patients. CONCLUSIONS These data suggest gut dysbiosis in ACLF and its predictive value for mortality. The results thus open up the possibility of designing diagnostic biomarkers and targeted probiotics aimed at decreasing mortality in ACLF.
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Affiliation(s)
- Yanfei Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China
| | - Jing Guo
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China
| | - Guirong Qian
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China
| | - Daiqiong Fang
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China
| | - Ding Shi
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China
| | - Lihua Guo
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China
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Population-based epidemiology and microbiology of community-onset bloodstream infections. Clin Microbiol Rev 2015; 27:647-64. [PMID: 25278570 DOI: 10.1128/cmr.00002-14] [Citation(s) in RCA: 189] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bloodstream infection (BSI) is a major cause of infectious disease morbidity and mortality worldwide. While a positive blood culture is mandatory for establishment of the presence of a BSI, there are a number of determinants that must be considered for establishment of this entity. Community-onset BSIs are those that occur in outpatients or are first identified <48 h after admission to hospital, and they may be subclassified further as health care associated, when they occur in patients with significant prior health care exposure, or community associated, in other cases. The most common causes of community-onset BSI include Escherichia coli, Staphylococcus aureus, and Streptococcus pneumoniae. Antimicrobial-resistant organisms, including methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase/metallo-β-lactamase/carbapenemase-producing Enterobacteriaceae, have emerged as important etiologies of community-onset BSI.
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Abstract
Due to the introduction of the conjugate vaccine against serotype b, neonatal sepsis caused by Haemophilus influenzae became very rare. There is little data in Belgium concerning the prevalence of H. influenzae early onset neonatal sepsis and articles about neonatal sepsis and H. influenzae published in the last decade are scarce. We report two invasive infections with a non-typeable H. influenzae. These cases show that neonatal sepsis caused by non-typeable H. influenzae may be underestimated and we believe that there is need for a better registration of this kind of infection.
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Gilsdorf JR. What the pediatrician should know about non-typeable Haemophilus influenzae. J Infect 2015; 71 Suppl 1:S10-4. [PMID: 25917803 DOI: 10.1016/j.jinf.2015.04.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 11/25/2022]
Abstract
Non-typeable Haemophilus influenzae (NTHi) live exclusively in the pharynges of humans and are increasingly recognized as pathogens that cause both localized infections of the respiratory tract (middle ear spaces, sinuses, and bronchi) and systemic infections such as bacteraemia and pneumonia. Only one vaccine antigen of NTHi, Protein D, has been extensively studied in humans and its efficacy in preventing NTHi otitis media is modest. Recent genetic analyses reveal that NTHi are closely related to Haemophilus haemolyticus (Hh), previously thought to be a non-pathogenic commensal of the pharynx. This review discusses the differences between the pathogenic potential of encapsulated and non-typeable Hi. In addition, information on the lifestyles and bacterial characteristics of NTHi and Hh as they pertain to their pathogenic capacities and the value of the Haemophilus taxonomy to clinicians are presented. Further, the epidemiology and mechanisms of NTHi antibiotic resistance, which include production of β-lactamase and alterations of penicillin-binding protein 3, are reviewed, as are the challenges of vaccine antigen discovery in NTHi.
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Affiliation(s)
- Janet R Gilsdorf
- D5101 Medical Professional Building SPC 5718, Ann Arbor, MI 48109-5718, United States.
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Vaccines for Nontypeable Haemophilus influenzae: the Future Is Now. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2015; 22:459-66. [PMID: 25787137 DOI: 10.1128/cvi.00089-15] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Infections due to nontypeable Haemophilus influenzae result in enormous global morbidity in two clinical settings: otitis media in children and respiratory tract infections in adults with chronic obstructive pulmonary disease (COPD). Recurrent otitis media affects up to 20% of children and results in hearing loss, delays in speech and language development and, in developing countries, chronic suppurative otitis media. Infections in people with COPD result in clinic and emergency room visits, hospital admissions, and respiratory failure. An effective vaccine would prevent morbidity, help control health care costs, and reduce antibiotic use, a major contributor to the global crisis in bacterial antibiotic resistance. The widespread use of the pneumococcal conjugate vaccines is causing a relative increase in H. influenzae otitis media. The partial protection against H. influenzae otitis media induced by the pneumococcal H. influenzae protein D conjugate vaccine represents a proof of principle of the feasibility of a vaccine for nontypeable H. influenzae. An ideal vaccine antigen should be conserved among strains, have abundant epitopes on the bacterial surface, be immunogenic, and induce protective immune responses. Several surface proteins of H. influenzae have been identified as potential vaccine candidates and are in various stages of development. With continued research, progress toward a broadly effective vaccine to prevent infections caused by nontypeable H. influenzae is expected over the next several years.
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Haemophilus influenzae: recent advances in the understanding of molecular pathogenesis and polymicrobial infections. Curr Opin Infect Dis 2015; 27:268-74. [PMID: 24699388 DOI: 10.1097/qco.0000000000000056] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Non-typeable Haemophilus influenzae (NTHi) is a human-specific mucosal pathogen and one of the most common causes of bacterial infections in children and patients with chronic obstructive pulmonary disease. It is also frequently found in polymicrobial superinfections. Great strides have recently been made in the understanding of the molecular mechanisms underlying NTHi pathogenesis. RECENT FINDINGS By using new methodology, such as experimental human colonization models and whole-genome approaches, investigators have shed light upon the various strategies of NTHi that are involved in pathogenesis. These include the escape of the mucociliary elevator, evasion of host immunity, survival in environments with scarce nutrients, and finally participation in polymicrobial infections. Lipooligosaccharide branching, proteinous adhesins, metabolic adaption to nutrient availability and many scavenging systems are implicated in these processes. Interestingly, genome-based studies comparing virulent and commensal strains have identified many hypothetical proteins as virulence determinants, suggesting that much regarding the molecular pathogenesis of NTHi remains to be solved. SUMMARY NTHi is an opportunistic pathogen and highly specialized colonizer of the human respiratory tract that has developed intricate mechanisms to establish growth and survival in the human host. Continued research is needed to further elucidate NTHi host-pathogen and pathogen-pathogen interactions.
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Blain A, MacNeil J, Wang X, Bennett N, Farley MM, Harrison LH, Lexau C, Miller L, Nichols M, Petit S, Reingold A, Schaffner W, Thomas A, Clark T, Cohn A, Briere E. Invasive Haemophilus influenzae Disease in Adults ≥65 Years, United States, 2011. Open Forum Infect Dis 2014; 1:ofu044. [PMID: 25734116 PMCID: PMC4281775 DOI: 10.1093/ofid/ofu044] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 05/15/2014] [Indexed: 11/25/2022] Open
Abstract
In this older age group burden of disease and CFR both increase significantly as age increases. Several underlying conditions increased risk of disease severity and patients with severe disease were more likely to die. Background Since the introduction of the Haemophilus influenzae serotype b vaccine, H influenzae epidemiology has shifted. In the United States, the largest burden of disease is now in adults aged ≥65 years. However, few data exist on risk factors for disease severity and outcome in this age group. Methods A retrospective case-series review of invasive H influenzae infections in patients aged ≥65 years was conducted for hospitalized cases reported to Active Bacterial Core surveillance in 2011. Results There were 299 hospitalized cases included in the analysis. The majority of cases were caused by nontypeable H influenzae, and the overall case fatality ratio (CFR) was 19.5%. Three or more underlying conditions were present in 63% of cases; 94% of cases had at least 1. Patients with chronic heart conditions (congestive heart failure, coronary artery disease, and/or atrial fibrillation) (odds ratio [OR], 3.27; 95% confidence interval [CI], 1.65–6.46), patients from private residences (OR, 8.75; 95% CI, 2.13–35.95), and patients who were not resuscitate status (OR, 2.72; 95% CI, 1.31–5.66) were more likely to be admitted to the intensive care unit (ICU). Intensive care unit admission (OR, 3.75; 95% CI, 1.71–8.22) and do not resuscitate status (OR, 12.94; 95% CI, 4.84–34.55) were significantly associated with death. Conclusions Within this age group, burden of disease and CFR both increased significantly as age increased. Using ICU admission as a proxy for disease severity, our findings suggest several conditions increased risk of disease severity and patients with severe disease were more likely to die. Further research is needed to determine the most effective approach to prevent H influenzae disease and mortality in older adults.
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Affiliation(s)
- Amy Blain
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , Georgia
| | - Jessica MacNeil
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , Georgia
| | - Xin Wang
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , Georgia
| | | | - Monica M Farley
- Department of Medicine , Emory University School of Medicine and the Atlanta VA Medical Center , Atlanta , Georgia
| | - Lee H Harrison
- Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
| | | | - Lisa Miller
- Colorado Department of Public Health and Environment , Denver
| | | | - Susan Petit
- Connecticut Department of Public Health , Hartford
| | - Arthur Reingold
- School of Public Health , University of California , Berkley
| | - William Schaffner
- Department of Preventive Medicine , Vanderbilt University School of Medicine , Nashville, Tennessee
| | - Ann Thomas
- Oregon Department of Human Services , Portland
| | - Thomas Clark
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , Georgia
| | - Amanda Cohn
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , Georgia
| | - Elizabeth Briere
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , Georgia
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Abstract
We reviewed our Children's Hospital autopsies (1986-2009, 3-8 year groups) to determine the contribution of infections/inflammation to death and trends over time. Infections were categorized as (1) underlying cause of death, (2) mechanism of death complicating another underlying cause of death, (3) contributing (4) agonal or (5) incidental. Of 608 autopsies (44% of deaths), 401 had 691 infections (66%, 1.72 infections/infected child). In categories 1-5, there were 85 (12.3%), 237(34.3%), 231 (33.4%), 82 (11.9%) and 56(8.1%) infections. Leading infections include bronchopneumonia (188), sepsis (144- Enterococcus most common with 22), meningitis (35- Streptococcus pneumoniae most common with 10), pneumonitis (33), peritonitis (29). Sepsis declined in 2002-2009, attributed to fluid resuscitation standardization. Meningitis declined after 1993, and may be partially attributed to vaccines (Hemophilus influenza, Streptococcus pneumoniae). Despite advances in anti-microbial therapy, 66% of pediatric autopsies had inflammatory lesions, predominately as the mechanism or contributing factor rather than the underlying cause of death.
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Affiliation(s)
- Randall Craver
- 1Children's Hospital of New Orleans, Laboratory, New Orleans, LA, USA
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Jalalvand F, Littorin N, Su YC, Riesbeck K. Impact of immunization with Protein F on pulmonary clearance of nontypeable Haemophilus influenzae. Vaccine 2014; 32:2261-4. [PMID: 24631068 DOI: 10.1016/j.vaccine.2014.02.082] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 01/24/2014] [Accepted: 02/25/2014] [Indexed: 11/27/2022]
Abstract
Nontypeable Haemophilus influenzae (NTHi) is one of the main aetiologies of childhood bacterial infections as well as exacerbations in COPD patients. Currently, no licensed NTHi vaccine exists. In the present study, we evaluated the potential of the conserved and ubiquitous surface protein Haemophilus Protein F (PF) as a vaccine candidate. Our results show that incubation of NTHi with anti-PF antibodies significantly increased the opsonophygocytosis of human promyelocytic leukemia cell line-derived granulocytes, leading to efficient killing of the bacteria (P≤0.05). The presence of anti-PF IgG titers in healthy adults (n=60) was investigated, and we found that 26% of healthy blood donors carried antibodies with the main antigenic epitope being PF(23-48). Finally, mice immunized with PF(23-48) attained a significantly increased capacity to clear NTHi as compared to a control group immunized with a peptide derived from Moraxella catarrhalis β-lactamase (P≤0.05). Taken together, our results indicate that PF is a potential NTHi-vaccine candidate.
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Affiliation(s)
- Farshid Jalalvand
- Medical Microbiology, Department of Laboratory Medicine Malmö, Lund University, Malmö, Sweden
| | - Nils Littorin
- Medical Microbiology, Department of Laboratory Medicine Malmö, Lund University, Malmö, Sweden
| | - Yu-Ching Su
- Medical Microbiology, Department of Laboratory Medicine Malmö, Lund University, Malmö, Sweden
| | - Kristian Riesbeck
- Medical Microbiology, Department of Laboratory Medicine Malmö, Lund University, Malmö, Sweden.
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Revised recommendations for the prevention of secondary Haemophilus influenzae type b (Hib) disease. J Infect 2013; 67:486-9. [DOI: 10.1016/j.jinf.2013.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 06/24/2013] [Accepted: 06/28/2013] [Indexed: 11/18/2022]
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Bajanca-Lavado MP, Simões AS, Betencourt CR, Sá-Leão R. Characteristics of Haemophilus influenzae invasive isolates from Portugal following routine childhood vaccination against H. influenzae serotype b (2002-2010). Eur J Clin Microbiol Infect Dis 2013; 33:603-10. [PMID: 24154654 DOI: 10.1007/s10096-013-1994-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 10/03/2013] [Indexed: 10/26/2022]
Abstract
We aimed to characterize Haemophilus influenzae invasive isolates recovered in Portugal over a 9-year period (2002-2010) following the inclusion of H. influenzae serotype b (Hib) conjugate vaccination in the National Immunization Program (NIP) in the year 2000 and compare the results with those obtained in a similar study from the pre-vaccination era (1989-2001) previously described by us. As part of a laboratory-based passive surveillance system, 144 invasive isolates obtained in 28 Portuguese hospitals were received at the National Reference Laboratory for Bacterial Respiratory Infections and were characterized. Capsular types and antibiotic susceptibility patterns were determined. The ftsI gene encoding PBP3 was sequenced for β-lactamase-negative ampicillin-resistant (BLNAR) isolates. Genetic relatedness among isolates was examined by multilocus sequencing typing (MLST). Most isolates (77.1%) were non-capsulated, a significant increase compared to the pre-vaccination era (19.0%, p < 0.001). Serotype b strains decreased significantly (from 81.0 to 13.2%, p < 0.001) and serotype f increased significantly (from 0.8 to 6.9%, p = 0.03). Ten percent of the isolates were β-lactamase producers, a value lower than that previously observed (26.9%, p = 0.005). Eight percent of all isolates were BLNAR. A high genetic diversity among non-capsulated isolates was found. By contrast, capsulated isolates were clonal. The implementation of Hib vaccination has resulted in a significant decline in the proportion of serotype b H. influenzae invasive disease isolates. Most episodes of invasive disease occurring in Portugal are now due to fully susceptible, highly diverse, non-capsulated strains. Given the evolving dynamics of this pathogen and the increase in non-type b capsulated isolates, continuous surveillance is needed.
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Affiliation(s)
- M P Bajanca-Lavado
- National Reference Laboratory for Bacterial Respiratory Infections, Department of Infectious Disease, National Institute of Health Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016, Lisboa, Portugal,
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Abstract
In a world where most emerging and reemerging infectious diseases are zoonotic in nature and our contacts with both domestic and wild animals abound, there is growing awareness of the potential for human acquisition of animal diseases. Like other Pasteurellaceae, Pasteurella species are highly prevalent among animal populations, where they are often found as part of the normal microbiota of the oral, nasopharyngeal, and upper respiratory tracts. Many Pasteurella species are opportunistic pathogens that can cause endemic disease and are associated increasingly with epizootic outbreaks. Zoonotic transmission to humans usually occurs through animal bites or contact with nasal secretions, with P. multocida being the most prevalent isolate observed in human infections. Here we review recent comparative genomics and molecular pathogenesis studies that have advanced our understanding of the multiple virulence mechanisms employed by Pasteurella species to establish acute and chronic infections. We also summarize efforts being explored to enhance our ability to rapidly and accurately identify and distinguish among clinical isolates and to control pasteurellosis by improved development of new vaccines and treatment regimens.
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Affiliation(s)
- Brenda A Wilson
- Department of Microbiology and Host-Microbe Systems Theme of the Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
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