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An epidemiological study of Haemophilus influenzae at a Brazilian day care center
1University of São Paulo, Ribeirão Preto Campus, Av do Café/No. Campus USP, CEP 14040-904, Ribeirão Preto, São Paulo, Brazil.
Insights
Day care centers show high rates of Haemophilus influenzae (Hi) carriage in young children. Frequent changes in bacterial types highlight the need for monitoring these settings for potential disease outbreaks.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Day care centers gather young children, increasing susceptibility to contagious diseases.
- Haemophilus influenzae (Hi) is a significant pathogen in the pediatric population attending day care.
Purpose of the Study:
- To determine the carriage rate of Haemophilus influenzae in children and staff at a Brazilian day care center.
- To analyze the serotypes and genetic diversity of Hi isolates.
Main Methods:
- Nasopharyngeal swabs collected from 38 children (6-37 months) and 23 staff members in July and December.
- Isolates identified and characterized for serotype and ribotype patterns.
Main Results:
- High carriage rate of Hi among children (77%) compared to staff (9%).
- Non-typeable Hi strains predominated (48/58 isolates).
- High diversity of ribotype patterns indicated frequent exchange of non-typeable Hi.
Conclusions:
- Day care centers exhibit high and dynamic carriage of Hi, posing a risk for disease transmission.
- Close monitoring of day care centers is crucial for controlling Hi infections in the community.
Abstract:
Day care centers are a relatively new phenomenon in Brazil that bring together large numbers of young children susceptible to contagious diseases. Haemophilus influenzae (Hi) is an important infection in the age range of those attending day care centers. In the present study, the carriage rate of Haemophilus influenzae was identified in 38 day care attendees age 6 to 37 months, and 23 staff members, at a day care center in Ribeirão Preto-São Paulo, in 1997. To identify the carriers, two nasopharyngeal swabs were collected; one in July and one in December. The rate of H. influenzae carriers among the children was 77%. Only 2 of 23 staff members (9%) had Hi. Among the children, there were 58 isolates in the two sampling periods; 6 of the Hi were serotype b, 1 was serotype e, and 48 isolates were non-typeable. Two were identified as H. parainfluenzae. One adult had a non-typeable Hi and 1 had H. paraphrohaemolyticus. Three of the 6 children with type B had received a conjugate vaccine against H. influenzae type b, but they still carried this bacterium in the nasopharynx (50%). Forty ribotype patterns were found among the isolates, showing a high exchange rate of nontypeable H. influenzae carriers. The results indicate that, because of the high and changing biotype of Hi carriage, day care centers should be carefully monitored as potential point source of HI disease in the community.