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Increasing ampicillin-resistance rates in Hemophilus influenzae meningitis
Abstract:
We studied the epidemiology of reported Hemophilus influenzae meningitis in Colorado for the years 1977 through 1981. Of 340 culture-confirmed cases, 94% occurred in children less than 5 years old. A marked seasonal variation was present, with peaks in late fall-early winter and late spring. The percentage of H influenzae isolates resistant to ampicillin increased from 4.2% in 1977 to 31.3% in 1981. The incidence of reported disease in children younger than 5 years of age increased from 26 per 100,000 population in 1977 to 39 per 100,000 population in 1981, The overall case fatality rate was 5.2%; mortality was somewhat higher for persons with ampicillin-resistant infections (9.4%) than for those with ampicillin-sensitive infections (4.3%). Our results agree with previous reports of an increasing rate of ampicillin resistance in H influenzae meningitis and indicate a possible increasing incidence of this disease in Colorado.
Insights
Ampicillin resistance in Hemophilus influenzae meningitis cases increased significantly in Colorado from 1977 to 1981. This rise in resistance correlated with an increase in disease incidence and fatality rates, particularly in young children.
Area of Science:
- Epidemiology
- Infectious Diseases
- Bacteriology
Background:
- Hemophilus influenzae meningitis was a significant public health concern.
- Understanding disease trends and antimicrobial resistance is crucial for effective treatment and prevention.
Purpose of the Study:
- To investigate the epidemiology of Hemophilus influenzae meningitis in Colorado between 1977 and 1981.
- To assess trends in ampicillin resistance and disease incidence.
- To determine the impact of resistance on case fatality rates.
Main Methods:
- Retrospective analysis of culture-confirmed Hemophilus influenzae meningitis cases reported in Colorado.
- Data collection on patient demographics, disease seasonality, ampicillin resistance patterns, and outcomes.
- Calculation of incidence rates and case fatality rates.
Main Results:
- A total of 340 cases were studied, with 94% occurring in children under 5 years old.
- Ampicillin resistance in H. influenzae isolates rose from 4.2% in 1977 to 31.3% in 1981.
- Disease incidence in children under 5 increased from 26 to 39 per 100,000 population.
- Case fatality rate was 5.2%, with higher mortality for ampicillin-resistant infections (9.4%) versus sensitive infections (4.3%).
Conclusions:
- There was a notable increase in ampicillin resistance among H. influenzae meningitis isolates during the study period.
- The incidence of Hemophilus influenzae meningitis in young children in Colorado appeared to be increasing.
- Ampicillin resistance is associated with increased mortality in Hemophilus influenzae meningitis.