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Systemic Haemophilus influenzae disease in Thai children
1Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Insights
Haemophilus influenzae causes serious infections, particularly in infants, with meningitis being most common. Early diagnosis and vaccination are crucial for reducing severe illness and death.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Epidemiology
Background:
- Systemic Haemophilus influenzae disease poses a significant threat, especially to young children.
- Understanding the clinical spectrum and antimicrobial susceptibility is vital for effective management.
Purpose of the Study:
- To analyze the clinical characteristics, outcomes, and antimicrobial resistance patterns of systemic Haemophilus influenzae infections.
- To inform strategies for prevention and treatment of this serious infection.
Main Methods:
- Retrospective chart review of 50 patients with systemic Haemophilus influenzae disease from 1980-1992.
- Analysis of clinical entities, patient demographics, complications, mortality, and antimicrobial susceptibility.
Main Results:
- Meningitis (55.7%) and pneumonia (25.3%) were the most frequent manifestations.
- The mean age was 12.7 months, with peak incidence between 4-6 months.
- High resistance rates were observed for penicillin (57.1%) and ampicillin (76.4%), but not third-generation cephalosporins.
Conclusions:
- Haemophilus influenzae infections are life-threatening, necessitating prompt diagnosis and treatment.
- Antimicrobial resistance is a growing concern, highlighting the need for effective vaccination strategies.
- Vaccination against H. influenzae type b is essential for disease prevention.
Abstract:
Fifty patients with systemic Haemophilus influenzae disease were indentified by hospital chart review between 1980-1992. The age distribution varied from 8 days to 14 years; the mean age of the patients was 12.7 months. The peak incidence was between 4 and 6 months of age. There were 27 male patients and 23 female patients for a male:female ratio of 1.17:1. The relative frequencies of 79 clinical entities encountered in 50 patients are as follows: meningitis 55.7%, bacteremia 13.9%, pneumonia 25.3%, cellulitis 2.5% arthritis 1.3%, septic shock 1.3%. There were 23 patients (46%) who had more than one disease entity. Most of the patients were anemic (Hb < 10 gm%) when hospitalization. Sixty-four percent of the patients had early complications. The mortality rate was 8%. Although serotyping was not done from the isolates, at least 33 cerebrospinal fluid samples were positive for H. influenzae type b capsular antigen by counterimmunoelectrophoresis. The percentage of susceptible H. influenzae to penicillin, ampicillin, chloramphenicol, co-trimoxazole were 57.1%, 76.4%, 87.5% and 54.2%, respectively. There was no strain resistant to third generation cephalosporin. Our data indicate that H. influenzae is a serious and life threatening infection. Early diagnosis and proper treatment will reduce the morbidity and mortality rates. For prevention of infection, an appropriate strategy for vaccination is required.