Mulder D C, Padberg R D, Westra M, Fijen C A P M J
Afd. Kindergeneeskunde, Zaans Medisch Centrum, Koningin Julianaplein 58, 1502 DV Zaandam.
Ned Tijdschr Geneeskd. 2002 Aug 31;146(35):1651-3.
A 6-month-old girl had been ill with a cold for several days and was increasingly drowsy. She had been fully vaccinated against Haemophilus influenzae type b and had meningitis due to H. influenzae type a. She made a complete recovery after treatment with ceftriaxone and amoxicillin. In the Netherlands, vaccination with the conjugated H. influenzae type b vaccine was started in 1993 and since then invasive infections caused by H. influenzae type b have almost disappeared. Vaccination may suppress carriership of H. influenzae type b. However, vaccination does not elicit cross-protective antibodies against other serotypes of H. influenzae. H. influenzae non-type b may profit from the vaccination state, resulting in a higher carrier rate and an increased incidence of invasive infections. In the Netherlands, H. influenzae type a as the causative agent of an invasive infection has been recorded for the first time since registration started in 1975 and since then five such cases have been reported. In the literature, 45 cases of infection with H. influenzae type a have been described up until now.
一名6个月大的女孩患感冒已有数日,且愈发嗜睡。她已全程接种b型流感嗜血杆菌疫苗,却感染了a型流感嗜血杆菌脑膜炎。经头孢曲松和阿莫西林治疗后,她完全康复。在荷兰,1993年开始接种b型流感嗜血杆菌结合疫苗,自那时起,由b型流感嗜血杆菌引起的侵袭性感染几乎消失。接种疫苗可能会抑制b型流感嗜血杆菌的携带。然而,接种疫苗不会引发针对其他血清型流感嗜血杆菌的交叉保护性抗体。非b型流感嗜血杆菌可能会从疫苗接种状况中获益,导致携带率更高,侵袭性感染发病率增加。在荷兰,自1975年开始记录以来,a型流感嗜血杆菌作为侵袭性感染的病原体首次被记录,此后已报告了5例此类病例。在文献中,截至目前已描述了45例a型流感嗜血杆菌感染病例。