Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Utah,, Salt Lake City, Utah 84158, USA.
Clin Infect Dis. 2010 Apr 1;50(7):e41-6. doi: 10.1086/651165.
The incidence of invasive Haemophilus influenzae infection decreased dramatically since the introduction of the H. influenzae serotype b (Hib) conjugate vaccine. H. influenzae invasive disease continues to occur and cause significant morbidity and mortality in children aged <5 years. We aimed to report the epidemiology and serotypes of invasive H. influenzae disease in children from Utah in the post-Hib vaccine era.
We identified all cases of invasive H. influenzae disease, defined as H. influenzae isolated from a sterile site, during the period 1998-2008 among children aged <18 years who were living in Utah.
We identified 91 cases of invasive H. influenzae disease in children. Children aged <5 years accounted for 78 cases (86%). H. influenzae serotype a (Hia) was the most common serotype (22 cases), representing 28% of all cases of invasive disease among children aged <5 years. The majority (15 cases [93%]) of Hib disease cases occurred among children aged <5 years and accounted for 18% of all cases of H. influenzae invasive disease in this age group. The mean incidence of Hia disease increased from 0.8 cases per 100,000 child-years in 1998 to 2.6 cases per 100,000 child-years in 2008. The incidence of Hib disease among children aged <5 years remained steady at 0.5 cases per 100,000 child-years. Bacteremia accounted for 61% of all cases of invasive disease. One-half (13 of 26) of cases of H. influenzae meningitis were due to Hia.
H. influenzae continues to cause invasive disease in Utah children. Hia is the primary cause of the overall increased incidence of invasive H. influenzae disease and leads to disease similar to Hib. Isolated cases of Hib disease demonstrate a continued reservoir. The success of the Hib conjugate vaccine may therefore be vulnerable to vaccine shortages and refusal of vaccination.
自从引入乙型流感嗜血杆菌（Hib）结合疫苗以来，侵袭性流感嗜血杆菌感染的发病率显著下降。在 <5 岁的儿童中，流感嗜血杆菌侵袭性疾病仍在继续发生，并导致严重的发病率和死亡率。我们旨在报告犹他州在 Hib 疫苗时代后儿童侵袭性流感嗜血杆菌病的流行病学和血清型。
我们确定了所有 1998-2008 年期间居住在犹他州的 <18 岁儿童中，从无菌部位分离出流感嗜血杆菌的侵袭性流感嗜血杆菌病病例。
我们在儿童中确定了 91 例侵袭性流感嗜血杆菌病。<5 岁的儿童占 78 例（86%）。甲型流感嗜血杆菌（Hia）是最常见的血清型（22 例），占所有 <5 岁儿童侵袭性疾病的 28%。大多数（15 例[93%]）Hib 疾病病例发生在 <5 岁的儿童中，占该年龄组所有流感嗜血杆菌侵袭性疾病的 18%。Hia 疾病的平均发病率从 1998 年的每 100,000 名儿童 0.8 例增加到 2008 年的每 100,000 名儿童 2.6 例。<5 岁儿童 Hib 疾病的发病率保持在每 100,000 名儿童 0.5 例。菌血症占所有侵袭性疾病的 61%。26 例流感嗜血杆菌脑膜炎中有一半（13 例）是由 Hia 引起的。
流感嗜血杆菌继续在犹他州儿童中引起侵袭性疾病。Hia 是导致总体侵袭性流感嗜血杆菌病发病率增加的主要原因，并导致类似于 Hib 的疾病。孤立的 Hib 疾病病例表明存在持续的储库。因此，Hib 结合疫苗的成功可能容易受到疫苗短缺和接种疫苗的拒绝的影响。
