Sunakawa Keisuke, Takeuchi Yuriko, Iwata Satoshi
Kitasato Institute for Life Sciences, Kitasato University.
Kansenshogaku Zasshi. 2011 May;85(3):227-37. doi: 10.11150/kansenshogakuzasshi.85.227.
While most systemic pediatric Haemophilus influenzae infections are caused by the type b strain (Hib), nontypeable H. influenzae: (NTHi) has been considered a respiratory tract pathogen common in local infection such as acute otitis media, acute pneumonia, secondary chronic respiratory disease and other otorhinolaryngologic infections. Recent findings show, however, that NTHi also causes invasive infections such as meningitis, bacteremia, and lower respiratory tract infections such as pneumonia. A review of NTHi epidemiology from the 1990s onward shows that NTHi causes significant morbidity in pediatric acute otitis media, sinusitis, conjunctivitis and lower respiratory diseases such as pneumonia in Japan. This summary also reviews the worldwide influence of Streptococcus pneumoniae and Hib vaccines on causative pathogens, and several studies about increasing incidence of invasive infections due to NTHi. This review also touches on the emergence of treatment- and drug-resistant H. influenzae, which are now major public health challenges. As a cause of bacterial pediatric infection, NTHi is an important target for prevention.
虽然大多数全身性小儿流感嗜血杆菌感染是由b型菌株(Hib)引起的,但不可分型流感嗜血杆菌(NTHi)被认为是一种常见于局部感染的呼吸道病原体,如急性中耳炎、急性肺炎、继发性慢性呼吸道疾病和其他耳鼻喉感染。然而,最近的研究结果表明,NTHi也会引起侵袭性感染,如脑膜炎、菌血症,以及下呼吸道感染,如肺炎。对20世纪90年代以来NTHi流行病学的回顾表明,在日本,NTHi在小儿急性中耳炎、鼻窦炎、结膜炎和下呼吸道疾病(如肺炎)中导致了显著的发病率。本综述还回顾了肺炎链球菌和Hib疫苗对致病病原体的全球影响,以及几项关于NTHi导致侵袭性感染发病率增加的研究。本综述还涉及了治疗耐药和药物耐药流感嗜血杆菌的出现,它们现在是主要的公共卫生挑战。作为小儿细菌感染的一个原因,NTHi是预防的重要目标。