Wilfert C M
Dept of Pediatrics, Duke University Medical Center, Durham, NC 27710.
Pediatrics. 1990 Apr;85(4 Pt 2):631-5.
Haemophilus influenzae type b is a human bacterial pathogen that causes approximately 12,000 cases of H influenzae type b meningitis and 7500 cases of other forms of invasive disease annually in the United States. This organism is the leading cause of bacterial meningitis in the United States. The cause of meningitis can be established more accurately than that of other forms of invasive bacterial disease because the isolation of the bacterium from the cerebrospinal fluid or blood and/or the detection of bacterial antigen can correctly attribute the infection to a specific bacterial agent and dictate appropriate antimicrobial therapy. In children, more than 95% of all invasive diseases attributable to Haemophilus species, including septicemia, pneumonia, epiglottis, cellulitis, arthritis, osteomyelitis, and pericarditis, are due to H influenzae type b. It has been estimated that systemic disease caused by H influenzae type b occurs in approximately 1 in 200 children in the United States before the age of five. The case fatality rate for H influenzae type b meningitis is approximately 5%, and substantial morbidity has also been documented to result from central nervous system infection with this agent. Of surviving children reported in a 1969 paper, 40% had significant neurologic sequelae after meningitis. A more recent study demonstrated substantial neurologic improvement during the first few months after hospitalization, but at 1 year of age 8% of the children had neurologic or intellectual sequelae of their meningitis. Milder defects with an array of developmental problems have been reported in as many as one third to one half of all survivors.(ABSTRACT TRUNCATED AT 250 WORDS)
b型流感嗜血杆菌是一种人类细菌病原体,在美国每年导致约12000例b型流感嗜血杆菌脑膜炎病例和7500例其他形式的侵袭性疾病。这种病原体是美国细菌性脑膜炎的主要病因。与其他形式的侵袭性细菌疾病相比,脑膜炎的病因能够更准确地确定,因为从脑脊液或血液中分离出该细菌和/或检测到细菌抗原可以正确地将感染归因于特定的细菌病原体,并指导适当的抗菌治疗。在儿童中,所有可归因于嗜血杆菌属的侵袭性疾病,包括败血症、肺炎、会厌炎、蜂窝织炎、关节炎、骨髓炎和心包炎,超过95%是由b型流感嗜血杆菌引起的。据估计,在美国,五岁前每200名儿童中约有1人会发生由b型流感嗜血杆菌引起的全身性疾病。b型流感嗜血杆菌脑膜炎的病死率约为5%,而且有文献记载,这种病原体引起的中枢神经系统感染也会导致严重的发病率。在1969年一篇论文中报告的存活儿童中,40%在患脑膜炎后有明显的神经后遗症。一项更近的研究表明,住院后的头几个月内神经功能有显著改善,但在1岁时,8%的儿童有脑膜炎导致的神经或智力后遗症。据报道,在所有幸存者中,多达三分之一至二分之一有一系列发育问题的较轻缺陷。(摘要截选至250词)