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[B型流感嗜血杆菌。疾病与预防]

[Haemophilus influenzae type B. Disease and prevention].

作者信息

Stehr K

机构信息

Universitätsklinik für Kinder und Jugendliche Erlangen.

出版信息

Monatsschr Kinderheilkd. 1990 May;138(5):240-3.

PMID:2198458
Abstract

Haemophilus influenzae is a gram-negative rod, causing severe infections in childhood, including meningitis, sepsis, epiglottits, pneumonia and otitis. Most of the invasive infections are due to serotype b. Since ampicillin-resistance is increasing, modern cephalosporines like cefotaxime and ceftriaxone are the antibiotics of choice in severe disease. Bacterial meningitis due to Haemophilus influenzae and epiglottitis are both still life-threatening diseases with a lethality of 5% to 25%, and there are severe sequelae in 35% of meningitis cases. Efforts have been made to develop efficacious vaccines. While immunogenicity of type b polysaccharide was low in the high-risk age (below 18 months), conjugated vaccines with either diphtheria-toxoid or Neisseria meningitis outer membrane protein and the Hib polysaccharide were found to be strongly immunogenic even in the first months of life. These vaccines show every few side-effects and can easily be combined with other immunizations such as DPT and DT. Thus, the incidence of invasive infections due to Haemophilus influenzae type b might decline in future.

摘要

流感嗜血杆菌是一种革兰氏阴性杆菌,可导致儿童严重感染,包括脑膜炎、败血症、会厌炎、肺炎和中耳炎。大多数侵袭性感染是由b型血清型引起的。由于对氨苄西林的耐药性不断增加,现代头孢菌素如头孢噻肟和头孢曲松是重症疾病的首选抗生素。由流感嗜血杆菌引起的细菌性脑膜炎和会厌炎仍然是危及生命的疾病,致死率为5%至25%,35%的脑膜炎病例会出现严重后遗症。人们已努力研发有效的疫苗。虽然b型多糖在高危年龄(18个月以下)的免疫原性较低,但发现与白喉类毒素或脑膜炎奈瑟菌外膜蛋白及b型流感嗜血杆菌多糖结合的疫苗即使在生命的最初几个月也具有很强的免疫原性。这些疫苗几乎没有副作用,并且可以很容易地与其他免疫接种如百白破疫苗和白破疫苗联合使用。因此,未来由b型流感嗜血杆菌引起的侵袭性感染的发病率可能会下降。

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