安大略省西北部非 b 型荚膜流感嗜血杆菌引起小儿脑膜炎的出现。
Emergence of non-serotype b encapsulated Haemophilus influenzae as a cause of pediatric meningitis in northwestern Ontario.
机构信息
Northern Ontario School of Medicine, Thunder Bay, Ontario;
Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba;
出版信息
Can J Infect Dis Med Microbiol. 2013 Spring;24(1):13-6. doi: 10.1155/2013/828730.
Before the introduction of the conjugate vaccine, Haemophilus influenzae serotype b (Hib) was the leading cause of bacterial meningitis in children. Although successful in reducing Hib cases, the vaccine confers no protection against other serotypes of H influenzae, such as a (Hia), or f (Hif). The emergence of invasive disease caused by non-Hib in northwestern Ontario (38 cases between 2002 and 2008) with predominance of Hia was previously reported by the authors. At that time, no cases of pediatric meningitis caused by H influenzae were recorded in the region. Continued surveillance identified 12 new cases of invasive non-Hib between January 2009 and July 2011. Among these cases, three young children developed meningitis with severe complications caused by Hia or Hif. The present article describes these cases along with the characteristics of recent H influenzae isolates from the region, (ie, their genetic background and antibiotic sensitivity). The findings point to the clonal nature of circulating Hia strains as well as to an increase in frequency and severity of pediatric invasive H influenzae infections in northwestern Ontario.
在结合疫苗问世之前，b 型流感嗜血杆菌（Hib）是导致儿童细菌性脑膜炎的主要原因。尽管该疫苗成功降低了 Hib 病例数，但它不能提供针对其他流感嗜血杆菌血清型（如 a 型[Hia]或 f 型[Hif]）的保护。作者曾报道，在安大略省西北部（2002 年至 2008 年期间有 38 例）出现了由非 Hib 引起的侵袭性疾病，其中以 Hia 为主。当时，该地区没有记录到由流感嗜血杆菌引起的小儿脑膜炎病例。持续监测发现，2009 年 1 月至 2011 年 7 月期间又出现了 12 例新的侵袭性非 Hib 病例。这些病例中，有 3 名幼儿因 Hia 或 Hif 引起脑膜炎并伴有严重并发症。本文描述了这些病例以及该地区近期流感嗜血杆菌分离株的特征（即它们的遗传背景和抗生素敏感性）。研究结果表明，循环 Hia 菌株具有克隆性，安大略省西北部儿童侵袭性流感嗜血杆菌感染的频率和严重程度也有所增加。
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