School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Southport, Queensland, Australia.
Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, Australia.
Clin Microbiol Rev. 2021 Jun 16;34(3):e0002821. doi: 10.1128/CMR.00028-21. Epub 2021 Jun 2.
Haemophilus influenzae serotype b (Hib) was previously the most common cause of bacterial meningitis and an important etiologic agent of pneumonia in children aged <5 years. Its major virulence factor is the polyribosyl ribitol phosphate (PRP) polysaccharide capsule. In the 1980s, PRP-protein conjugate Hib vaccines were developed and are now included in almost all national immunization programs, achieving a sustained decline in invasive Hib infections. However, invasive Hib disease has not yet been eliminated in countries with low vaccine coverage, and sporadic outbreaks of Hib infection still occur occasionally in countries with high vaccine coverage. Over the past 2 decades, other capsulated serotypes have been recognized increasingly as causing invasive infections. H. influenzae serotype a (Hia) is now a major cause of invasive infection in Indigenous communities of North America, prompting a possible requirement for an Hia conjugate vaccine. H. influenzae serotypes e and f are now more common than serotype b in Europe. Significant year-to-year increases in nontypeable H. influenzae invasive infections have occurred in many regions of the world. Invasive H. influenzae infections are now seen predominantly in patients at the extremes of life and those with underlying comorbidities. This review provides a comprehensive and critical overview of the current global epidemiology of invasive H. influenzae infections in different geographic regions of the world. It discusses those now at risk of invasive Hib disease, describes the emergence of other severe invasive H. influenzae infections, and emphasizes the importance of long-term, comprehensive, clinical and microbiologic surveillance to monitor a vaccine's impact.
流感嗜血杆菌 b 型（Hib）曾是细菌性脑膜炎的最常见病因，也是<5 岁儿童肺炎的重要病原体。其主要毒力因子是多聚核糖基核糖醇磷酸（PRP）多糖荚膜。20 世纪 80 年代，开发了 PRP-蛋白结合 Hib 疫苗，目前几乎所有国家的免疫规划都纳入了 Hib 疫苗，使侵袭性 Hib 感染持续下降。然而，在疫苗覆盖率低的国家，侵袭性 Hib 病尚未消除，高疫苗覆盖率的国家仍偶尔发生散发性 Hib 感染暴发。在过去 20 年中，其他荚膜血清型越来越被认为可引起侵袭性感染。H. influenzae 血清型 a（Hia）现在是北美原住民社区侵袭性感染的主要原因，可能需要 Hia 结合疫苗。H. influenzae 血清型 e 和 f 在欧洲比血清型 b 更为常见。在世界许多地区，无定型流感嗜血杆菌侵袭性感染的年增长率显著增加。侵袭性 H. influenzae 感染现在主要见于生命末期和伴有基础合并症的患者。本文全面、批判性地综述了世界不同地理区域侵袭性 H. influenzae 感染的当前全球流行病学，讨论了目前有侵袭性 Hib 病风险的人群，描述了其他严重侵袭性 H. influenzae 感染的出现，并强调了长期、全面、临床和微生物监测的重要性，以监测疫苗的效果。
