Murphy T V, McCracken G H, Moore B S, Gulig P A, Hansen E J
Pediatr Infect Dis. 1983 May-Jun;2(3):193-8. doi: 10.1097/00006454-198305000-00004.
Five infants enrolled in a day care center (DCC) developed invasive disease due to Haemophilus influenzae type b during a 25-week period. The isolates from four patients had identical outer membrane proteins and were biotype 1. Although rifampin prophylaxis was recommended on two different occasions, retrospective surveys demonstrated that 39 and 60%, respectively, of infants failed to receive the agent for various reasons. Pharyngeal cultures were obtained from infants, their families and DCC staff after prophylaxis was given the second time. Forty-seven % of DCC infants had positive cultures, and 59% of their households had at least one carrier of the invasive strain. Rifampin prophylaxis administered a third time to infants and members of their households was unsuccessful in eradicating the invasive Haemophilus influenzae type b strain from DCC infants. The possible reasons for failure of rifampin in this DCC outbreak included incomplete understanding by physicians and health department officials of the factors affecting a DCC outbreak of Haemophilus influenzae type b disease and failure properly to implement rifampin prophylaxis to all contacts and the index cases.
在25周的时间里，一家日托中心（DCC）有5名婴儿因b型流感嗜血杆菌感染而患上侵袭性疾病。4名患者的分离株具有相同的外膜蛋白，生物型为1型。尽管在两个不同的时间段都建议使用利福平进行预防，但回顾性调查显示，分别有39%和60%的婴儿因各种原因未能接受该药物治疗。在第二次进行预防后，从婴儿、他们的家人和日托中心工作人员那里采集了咽拭子培养样本。47%的日托中心婴儿培养结果呈阳性，其家庭中有59%至少有一名侵袭性菌株携带者。对日托中心婴儿及其家庭成员第三次施用利福平预防措施，未能成功清除日托中心婴儿体内的侵袭性b型流感嗜血杆菌菌株。在这次日托中心疫情中，利福平预防措施失败的可能原因包括医生和卫生部门官员对影响b型流感嗜血杆菌疾病日托中心疫情的因素认识不足，以及未能对所有接触者和索引病例正确实施利福平预防措施。
