Wang C H, Lin T Y
Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
J Formos Med Assoc. 1996 Aug;95(8):599-604.
We conducted a 3-year Taiwan-wide hospital-based survey of invasive Haemophilus influenzae infections in children less than 15 years of age. From January 1992 to December 1994, 105 cases (57 boys, 48 girls) were reported. Seventy-three patients (69.5%) had meningitis and 32 patients had other diseases (12 pneumonia, 10 sepsis, 7 cellulitis, 3 arthritis). Fourteen patients (13%) died, all of whom had meningitis or sepsis. Among the 63 patients who survived meningitis, 17 (27%) had neurologic sequelae and eight (47%) had hearing impairment. The number of cases of H. influenzae meningitis (30%) and other H. influenzae diseases (29%) peaked in children between 6 and 12 months of age. Patients with invasive infections (82%) and meningitis (73%) were younger than 24 months of age. Only 12 patients (11%) were older than 5 years of age and four had underlying diseases. The annual incidence of invasive H. influenzae infections in children less than 5 years old was 1.9 per 100,000 per year. During the same period a survey of purulent meningitis in children younger than 15 years of age was also conducted in 20 hospitals. A total of 198 patients, in whom the causative organisms were identified, were included; 94 patients were 2 months of age or under and the most frequent pathogen was group B streptococci (35 cases, 37%). Among the 104 patients who were older than 2 months of age, H. influenzae was the leading cause (38 cases, 37%). In conclusion, invasive H. influenzae type b (Hib) diseases exist in Taiwan but have an incidence lower than in Western countries. Hib meningitis is still the most common cause of purulent meningitis in children in Taiwan and is an important cause of mortality and morbidity. Continuous active surveillance of invasive H. influenzae infections is suggested to determine the best time to introduce an Hib conjugate vaccine in Taiwan.
我们在台湾地区开展了一项为期3年的、基于医院的15岁以下儿童侵袭性流感嗜血杆菌感染情况调查。1992年1月至1994年12月期间，共报告了105例病例（57名男孩，48名女孩）。73例患者（69.5%）患有脑膜炎，32例患者患有其他疾病（12例肺炎、10例败血症、7例蜂窝织炎、3例关节炎）。14例患者（13%）死亡，均患有脑膜炎或败血症。在63例脑膜炎幸存者中，17例（27%）有神经系统后遗症，8例（47%）有听力障碍。流感嗜血杆菌脑膜炎病例数（30%）和其他流感嗜血杆菌疾病病例数（29%）在6至12个月大的儿童中达到峰值。侵袭性感染患者（82%）和脑膜炎患者（73%）年龄小于24个月。只有12例患者（11%）年龄大于5岁，其中4例有基础疾病。5岁以下儿童侵袭性流感嗜血杆菌感染的年发病率为每10万人每年1.9例。同期，还在20家医院对15岁以下儿童的化脓性脑膜炎进行了调查。共纳入198例已确定病原体的患者；94例患者年龄在2个月及以下，最常见的病原体是B组链球菌（35例，37%）。在104例年龄大于2个月的患者中，流感嗜血杆菌是主要病因（38例，37%）。总之，台湾地区存在侵袭性b型流感嗜血杆菌（Hib）疾病，但发病率低于西方国家。Hib脑膜炎仍是台湾地区儿童化脓性脑膜炎的最常见病因，也是死亡和发病的重要原因。建议持续积极监测侵袭性流感嗜血杆菌感染情况，以确定在台湾地区引入Hib结合疫苗的最佳时机。
