Slack M P, Azzopardi H J, Hargreaves R M, Ramsay M E
Haemophilus Reference Laboratory, John Radcliffe Hospital, Oxford, UK.
Pediatr Infect Dis J. 1998 Sep;17(9 Suppl):S204-7. doi: 10.1097/00006454-199809001-00026.
We report an enhanced prospective survey of invasive Haemophilus influenzae infections that has defined the pattern of invasive disease in five English regions for 2 years before and 4 years after the introduction of the H. influenzae type b (Hib) vaccination program. During the prevaccination period the majority of cases of invasive H. influenzae were caused by type b; most (89%) of these infections occurred in children <5 years of age and the most common presentation was meningitis. Since the introduction of routine immunization of infants with conjugate Hib vaccine, there has been a 16-fold reduction in the annual attack rate of invasive Hib disease recorded in children <5 years of age. This reduction is of a magnitude similar to that observed in other countries with Hib vaccination programs. The number of infections caused by non-type b H. influenzae has shown a small but progressive increase over the same period, emphasizing the need for continued surveillance. There was no increase in the number of infections caused by other serotypes. Diagnostic category varied with both age and serotype but was not affected by vaccine introduction; meningitis was the most common presentation overall but pneumonia and bacteremia were more common in adults and with noncapsulated isolates.
我们报告了一项关于侵袭性流感嗜血杆菌感染的强化前瞻性调查，该调查确定了在引入b型流感嗜血杆菌（Hib）疫苗接种计划之前2年和之后4年，五个英国地区的侵袭性疾病模式。在疫苗接种前时期，大多数侵袭性流感嗜血杆菌病例由b型引起；这些感染大多数（89%）发生在5岁以下儿童，最常见的表现是脑膜炎。自从对婴儿进行Hib结合疫苗常规免疫接种以来，5岁以下儿童侵袭性Hib疾病的年发病率下降了16倍。这种下降幅度与其他实施Hib疫苗接种计划的国家所观察到的相似。同期，非b型流感嗜血杆菌引起的感染数量虽有小幅但持续的增加，这凸显了持续监测的必要性。其他血清型引起的感染数量没有增加。诊断类别随年龄和血清型而异，但不受疫苗引入影响；总体而言，脑膜炎是最常见的表现，但肺炎和菌血症在成人以及非包膜菌株感染中更为常见。
