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Fong W, Martinez E, Timms V, Ginn A, Nguyen T, Rahman H, Sintchenko V. Increase in invasive Haemophilus influenzae serotype A infections during the COVID-19 pandemic in New South Wales, Australia. Pathology 2024:S0031-3025(24)00122-3. [PMID: 38777739 DOI: 10.1016/j.pathol.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/30/2024] [Accepted: 02/23/2024] [Indexed: 05/25/2024]
Abstract
Haemophilus influenzae, a causative agent of severe invasive infections such as meningitis, sepsis and pneumonia, is classified into encapsulated or typeable (represented by serotypes A to F) and non-typeable varieties (NTHi) by the presence or absence of the polysaccharide capsule. Invasive disease caused by H. influenzae type B (HIB) can be prevented through vaccination which remains the main disease control intervention in many countries. This study examined the genomic diversity of circulating H. influenzae strains associated with invasive disease in New South Wales, Australia, before and during the COVID-19 pandemic. Ninety-six isolates representing 95 cases of invasive H. influenzae infections (iHi) diagnosed between January 2017 and September 2022 were typed and characterised using whole genome sequencing. These cases were caused by serotypes A (n=24), B (n=35), E (n=3), F (n=2) and NTHi (n=32). There was an apparent decline in the number of iHi infections during the COVID-19 pandemic, with a corresponding increase in the proportion of iHi cases caused by serotype A (HIA), which returned to pre-pandemic levels in 2022. Fifteen isolates associated with HIB or non-typeable iHi were resistant to β-lactams due to a PBP3 mutation or carriage of blaTEM-1. Further, capsular gene duplication was observed in HIB isolates but was not found in HIA. These findings provide important baseline genomic data for ongoing iHi surveillance and control.
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Affiliation(s)
- Winkie Fong
- Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Westmead, NSW, Australia; Sydney Institute of Infectious Diseases, The University of Sydney, Camperdown, NSW, Australia.
| | - Elena Martinez
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, NSW, Australia
| | - Verlaine Timms
- Sydney Institute of Infectious Diseases, The University of Sydney, Camperdown, NSW, Australia; School of Environmental and Life Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Andrew Ginn
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, NSW, Australia; Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia
| | - Trang Nguyen
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, NSW, Australia
| | - Hossinur Rahman
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, NSW, Australia
| | - Vitali Sintchenko
- Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Westmead, NSW, Australia; Sydney Institute of Infectious Diseases, The University of Sydney, Camperdown, NSW, Australia; Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, NSW, Australia
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Ferris CL, Ulanova M. Invasive and Non-invasive Clinical Haemophilus influenzae Type A Isolates Activate Differentiated HL-60 Cells In Vitro. Pathog Immun 2024; 9:38-55. [PMID: 38774126 PMCID: PMC11107419 DOI: 10.20411/pai.v9i1.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/30/2024] [Indexed: 05/24/2024] Open
Abstract
Background The effective elimination of encapsulated bacteria like Haemophilus influenzae type a (Hia) relies on immune mechanisms such as complement-mediated opsonophagocytosis by neutrophils in coordination with opsonization by anti-capsular antibodies. This study evaluated if Hia could activate the immune response through neutrophils and if these responses differed between encapsulated versus unencapsulated or invasive versus non-invasive strains. Methods HL-60-derived neutrophil-like cells (dHL-60), differentiated with 1.25% dimethyl sulfoxide over 9 days, were used in an opsonophagocytosis assay and in vitro infection model to measure Hia's susceptibility to killing and dHL-60 surface molecule expression, respectively. The impact of strain-specific features on the immune response was investigated using clinical isolates of a dominant North American sequence type (ST)-23, including Hia 11-139 (encapsulated, invasive), 14-61 (encapsulated, non-invasive), 13-0074 (unencapsulated, invasive), as well as a representative ST-4 isolate (Hia 13-240, encapsulated, invasive), and a nontypeable strain (NTHi 375, unencapsulated, non-invasive). Results Unencapsulated and non-invasive Hi strains were more susceptible to killing by the innate immune response while the ST-23 invasive strain, Hia 11-139 required serum antibodies for destruction. Flow cytometry analysis showed increased expression of co-stimulatory molecule ICAM-1 and Fc receptors (CD89, CD64) but decreased expression of the Fc receptor CD16, revealing potential mechanisms of neutrophil-mediated defense against Hia that extend to both non-invasive and invasive strains. Conclusions Hia clinical isolates with diverse pathogenicity illustrated contrasting susceptibility to killing by immune mechanisms while maintaining the same capacity to activate neutrophil-like cells, further underscoring the need for additional studies on Hia's pathogenesis.
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Affiliation(s)
| | - Marina Ulanova
- Department of Biology, Lakehead University, Thunder Bay, ON, Canada
- Northern Ontario School of Medicine University, Thunder Bay, ON, Canada
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McClure M, Miernyk K, Bruden D, Rudolph K, Hennessy TW, Bruce MG, Nolen LD. Presence of Antibodies Against Haemophilus influenzae Serotype a in Alaska Before and After the Emergence of Invasive Infections. J Infect Dis 2021; 223:326-332. [PMID: 32594132 DOI: 10.1093/infdis/jiaa369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/19/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Haemophilus influenzae bacteria can cause asymptomatic carriage and invasive disease. Haemophilus influenzae serotype a (Hia) is an emerging cause of invasive disease in Alaska, with greatest burden occurring among rural Alaska Native (AN) children. The first case of invasive Hia (iHia) in Alaska was reported in 2002; however, it is unclear how long the pathogen has been in Alaska. METHODS We quantified immunoglobulin G antibodies against Hia (anti-Hia) in 839 banked serum samples from Alaska residents, comparing antibody concentrations in samples drawn in the decades before (1980s and 1990s) and after (2000s) the emergence of iHia. We also assessed serum antibody concentration by age group, region of residence, and race. RESULTS The anti-Hia was >0.1 µg/mL in 88.1% (348 of 395) and 91.0% (404 of 444) of samples from the decades prior and after the emergence of Hia, respectively (P = .17). No significant differences in antibody levels were detected between people from rural and urban regions (1.55 vs 2.08 µg/mL, P = .91 for age ≥5) or between AN and non-AN people (2.50 vs 2.60 µg/mL, P = .26). CONCLUSIONS Our results are consistent with widespread Hia exposure in Alaska predating the first iHia case. No difference in Hia antibody prevalence was detected between populations with differing levels of invasive disease.
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Affiliation(s)
- Max McClure
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Karen Miernyk
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Dana Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Karen Rudolph
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Thomas W Hennessy
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Michael G Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Leisha D Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
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López-Olaizola M, Aguirre-Quiñonero A, Canut A, Barrios JL, Cilla G, Vicente D, Marimón JM. Haemophilus influenzae Type a Sequence Type 23, Northern Spain. Emerg Infect Dis 2021; 27:2504-2506. [PMID: 34424176 PMCID: PMC8386772 DOI: 10.3201/eid2709.204247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Two consecutive cases of Haemophilus influenzae type a sequence type 23 invasive infection in 2 children attending the same daycare in 2019 triggered epidemiologic surveillance of H. influenzae infections in northern Spain. Despite the invasiveness potential of this virus strain, we detected no additional cases for 2013–2020.
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Soeters HM, Oliver SE, Plumb ID, Blain AE, Zulz T, Simons BC, Barnes M, Farley MM, Harrison LH, Lynfield R, Massay S, McLaughlin J, Muse AG, Petit S, Schaffner W, Thomas A, Torres S, Watt J, Pondo T, Whaley MJ, Hu F, Wang X, Briere EC, Bruce MG. Epidemiology of Invasive Haemophilus influenzae Serotype a Disease-United States, 2008-2017. Clin Infect Dis 2021; 73:e371-e379. [PMID: 32589699 PMCID: PMC9628811 DOI: 10.1093/cid/ciaa875] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/19/2020] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Haemophilus influenzae serotype a (Hia) can cause invasive disease similar to serotype b; no Hia vaccine is available. We describe the epidemiology of invasive Hia disease in the United States overall and specifically in Alaska during 2008-2017. METHODS Active population- and laboratory-based surveillance for invasive Hia disease was conducted through Active Bacterial Core surveillance sites and from Alaska statewide invasive bacterial disease surveillance. Sterile-site isolates were serotyped via slide agglutination or real-time polymerase chain reaction. Incidences in cases per 100 000 were calculated. RESULTS From 2008 to 2017, an estimated average of 306 invasive Hia disease cases occurred annually in the United States (estimated annual incidence: 0.10); incidence increased by an average of 11.1% annually. Overall, 42.7% of cases were in children aged <5 years (incidence: 0.64), with highest incidence among children aged <1 year (1.60). Case fatality was 7.8% overall and was highest among adults aged ≥65 years (15.1%). Among children aged <5 years, the incidence was 17 times higher among American Indian and Alaska Native (AI/AN) children (8.29) than among children of all other races combined (0.49). In Alaska, incidences among all ages (0.68) and among children aged <1 year (24.73) were nearly 6 and 14 times higher, respectively, than corresponding US incidences. Case fatality in Alaska was 10.2%, and the vast majority (93.9%) of cases occurred among AI/AN. CONCLUSIONS Incidence of invasive Hia disease has increased since 2008, with the highest burden among AI/AN children. These data can inform prevention strategies, including Hia vaccine development.
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Affiliation(s)
- Heidi M. Soeters
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Sara E. Oliver
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Ian D. Plumb
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Amy E. Blain
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Tammy Zulz
- Arctic Investigations Program, CDC, Anchorage, AK, USA
| | | | - Meghan Barnes
- Colorado Department of Public Health and Environment, Denver, CO, USA
| | - Monica M. Farley
- Emory University School of Medicine and The Atlanta VA Medical Center, Atlanta, GA, USA
| | - Lee H. Harrison
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | - Susan Petit
- Connecticut Department of Public Health, Hartford, CT, USA
| | | | - Ann Thomas
- Oregon Health Authority, Portland, OR, USA
| | | | - James Watt
- California Department of Public Health, Richmond, CA, USA
| | - Tracy Pondo
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Fang Hu
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Xin Wang
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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Invasive Haemophilus influenzae type a infection and polyarthritis in a 72-year-old Japanese man: A case report. J Infect Chemother 2021; 27:1084-1088. [PMID: 33602639 DOI: 10.1016/j.jiac.2021.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/18/2020] [Accepted: 01/25/2021] [Indexed: 10/22/2022]
Abstract
Haemophilus influenzae is a small, nonmotile, non-spore-forming bacterium classified into 6 serotypes (a to f) and non-typeable strains that lack a capsule. Although H. influenzae serotype a (Hia) is prevalent in Canada, the United States, Brazil, Australia, across the African continent, and several other locations, it has not been reported in Japan thus far. Our case was of a 72-year-old Japanese man who sought medical consultation after presenting with chills, fever, and polyarthritis. Cultures of blood and synovial fluid from the left knee revealed H. influenzae infection. Diagnostic imaging showed poor contrast regions in both kidneys, fluid retention around both knee joints, the left shoulder joint, and both elbow joints. Subsequently, the patient was diagnosed with invasive H. influenzae infection accompanied by polyarthritis and renal infarction. 16S ribosomal RNA gene sequencing revealed that the bacterial strain was Hia. The patient was treated with antimicrobial agents and arthroscopic curettage. We present a case of invasive Hia infection accompanied by polyarthritis and renal infarction. To the best of our knowledge, this is the first case of Hia infection in Japan. The case is very rare considering that the disease occurred in an elderly patient who developed polyarthritis.
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Crandall H, Christiansen J, Varghese AA, Russon A, Korgenski EK, Bengtson EK, Dickey M, Killpack J, Knackstedt ED, Daly JA, Ampofo K, Pavia AT, Blaschke AJ. Clinical and Molecular Epidemiology of Invasive Haemophilus influenzae Serotype a Infections in Utah Children. J Pediatric Infect Dis Soc 2020; 9:650-655. [PMID: 31858115 PMCID: PMC10147389 DOI: 10.1093/jpids/piz088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/02/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Following widespread use of the Haemophilus influenzae serotype b (Hib) vaccine, H. influenzae serotype a (Hia) has emerged as an important pathogen in children in some regions. We describe the clinical features and molecular epidemiology of invasive Hia disease in children in Utah over an 11-year period. METHODS We identified cases of invasive Hia disease, defined as detection of Hia from a normally sterile site, in children aged <18 years from Utah between 2007 and 2017. Medical records were reviewed to determine demographic characteristics and clinical outcomes. Available Hia isolates were genotyped using multilocus sequence typing, and phylogenetic division was determined using sodC polymerase chain reaction. Presence of the putative virulence-associated IS1016-bexA duplication-deletion was evaluated. RESULTS We identified 51 children with invasive Hia. The average annual incidence was 1.7 cases per 100 000 children aged <5 years; 4.8 cases per 100 000 children aged <1 year. The median age was 11.3 months. The most common clinical presentation was meningitis (53%), followed by pneumonia (14%) and septic arthritis (14%). Twenty-two children (43%) required admission to an intensive care unit; 1 died. Sequence type (ST) 62, phylogenetic division II isolates caused 75% (21/28) of disease. No isolates contained the virulence-associated IS1016-bexA duplication-deletion. CONCLUSIONS Hia is a significant cause of severe invasive bacterial infection in Utah. The majority of infections were caused by ST62 isolates, a phylogenetic division II Hia type that lacks the IS1016-bexA duplication-deletion. Hia ST62 has not been commonly reported elsewhere, suggesting a unique molecular epidemiology in our population.
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Affiliation(s)
- Hillary Crandall
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jennifer Christiansen
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Alyssa A Varghese
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Adam Russon
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - E Kent Korgenski
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.,Pediatric Clinical Program, Intermountain Health Care, Salt Lake City, Utah, USA
| | - Erika K Bengtson
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Mandy Dickey
- Department of Microbiology, Primary Children's Hospital, Salt Lake City, Utah, USA
| | - Jarrett Killpack
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Elizabeth D Knackstedt
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Judy A Daly
- Department of Microbiology, Primary Children's Hospital, Salt Lake City, Utah, USA.,Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Krow Ampofo
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Andrew T Pavia
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Anne J Blaschke
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Bozio CH, Blain A, Edge K, Farley MM, Harrison LH, Poissant T, Schaffner W, Scheuer T, Torres S, Triden L, Briere E, Oliver SE. Clinical characteristics and adverse clinical outcomes of invasive Haemophilus influenzae serotype a cases - United States, 2011-2015. Clin Infect Dis 2020; 73:e3670-e3676. [PMID: 32668450 DOI: 10.1093/cid/ciaa990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Incidence of invasive disease due to H. influenzae serotype a (Hia) increased an average of 13% annually from 2002-2015. We described clinical characteristics and adverse clinical outcomes of U.S. invasive Hia cases detected through multi-state surveillance during 2011-2015. METHODS Medical record data were abstracted for cases reported in eight jurisdictions conducting active population- and laboratory-based surveillance for invasive Hia disease across the United States. Isolates from sterile sites were serotyped by real-time polymerase chain reaction. Adverse clinical outcomes were defined as any possible complication of meningitis, bacteremic pneumonia, or bacteremia (including hearing loss, developmental delay, and speech delay, but excluding death), and were assessed at hospital discharge and one-year post-disease onset. RESULTS During 2011-2015, 190 Hia cases were reported to the eight participating sites; 169 (88.9%) had data abstracted. Many patients were aged <5 years (42.6%) or ≥65 years (20.7%). Meningitis was the most common clinical presentation among <1 year olds (71.4%); bacteremic pneumonia was the most common presentation among persons aged ≥50 years (78.7%). Overall, 95.9% of patients were hospitalized: among those hospitalized, 47.5% were admitted to an intensive care unit, and 6.2% died during hospitalization. At hospital discharge and one-year post-disease onset, adverse outcomes were identified in 17.7% and 17.8% of patients overall, and in 43.9% and 48.5% of patients with meningitis (primarily children). CONCLUSIONS Hia infection can cause severe disease requiring hospitalization and may also cause short- and long-term adverse clinical outcomes, especially among children. Novel vaccines could prevent morbidity and mortality.
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Affiliation(s)
- Catherine H Bozio
- Epidemic Intelligence Service, Centers for Disease Control and Prevention (CDC), Atlanta, GA.,National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
| | - Amy Blain
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
| | - Karen Edge
- Colorado Department of Public Health and Environment, Colorado
| | - Monica M Farley
- Emory University School of Medicine, Atlanta, GA.,Atlanta VA Medical Center, Atlanta, GA
| | - Lee H Harrison
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | | | - Tara Scheuer
- California Emerging Infections Program, Oakland, CA
| | | | - Lori Triden
- Minnesota Department of Health, St. Paul, MN
| | - Elizabeth Briere
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
| | - Sara E Oliver
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
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Abstract
BACKGROUND Universal vaccination with Haemophilus influenzae type b conjugate vaccines has significantly changed the epidemiology of invasive H. influenzae disease in the United States. We reviewed the epidemiology, clinical features, and outcomes in 61 patients with invasive H. influenzae disease evaluated at Texas Children's Hospital (TCH). METHODS Cases of invasive H. influenzae disease, defined as isolation of the organism from cerebrospinal fluid, blood, synovial fluid or pleural fluid, during 2011 to 2018 among children cared for at TCH in Houston, TX, were included. RESULTS We identified 61 cases of invasive H. influenzae disease in children ≤18 years of age. The overall hospitalization rate due to invasive H. influenzae disease increased between 2011 and 2018 (0 vs. 0.64/1000 hospitalizations; P = 0.019). The majority (80%) of infections occurred in children <5 years of age. Of the 61 H. influenzae infections, 24 (39.3%) infections were caused by nontypeable H. influenzae strains, 18 (29.5%) infections were caused by H. influenzae type a, 12 (19.7%) infections were caused by H. influenzae type f, 3 (4.9%) infections were caused by H. influenzae type e and 4 (6.6%) isolates were not typed. A total of 78.7% of the isolates were β-lactamase negative. The most common clinical presentations were bacteremia without a source, pneumonia and meningitis. CONCLUSIONS The hospitalization rate for H. influenzae invasive disease increased over an 8-year period at TCH. The overall trend was mainly driven by an increasing number of invasive infections caused by nontypeable H. influenzae and H. influenzae type a. Morbidity was substantial, especially in meningitis cases.
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hicap: In Silico Serotyping of the Haemophilus influenzae Capsule Locus. J Clin Microbiol 2019; 57:JCM.00190-19. [PMID: 30944197 PMCID: PMC6535587 DOI: 10.1128/jcm.00190-19] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 03/29/2019] [Indexed: 11/20/2022] Open
Abstract
Haemophilus influenzae exclusively colonizes the human nasopharynx and can cause a variety of respiratory infections as well as invasive diseases, including meningitis and sepsis. A key virulence determinant of H. influenzae is the polysaccharide capsule, of which six serotypes are known, each encoded by a distinct variation of the capsule biosynthesis locus (cap-a to cap-f). Haemophilus influenzae exclusively colonizes the human nasopharynx and can cause a variety of respiratory infections as well as invasive diseases, including meningitis and sepsis. A key virulence determinant of H. influenzae is the polysaccharide capsule, of which six serotypes are known, each encoded by a distinct variation of the capsule biosynthesis locus (cap-a to cap-f). H. influenzae type b (Hib) was historically responsible for the majority of invasive H. influenzae disease, and its prevalence has been markedly reduced in countries that have implemented vaccination programs targeting this serotype. In the postvaccine era, nontypeable H. influenzae emerged as the most dominant group causing disease, but in recent years a resurgence of encapsulated H. influenzae strains has also been observed, most notably serotype a. Given the increasing incidence of encapsulated strains and the high frequency of Hib in countries without vaccination programs, there is growing interest in genomic epidemiology of H. influenzae. Here we present hicap, a software tool for rapid in silico serotype prediction from H. influenzae genome sequences. hicap is written using Python3 and is freely available at https://github.com/scwatts/hicap under the GNU General Public License v3 (GPL3). To demonstrate the utility of hicap, we used it to investigate the cap locus diversity and distribution in 691 high-quality H. influenzae genomes from GenBank. These analyses identified cap loci in 95 genomes and confirmed the general association of each serotype with a unique clonal lineage, and they also identified occasional recombination between lineages that gave rise to hybrid cap loci (2% of encapsulated strains).
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Soeters HM, Blain A, Pondo T, Doman B, Farley MM, Harrison LH, Lynfield R, Miller L, Petit S, Reingold A, Schaffner W, Thomas A, Zansky SM, Wang X, Briere EC. Current Epidemiology and Trends in Invasive Haemophilus influenzae Disease-United States, 2009-2015. Clin Infect Dis 2018; 67:881-889. [PMID: 29509834 PMCID: PMC6181225 DOI: 10.1093/cid/ciy187] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/01/2018] [Indexed: 01/15/2023] Open
Abstract
Background Following Haemophilus influenzae serotype b (Hib) conjugate vaccine introduction in the 1980s, Hib disease in young children dramatically decreased, and epidemiology of invasive H. influenzae changed. Methods Active surveillance for invasive H. influenzae disease was conducted through Active Bacterial Core surveillance sites. Incidence rates were directly standardized to the age and race distribution of the US population. Results During 2009-2015, the estimated mean annual incidence of invasive H. influenzae disease was 1.70 cases per 100000 population. Incidence was highest among adults aged ≥65 years (6.30) and children aged <1 year (8.45); many cases in infants aged <1 year occurred during the first month of life in preterm or low-birth-weight infants. Among children aged <5 years (incidence: 2.84), incidence was substantially higher in American Indian and Alaska Natives AI/AN (15.19) than in all other races (2.62). Overall, 14.5% of cases were fatal; case fatality was highest among adults aged ≥65 years (20%). Nontypeable H. influenzae had the highest incidence (1.22) and case fatality (16%), as compared with Hib (0.03; 4%) and non-b encapsulated serotypes (0.45; 11%). Compared with 2002-2008, the estimated incidence of invasive H. influenzae disease increased by 16%, driven by increases in disease caused by serotype a and nontypeable strains. Conclusions Invasive H. influenzae disease has increased, particularly due to nontypeable strains and serotype a. A considerable burden of invasive H. influenzae disease affects the oldest and youngest age groups, particularly AI/AN children. These data can inform prevention strategies, including vaccine development.
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Affiliation(s)
- Heidi M Soeters
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amy Blain
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tracy Pondo
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Monica M Farley
- Emory University School of Medicine, Georgia
- Atlanta Veterans Affairs Medical Center, Georgia
| | - Lee H Harrison
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Lisa Miller
- University of Colorado School of Public Health, Denver
| | - Susan Petit
- Connecticut Department of Public Health, Hartford
| | | | | | | | | | - Xin Wang
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth C Briere
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Characterization of natural bactericidal antibody against Haemophilus influenzae type a in Canadian First Nations: A Canadian Immunization Research Network (CIRN) Clinical Trials Network (CTN) study. PLoS One 2018; 13:e0201282. [PMID: 30110339 PMCID: PMC6093645 DOI: 10.1371/journal.pone.0201282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/12/2018] [Indexed: 01/28/2023] Open
Abstract
During the last two decades, Haemophilus influenzae serotype a (Hia) emerged as an important cause of invasive disease in Canadian First Nations and Inuit, and Alaskan Native populations, with the highest rates reported in young children. Immunocompetent adults, in contrast to children, do not typically develop invasive Hia disease. To clarify factors responsible for an increased burden of invasive Hia disease in certain population groups we studied serum bactericidal activity (SBA) against Hia and quantified IgG and IgM specific to Hia capsular polysaccharide in healthy adult members of two First Nations communities: 1) with reported cases of invasive Hia disease (Northern Ontario, NO), and 2) without reported cases (Southern Ontario, SO), in comparison to non-First Nations living in proximity to the NO First Nations community, and non-First Nations elderly non-frail Canadians from across the country (total of 110 First Nations and 76 non-First Nations). To elucidate the specificity of bactericidal antibodies, sera were absorbed with various Hia antigens. Naturally acquired SBA against Hia was detected at higher rates in First Nations (NO, 80%; SO, 96%) than non-First Nations elderly Canadians (64%); the SBA titres in First Nations were higher than in non-First Nations elderly Canadians (P<0.001) and NO non-First Nations adults (P>0.05). Among First Nations, SBA was mediated predominantly by IgM, and by both antibodies specific to Hia capsular polysaccharide and lipooligosaccharide. Conclusions: The SBA against Hia is frequently present in sera of First Nations adults regardless of the burden of Hia disease observed in their community; it may represent part of the natural antibody repertoire, which is potentially formed in this population under the influence of certain epigenetic factors. Although the nature of these antibodies deserves further studies to understand their origin, the data suggest that they may represent important protective mechanism against invasive Hia disease.
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Giufrè M, Cardines R, Brigante G, Orecchioni F, Cerquetti M. Emergence of Invasive Haemophilus influenzae Type A Disease in Italy. Clin Infect Dis 2018; 64:1626-1628. [PMID: 28369218 DOI: 10.1093/cid/cix234] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 03/14/2017] [Indexed: 11/14/2022] Open
Abstract
We report on the first detection of 2 cases of invasive Haemophilus influenzae type a (Hia) disease in Italy. The cases were sustained by the same Hia "strain" belonging to the ST23 clone that has previously been reported only outside Europe. The emergence of invasive Hia disease is of concern.
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Affiliation(s)
- Maria Giufrè
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome
| | - Rita Cardines
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome
| | | | - Francesca Orecchioni
- Clinical Analysis Laboratory, Section of Microbiology, Ospedali Riuniti di Ancona, Italy
| | - Marina Cerquetti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome
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Pavlik DF, Johnston JJ, Eldredge JD, Dehority W. Non-Type b Haemophilus influenzae Septic Arthritis in Children. J Pediatric Infect Dis Soc 2017; 6:e134-e139. [PMID: 27150112 DOI: 10.1093/jpids/piw024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 03/29/2016] [Indexed: 11/14/2022]
Abstract
Invasive disease caused by non-type b Haemophilus influenzae serotypes has been increasingly reported. Although to date it has been a rarely described cause of septic arthritis, we present 10 cases of non-type b H influenzae septic arthritis in children seen in a tertiary care center that serves a large Native American population.
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Affiliation(s)
| | | | - Jon D Eldredge
- University of New Mexico Health Informatics Center, Albuquerque
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15
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Tsang RSW, Ulanova M. The changing epidemiology of invasive Haemophilus influenzae disease: Emergence and global presence of serotype a strains that may require a new vaccine for control. Vaccine 2017; 35:4270-4275. [PMID: 28666758 DOI: 10.1016/j.vaccine.2017.06.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/23/2017] [Accepted: 06/01/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND More than two decades after the implementation of the Hib conjugate vaccine in North America, Haemophilus influenzae serotype a (Hia) has emerged as a significant cause of invasive disease in Indigenous communities. However, little is known about the global presence of this pathogen. METHODS We interrogated the H. influenzae Multi-Locus Sequence Typing (MLST) website (https://pubmlst.org/hinfluenzae/) by selecting for serotype a records. We also updated our previous literature review on this subject matter. RESULTS Hia has been reported from at least 35 countries on six major continents. However, most Hia diseases were associated with Indigenous communities. Clonal analysis identified two clonal populations with one typified as ST-23 responsible for most invasive disease in North America and being the predominant clone described on the H. influenzae MLST website. Incidence of invasive Hia disease in Indigenous communities in North America are similar to the rates of Hib disease reported prior to the Hib conjugate vaccine era. Hia causes severe clinical diseases, such as meningitis, septicaemia, pneumonia, and septic arthritis with case-fatality rates between 5.6% and 33% depending on the age of the patient and the genetic makeup of the Hia strain. CONCLUSION Although invasive Hia disease can be found globally, the current epidemiological data suggest that this infection predominantly affects Indigenous communities in North America. The clinical disease of Hia and the clonal nature of the bacteria resemble that of Hib. The high incidence of invasive Hia disease in Indigenous communities, along with potential fatality and severe sequelae causing long-term disability in survivors, may support the development of a new Hia conjugate vaccine for protection against this infection similar in design to the one introduced in the 1990s to control invasive Hib disease.
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Affiliation(s)
- Raymond S W Tsang
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.
| | - Marina Ulanova
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario, Canada
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Characteristics of invasive Haemophilus influenzae serotype a (Hia) from Nunavik, Canada and comparison with Hia strains in other North American Arctic regions. Int J Infect Dis 2017; 57:104-107. [DOI: 10.1016/j.ijid.2017.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/02/2017] [Accepted: 02/05/2017] [Indexed: 11/21/2022] Open
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Tuyama M, Corrêa-Antônio J, Schlackman J, Marsh JW, Rebelo MC, Cerqueira EO, Nehab M, Kegele F, Carmo GF, Thielmann DC, Barroso PF, Harrison LH, Barroso DE. Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil. Mem Inst Oswaldo Cruz 2017; 112:196-202. [PMID: 28225904 PMCID: PMC5319370 DOI: 10.1590/0074-02760160391] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/23/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Haemophilus influenzae (Hi) serotype b (Hib) conjugate vaccine was incorporated into the infant immunisation schedule in Brazil in 1999, where Hib was one of the major etiologic sources of community-acquired bacterial meningitis. OBJECTIVES The purpose of this study is to describe the molecular epidemiology of invasive Hi disease in Rio de Janeiro state, Brazil, before and after vaccine introduction. METHODS Surveillance data from 1986 to 2014 were analysed. Hi isolates recovered from cerebrospinal fluid (CSF) or blood from 1993 to 2014 were serotyped by slide agglutination, genotyped by multilocus sequence typing (MLST), and the capsule type evaluation, differentiation of serologically non-typeable isolates, and characterisation of the capsule (cap) locus was done by polymerase chain reaction. Antimicrobial susceptibility testing was performed using E-test. FINDINGS From 1986 to 1999 and from 2000 to 2014, 2580 and 197 (42% without serotype information) confirmed cases were reported, respectively. The case fatality rate was 17% and did not correlate with the strain. Hib and b- variant isolates belonged to ST-6, whereas serotype a isolates belonged to the ST-23 clonal complex. Serotype a appeared to emerge during the 2000s. Non-encapsulated isolates were non-clonal and distinct from the encapsulated isolates. Ampicillin-resistant isolates were either of serotype b or were non-encapsulated, and all of them were β-lactamase-positive but amoxicillin-clavulanic acid susceptible. MAIN CONCLUSIONS Although Hi meningitis became a relatively rare disease in Rio de Janeiro after the introduction of the Hib conjugate vaccine, the isolates recovered from patients have become more diverse. These results indicate the need to implement an enhanced surveillance system to continue monitoring the impact of the Hib conjugate vaccine.
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Affiliation(s)
- Mari Tuyama
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, RJ, Brasil.,Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brasil
| | - Jessica Corrêa-Antônio
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, RJ, Brasil
| | - Jessica Schlackman
- University of Pittsburgh, School of Medicine and Graduate School of Public Health, Infectious Diseases Epidemiology Research Unit, Pittsburgh, PA, United States of America
| | - Jane W Marsh
- University of Pittsburgh, School of Medicine and Graduate School of Public Health, Infectious Diseases Epidemiology Research Unit, Pittsburgh, PA, United States of America
| | - Maria C Rebelo
- Secretaria de Estado de Saúde do Rio de Janeiro, Assessoria de Meningites, Rio de Janeiro, RJ, Brasil
| | - Elaine O Cerqueira
- Secretaria de Estado de Saúde do Rio de Janeiro, Assessoria de Meningites, Rio de Janeiro, RJ, Brasil
| | - Márcio Nehab
- Fundação Oswaldo Cruz-Fiocruz, Instituto Fernandes Figueira, Rio de Janeiro, RJ, Brasil
| | - Fabíola Kegele
- Fundação Oswaldo Cruz-Fiocruz, Instituto Fernandes Figueira, Rio de Janeiro, RJ, Brasil
| | | | | | - Paulo F Barroso
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brasil
| | - Lee H Harrison
- University of Pittsburgh, School of Medicine and Graduate School of Public Health, Infectious Diseases Epidemiology Research Unit, Pittsburgh, PA, United States of America
| | - David E Barroso
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, RJ, Brasil
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18
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Thorgrimson J, Ulanova M. Haemophilus influenzae type a as a cause of paediatric septic arthritis. JMM Case Rep 2016; 3:e005064. [PMID: 28348786 PMCID: PMC5343144 DOI: 10.1099/jmmcr.0.005064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 08/19/2016] [Indexed: 12/13/2022] Open
Abstract
Introduction: Incidence rates of invasive Haemophilus influenzae serotype b disease have decreased significantly since the introduction of the Hib vaccine; however, the rates in indigenous populations remain disproportionately high, specifically in the paediatric population. Additionally, with the decline of type b invasive infections, there has been a rebound in the incidence of invasive infections caused by other strains of H. influenzae, particularly serotype a. Case presentation: We present a paediatric case of septic arthritis caused by H. influenzae type a in a toddler that was fully resolved following antibiotic therapy. This report adds to other reports of septic arthritis in indigenous populations as shown through a review of recently documented H. influenzae type a septic arthritis cases. Conclusion: Socio-economic risk factors for invasive H. influenzae type a disease, such as poverty, poor housing conditions, overcrowding, smoking and substance abuse during pregnancy, as well as the need for H. influenzae type a immunization of vulnerable populations, are discussed.
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Affiliation(s)
- Joelle Thorgrimson
- Northern Ontario School of Medicine , 955 Oliver Road, Thunder Bay, ON P7B 5E1 , Canada
| | - Marina Ulanova
- Northern Ontario School of Medicine , 955 Oliver Road, Thunder Bay, ON P7B 5E1 , Canada
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19
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Samraj RS, Fergie J. Septic Arthritis and Hemarthroses Caused by Haemophilus influenzae Serotype A in Children. Infect Dis Rep 2016. [PMCID: PMC5062627 DOI: 10.4081/idr.2016.6494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Invasive disease caused by Haemophilus influenzae serotype A (Hia) is rare in children. Clinical syndromes caused by Hia include meningitis, sepsis and respiratory tract infections. Septic arthritis is rare in children with invasive Hia infection and hemarthrosis has not been described in the published literature. We report a case of septic arthritis and hemarthrosis caused by Hia infection in a 2.5 year-old-boy and review invasive Hia infection in children.
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20
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Rostad CA, Berkowitz FE. Toddler with Fever and Grunting. J Pediatric Infect Dis Soc 2015; 4:370-2. [PMID: 26407254 DOI: 10.1093/jpids/piv016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 02/24/2015] [Indexed: 11/13/2022]
Affiliation(s)
- Christina A Rostad
- Department of Pediatrics Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia
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21
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Whyte K, Levett PN, Horsman GB, Chokani K, Hayden K, Shuel M, Tsang RSW. Recurrent invasive Haemophilus influenzae serotype a infection in an infant. ACTA ACUST UNITED AC 2015. [DOI: 10.7243/2052-6180-3-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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22
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TSANG RSW, BRUCE MG, LEM M, BARRETO L, ULANOVA M. A review of invasive Haemophilus influenzae disease in the Indigenous populations of North America. Epidemiol Infect 2014; 142:1344-54. [PMID: 24598220 PMCID: PMC9151223 DOI: 10.1017/s0950268814000405] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 01/30/2014] [Accepted: 02/04/2014] [Indexed: 11/06/2022] Open
Abstract
Historically, the highest incidence rates of invasive Haemophilus influenzae disease in the world were found in North American and Australian Indigenous children. Although immunization against H. influenzae type b (Hib) led to a marked decrease in invasive Hib disease in countries where it was implemented, this disease has not been eliminated and its rates in Indigenous communities remain higher than in the general North American population. In this literature review, we examined the epidemiology of invasive H. influenzae disease in the pre-Hib vaccine era, effect of carriage on disease epidemiology, immune response to H. influenzae infection and Hib vaccination in Indigenous and Caucasian children, and the changing epidemiology after Hib conjugate vaccine has been in use for more than two decades in North America. We also explored reasons behind the continued high rates of invasive H. influenzae disease in Indigenous populations in North America. H. influenzae type a (Hia) has emerged as a significant cause of severe disease in North American Indigenous communities. More research is needed to define the genotypic diversity of Hia and the disease burden that it causes in order to determine if a Hia vaccine is required to protect the vulnerable populations.
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Affiliation(s)
- R. S. W. TSANG
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - M. G. BRUCE
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, U.S. Centers for Disease Prevention and Control (CDC), Anchorage, AK, USA
| | - M. LEM
- Fraser Health Authority, Abbotsford, BC, Canada
| | - L. BARRETO
- Human Health Therapeutics Portfolio, National Research Council of Canada, Ottawa, ON, Canada
| | - M. ULANOVA
- Medical Sciences Division, Northern Ontario School of Medicine, Thunder Bay, ON, Canada
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23
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Ulanova M, Tsang RSW. Haemophilus influenzae serotype a as a cause of serious invasive infections. THE LANCET. INFECTIOUS DISEASES 2013; 14:70-82. [PMID: 24268829 DOI: 10.1016/s1473-3099(13)70170-1] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Haemophilus influenzae, particularly H influenzae serotype b (Hib), is an important pathogen that causes serious diseases like meningitis and septicaemia. Since the introduction of Hib conjugate vaccines in the 1990s, the epidemiology of invasive H influenzae disease has changed substantially, with most infections now caused by non-Hib strains. We discuss the importance of H influenzae serotype a (Hia) as a cause of serious morbidity and mortality and its global epidemiology, clinical presentation, microbiology, immunology, prevention, and control. Much like Hib, the capsule of Hia is an important virulence factor contributing to the development of invasive disease. Molecular typing of Hia has identified distinct clonal groups, with some linked to severe disease and high case-fatality rates. Similarities between Hia and Hib capsules, their clinical presentation, and immunology of infection suggest that a bivalent Hia-Hib capsular polysaccharide-protein conjugate vaccine could offer protection against these two important serotypes of H influenzae.
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Affiliation(s)
- Marina Ulanova
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada
| | - Raymond S W Tsang
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
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Rotondo JL, Sherrard L, Helferty M, Tsang R, Desai S. The epidemiology of invasive disease due to Haemophilus influenzae serotype a in the Canadian North from 2000 to 2010. Int J Circumpolar Health 2013; 72:21142. [PMID: 25152869 PMCID: PMC4141586 DOI: 10.3402/ijch.v72i0.21142] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction The International Circumpolar Surveillance (ICS) project is a
population-based surveillance network. Since 2000, Canada has participated
in the ICS Invasive Bacterial Disease Working Group's surveillance of
invasive disease due to Haemophilus influenzae (Hi). Methods A standardized case report form containing demographic and clinical
information was completed for all reported Hi cases in the study regions.
Isolates were sent to a reference laboratory for confirmation and
serotyping. Analysis was conducted on all Hi serotype a (Hia) cases reported
from 2000 to 2010. The northern Canadian population was estimated using
Statistics Canada information. Results Of the 130 Hi cases reported from 2000 to 2010, 72 (56% of cases with
serotype information) were due to Hia. The number of Hia cases reported each
year ranged from 2 in 2008 to 13 in 2010. The average Hia incidence over the
11 years was 4.6 cases per 100,000 population per year. The majority of Hia
occurred in infants less than 2 years of age (73% of cases). This age group
had an average annual incidence of 87.5 cases per 100,000 population. Among
cases for which ethnicity was indicated, 91% of Hia cases reported
Aboriginal status with the average incidence being 6.9 cases per 100,000
population per year. The most common clinical presentation was meningitis
(reported in 37% of cases), followed by bacteraemia (34%) and pneumonia
(27%). More than 90% of cases were hospitalized, and there were 4 deaths,
resulting in a case fatality ratio of 5.6%. Conclusion In the last decade, Hia has become an important cause of morbidity and
mortality in the Canadian North. More detailed surveillance information from
a national perspective is needed. Further work on vaccine development should
be encouraged.
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Affiliation(s)
- Jenny L Rotondo
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Lindsey Sherrard
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Melissa Helferty
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Raymond Tsang
- Syphilis Diagnostics and Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Shalini Desai
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Ontario, Canada
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Tsang RS, Shuel M, Wylie J, Lefebvre B, Hoang L, Law DK. Population genetics of Haemophilus influenzae serotype a in three Canadian provinces. Can J Microbiol 2013; 59:362-4. [DOI: 10.1139/cjm-2013-0156] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Haemophilus influenzae serotype a (Hia) is an important pathogen since the introduction of vaccines for control of disease due to serotype b strains. Using a sodC-based polymerase chain reaction, Hia can be divided into 2 phylogenetic divisions, each with their own unique multilocus sequence types. Most Canadian Hia belongs to clonal division I and the ST-23 clonal complex. The recently described hypervirulent clone of ST-4 was found in a single Canadian isolate. Therefore, surveillance of invasive H. influenzae disease should include serotyping to detect Hia and multilocus sequence typing to detect hypervirulent clones.
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Affiliation(s)
- Raymond S.W. Tsang
- Vaccine Preventable Bacterial Diseases Division, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB R3E 3R2, Canada
| | - Michelle Shuel
- Vaccine Preventable Bacterial Diseases Division, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB R3E 3R2, Canada
| | - John Wylie
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, MB R3C 3Y1, Canada
| | - Brigitte Lefebvre
- Laboratoire de santé publique du Québec, Sainte-Anne-de-Bellevue, QC H9X 3R5, Canada
| | - Linda Hoang
- Public Health Microbiology and Reference Laboratory, BC Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada
| | - Dennis K.S. Law
- Vaccine Preventable Bacterial Diseases Division, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB R3E 3R2, Canada
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27
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Ulanova M, Tsang R, Altman E. Neglected infectious diseases in Aboriginal communities: Haemophilus influenzae serotype a and Helicobacter pylori. Vaccine 2012; 30:6960-6. [DOI: 10.1016/j.vaccine.2012.09.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 07/04/2012] [Accepted: 09/25/2012] [Indexed: 12/17/2022]
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Abstract
Haemophilus influenzae strains are classified as typeable or nontypeable H. influenzae (NTHI) based upon the presence or absence of capsule. In addition to serotyping, which is subject to false-positive results, typeable strains can be identified through the detection of the capsular export gene bexA and one of six capsule-specific genes, but this method is resource intensive, especially in characterizing large numbers of strains. To address these challenges, we developed a bexB-based method to differentiate true NTHI strains from typeable strains. We validated a PCR-based method to detect bexB in 10 strains whose capsule status was well defined. Among 40 strains that were previously serotype positive in clinical microbiology laboratories, 5 lacked bexA, bexB, and capsule type-specific genes by PCR analysis and thus likely represent false-positive serotyping results. Among 94 additional otitis media, commensal, and serotype b-negative invasive strains, 85 were bexA and bexB negative and 9 contained either a complete or partial capsule locus, i.e., 8 were bexA and bexB positive and 1 was bexA negative but bexB positive. Finally, we adapted the method for use in a high-throughput DNA hybridization-based microarray method, which showed 98.75 and 97.5% concordance to the PCR methods for bexA and bexB, respectively. In addition, bexB showed 84% or greater nucleotide identity among strains containing the capsule locus. In this study, we demonstrate that bexB is a reliable proxy for the capsule locus and that its detection provides a simple and reliable method for differentiating strains that lack the entire capsule locus from those containing a partial or complete capsule locus.
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Kelly L, Tsang RSW, Morgan A, Jamieson FB, Ulanova M. Invasive disease caused by Haemophilus influenzae type a in Northern Ontario First Nations communities. J Med Microbiol 2011; 60:384-390. [DOI: 10.1099/jmm.0.026914-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Seven epidemiologically unrelated cases of invasive Haemophilus influenzae type a (Hia) disease were identified in First Nations communities of Northwestern Ontario, Canada, in 2004–2008. In all cases, Hia was isolated from blood. The clinical presentation in most of the cases was moderately severe and all patients responded to antibiotic therapy. Laboratory analysis of Hia isolates from Northwestern Ontario indicated striking similarities in their phenotypic and genotypic characteristics. The findings are discussed in the context of current epidemiology of invasive Hia disease. Our data along with some published studies by others suggest an increased susceptibility to this infection among North American indigenous populations.
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Affiliation(s)
- Len Kelly
- Northern Ontario School of Medicine, Thunder Bay and Sioux Lookout, Ontario, Canada
| | - Raymond S. W. Tsang
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Alanna Morgan
- Northern Ontario School of Medicine, Thunder Bay and Sioux Lookout, Ontario, Canada
| | - Frances B. Jamieson
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Ontario Agency for Health Protection and Promotion, Toronto, Ontario, Canada
| | - Marina Ulanova
- Northern Ontario School of Medicine, Thunder Bay and Sioux Lookout, Ontario, Canada
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Evaluation of serum bactericidal antibody assays for Haemophilus influenzae serotype a. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2010; 18:243-7. [PMID: 21177919 DOI: 10.1128/cvi.00219-10] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Haemophilus influenzae type a (Hia) is an important pathogen for some American Indian, Alaskan native, and Northern Canada aboriginal populations. Assays to measure serum bactericidal activity (SBA) to Hia have not been developed or validated. Here, we describe two methods for the measurement of SBA: SBA with a viability endpoint (CFU counts) and SBA with a fluorometric endpoint using alamarBlue as the metabolic indicator. Both SBA assays measure Hia-specific functional antibody and correlate with anti-Hia IgG enzyme-linked immunosorbent assay (ELISA) concentration of naturally acquired antibodies.
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Lima JBT, Ribeiro GS, Cordeiro SM, Gouveia EL, Salgado K, Spratt BG, Godoy D, Reis MG, Ko AI, Reis JN. Poor clinical outcome for meningitis caused by Haemophilus influenzae serotype A strains containing the IS1016-bexA deletion. J Infect Dis 2010; 202:1577-84. [PMID: 20932170 DOI: 10.1086/656778] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Since the introduction of Haemophilus influenzae type b (Hib) conjugate vaccines, meningitis caused by serotypes other than Hib has gained in importance. We conducted active hospital-based surveillance for meningitis over an 11-year period in Salvador, Brazil. H. influenzae isolates were serotyped and analyzed by polymerase chain reaction, pulsed-field gel electrophoresis, and DNA sequencing to identify strains with a specific deletion (IS1016) in the bexA gene (IS1016-bexA). We identified 43 meningitis cases caused by non-type b H. influenzae: 28 (65%) were caused by type a (Hia), 9 (21%) were caused by noncapsulated strains, and 3 (7%) each were caused by types e and f. Hia isolates clustered in 2 clonal groups; clonal group A strains (n = 9) had the IS1016-bexA deletion. Among children <5 years of age, meningitis caused by Hia from clonal group A had higher case-fatality than meningitis caused by clonal group B. Despite small numbers, these results indicate that the presence of the IS1016-bexA deletion is associated with enhanced virulence in non-type b H. influenzae.
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Affiliation(s)
- Josilene B T Lima
- Gonçalo Moniz Research Center, Oswaldo Cruz Foundation, Brazilian Ministry of Health, Salvador, Brazil
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Gómez de León Cruces P, Díaz García J, Santos JI. Effect of the DTwP Haemophilus influenzae b Conjugate Vaccination in Mexico (1999–2007). Arch Med Res 2010; 41:281-7. [DOI: 10.1016/j.arcmed.2010.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Accepted: 05/24/2010] [Indexed: 11/28/2022]
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Emergence and disappearance of a virulent clone of Haemophilus influenzae biogroup aegyptius, cause of Brazilian purpuric fever. Clin Microbiol Rev 2008; 21:594-605. [PMID: 18854482 DOI: 10.1128/cmr.00020-08] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
SUMMARY In 1984, children presented to the emergency department of a hospital in the small town of Promissão, São Paulo State, Brazil, with an acute febrile illness that rapidly progressed to death. Local clinicians and public health officials recognized that these children had an unusual illness, which led to outbreak investigations conducted by Brazilian health officials in collaboration with the U.S. Centers for Disease Control and Prevention. The studies that followed are an excellent example of the coordinated and parallel studies that are used to investigate outbreaks of a new disease, which became known as Brazilian purpuric fever (BPF). In the first outbreak investigation, a case-control study confirmed an association between BPF and antecedent conjunctivitis but the etiology of the disease could not be determined. In a subsequent outbreak, children with BPF were found to have bacteremia caused by Haemophilus influenzae biogroup aegyptius (H. aegyptius), an organism previously known mainly to cause self-limited purulent conjunctivitis. Molecular characterization of blood and other isolates demonstrated the clonal nature of the H. aegyptius strains that caused BPF, which were genetically distant from the diverse strains that cause only conjunctivitis. This led to an intense effort to identify the factors causing the unusual invasiveness of the BPF clone, which has yet to definitively identify the virulence factor or factors involved. After a series of outbreaks and sporadic cases through 1993, no additional cases of BPF have been reported.
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Nicol MP, Wilkinson RJ. The clinical consequences of strain diversity in Mycobacterium tuberculosis. Trans R Soc Trop Med Hyg 2008; 102:955-65. [PMID: 18513773 DOI: 10.1016/j.trstmh.2008.03.025] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 03/28/2008] [Accepted: 03/31/2008] [Indexed: 01/28/2023] Open
Abstract
The influence of strain variation on the outcome of infection with Mycobacterium tuberculosis is an emerging area of research. Significant genetic diversity is generated within the species through deletion, duplication and recombination events; however, unlike many bacterial pathogens gene exchange is rare in M. tuberculosis, resulting in the evolution of distinct clonal lineages. One such lineage, W-Beijing, is particularly virulent in animal models, may be emerging worldwide, has distinct phenotypic and genotypic characteristics and is associated with extrapulmonary disease and drug resistance. Strains of M. tuberculosis responsible for outbreaks have been shown to vary in virulence in animal models, which in turn has been related to their ability to inhibit innate immune responses. However, there is no clear evidence that this variability manifests as differences in human disease. An improved understanding of the phylogenetic relationship between strains of M. tuberculosis, based on increased availability of sequence data from the major strain lineages, will allow a structured approach to understand further the consequences of strain diversity in M. tuberculosis.
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Affiliation(s)
- Mark P Nicol
- Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, Cape Town, South Africa.
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McLellan E, Suvarna K, Townsend R. Fatal necrotizing fasciitis caused by Haemophilus influenzae serotype f. J Med Microbiol 2008; 57:249-251. [DOI: 10.1099/jmm.0.47603-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We describe a case of fatal lower limb necrotizing fasciitis in a 65-year-old man who was treated with broad-spectrum antibiotics, limb amputation and tissue debridement. The causative organism was identified by PCR as Haemophilus influenzae serotype f, which is a highly unusual cause of necrotizing fasciitis.
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Affiliation(s)
- Elizabeth McLellan
- Department of Microbiology, Northern General Hospital, Sheffield S17 3QU, UK
| | - Kim Suvarna
- Department of Histopathology, Northern General Hospital, Sheffield S17 3QU, UK
| | - Rob Townsend
- Department of Microbiology, Northern General Hospital, Sheffield S17 3QU, UK
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36
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Sill ML, Zhou J, Law DKS, Lorange M, Ringuette L, Bekal S, Tsang RSW. Molecular characterization of four Haemophilus influenzae serotype a strains isolated from patients in Quebec, Canada. Can J Microbiol 2008; 53:1191-4. [PMID: 18026212 DOI: 10.1139/w07-088] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Four epidemiologically unrelated Haemophilus influenzae serotype a (Hia) strains from patients in Quebec, Canada, were characterized and found to represent 3 distinct groups. One isolate, found to be biotype I and sequence type (ST)-62 by multilocus sequence typing, was shown to possess the copper- and zinc-containing superoxide dismutase gene, sodC, and was suspected to belong to clonal division II. The other 3 isolates were classified as clonal division I based on the absence of the sodC gene. Among the 3 sodC-negative Hia strains, 2 were biotype II and had related STs (ST-23 and ST-403) and highly similar DNA fingerprints, similar to a group of previously described Hia isolates causing invasive disease in Manitoba, Canada. The remaining sodC-negative strain belonged to biotype I and ST-4 and shared no common allele with ST-23, ST-403, or ST-62. This isolate also possessed the IS1016-bexA partial deletion, which is often associated with increased virulence. Despite the small number of isolates used in this study, our finding of 3 distinct groups shows the existence of a potential genetic diversity not previously described for Hia. Whether this genetic diversity is related to the severity and epidemiology of Hia disease requires further studies.
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Affiliation(s)
- Michelle L Sill
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB R3E 3R2, Canada
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38
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Craven SH, Neidle EL. Double trouble: medical implications of genetic duplication and amplification in bacteria. Future Microbiol 2007; 2:309-21. [PMID: 17661705 DOI: 10.2217/17460913.2.3.309] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Gene amplification allows organisms to adapt to changing environmental conditions. This type of increased gene dosage confers selectable benefits, typically by augmenting protein production. Gene amplification is a reversible process that does not require permanent genetic change. Although transient, altered gene dosage has significant medical impact. Recent examples of amplification in bacteria, described here, affect human disease by modifying antibiotic resistance, the virulence of pathogens, vaccine efficacy and antibiotic biosynthesis. Amplification is usually a two-step process whereby genetic duplication (step one) promotes further increases in copy number (step two). Both steps have important evolutionary significance for the emergence of innovative gene functions. Recent genome sequence analyses illustrate how genome plasticity can affect the evolution and immunogenic properties of bacterial pathogens.
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Affiliation(s)
- Sarah H Craven
- University of Georgia, Microbiology Department, Athens, GA 30602-2605, USA.
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Satola SW, Collins JT, Napier R, Farley MM. Capsule gene analysis of invasive Haemophilus influenzae: accuracy of serotyping and prevalence of IS1016 among nontypeable isolates. J Clin Microbiol 2007; 45:3230-8. [PMID: 17699642 PMCID: PMC2045354 DOI: 10.1128/jcm.00794-07] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We evaluated the accuracy of serologic capsule typing by analyzing capsule genes and related markers among invasive Haemophilus influenzae isolates before and after the introduction of H. influenzae serotype b (Hib) conjugate vaccines. Three hundred and sixty invasive H. influenzae isolates were collected as part of Active Bacterial Core surveillance within the Georgia Emerging Infections Program between 1 January 1989 and 31 July 1998. All isolates were biotyped, serotyped by slide agglutination serotyping (SAST), and evaluated using PCR capsule typing. Nontypeable H. influenzae (NTHi) isolates were probed with Hib cap-gene-containing plasmid pUO38 and with IS1016; a subset was examined with phosphoglucose isomerase (pgi) genotyping and pulsed-field gel electrophoresis (PFGE). Discrepancies between SAST and PCR capsule typing were found for 64/360 (17.5%) of the isolates; 48 encapsulated by SAST were NTHi by PCR, 8 NTHi by SAST were encapsulated by PCR, 6 encapsulated by SAST were a different capsule type by PCR, and 2 encapsulated by SAST were capsule-deficient Hib variants (Hib-minus). None of the PCR-confirmed NTHi isolates demonstrated homology with residual capsule gene sequences; 19/201 (9.5%) had evidence of IS1016, an insertion element associated with division I H. influenzae capsule serotypes. The majority of IS1016-positive NTHi were biotypes I and V and showed some genetic relatedness by PFGE. In conclusion, PCR capsule typing was more accurate than SAST and Hib-minus variants were rare. IS1016 was present in 9.5% of NTHi isolates, suggesting that this subset may be more closely related to encapsulated organisms. A better understanding of NTHi may contribute to vaccine development.
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Affiliation(s)
- Sarah W Satola
- Atlanta Veterans Affairs Medical Center, Medical Research Service 151, 1670 Clairmont Rd., Decatur, GA 30033, USA
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Jin Z, Romero-Steiner S, Carlone GM, Robbins JB, Schneerson R. Haemophilus influenzae type a infection and its prevention. Infect Immun 2007; 75:2650-4. [PMID: 17353280 PMCID: PMC1932902 DOI: 10.1128/iai.01774-06] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Zhigang Jin
- National Institutes of Health, Building 31, Room 2A29, Bethesda, MD 20892, USA
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Davidsen T, Koomey M, Tønjum T. Microbial genome dynamics in CNS pathogenesis. Neuroscience 2007; 145:1375-87. [PMID: 17367950 DOI: 10.1016/j.neuroscience.2007.01.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2006] [Revised: 01/19/2007] [Accepted: 01/19/2007] [Indexed: 10/23/2022]
Abstract
The balancing act between microbes and their host in commensal and disease states needs to be deciphered in order to fully treat and combat infectious diseases. The elucidation of microbial genome dynamics in each instance is therefore required. In this context, the major bacterial meningitis pathogens are Neisseria meningitidis, Haemophilus influenzae and Streptococcus pneumoniae. In prokaryotic CNS pathogenesis both the intact organism as well as its released components can elicit disease, often resulting in neurological sequelae, neurodegeneration or fatal outcome. The study of microbial virulence in CNS disease is expected to generate findings that yield new information on the general mechanisms of brain edema and excitatory neuronal disturbances due to meningitis, with significant potential for discoveries that can directly influence and inspire new strategies for prevention and treatment of this serious disease.
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Affiliation(s)
- T Davidsen
- Centre for Molecular Biology and Neuroscience, Institute of Microbiology, Rikshospitalet-Radiumhospitalet Medical Centre, Sognsvannsveien 20, NO-0027 Oslo, Norway
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Billal DS, Hotomi M, Suzumoto M, Yamauchi K, Kobayashi I, Fujihara K, Yamanaka N. Rapid identification of nontypeable and serotype b Haemophilus influenzae from nasopharyngeal secretions by the multiplex PCR. Int J Pediatr Otorhinolaryngol 2007; 71:269-74. [PMID: 17118463 DOI: 10.1016/j.ijporl.2006.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2006] [Revised: 10/13/2006] [Accepted: 10/15/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Heamophilus influenzae (H. influenzae) is an important pathogen responsible for both invasive and non-invasive infectious diseases. While encapsulated type b strain recognized as a major cause of severe invasive diseases, nontypeable strains are the major causes of non-invasive infectious diseases. Detection of this pathogen from nasopharyngeal secretions (NPS) is important. METHODS We developed a multiplex polymerase chain reaction (PCR) for rapid identification of nontypeable and serotype b H. influenzae from nasopharyngeal secretions. RESULTS A total 25 nasopharyngeal secretions were evaluated in this study. The multiplex PCR provided rapid and unequivocal results for determining either nontypeable or encapsulated typeable especially type b strains including a determination of beta-lactamase productions. CONCLUSION The multiplex PCR based serotyping provided more reliable results than slide agglutination test (SAT) and is a valuable and expeditious method for identification of H. influenzae with determining capsular serotypes.
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Affiliation(s)
- Dewan S Billal
- Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
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Giufrè M, Cardines R, Mastrantonio P, Cerquetti M. Variant IS1016 insertion elements in invasive Haemophilus influenzae type b isolates harboring multiple copies of the capsulation b locus. Clin Infect Dis 2006; 43:1225-6. [PMID: 17029153 DOI: 10.1086/508359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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44
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Hammitt LL, Hennessy TW, Romero-Steiner S, Butler JC. Assessment of Carriage ofHaemophilus influenzaeType a after a Case of Invasive Disease. Clin Infect Dis 2006; 43:386-7. [PMID: 16804859 DOI: 10.1086/505602] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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