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Dong Q, Shi W, Cheng X, Chen C, Meng Q, Yao K, Qian S. Widespread of non-typeable Haemophilus influenzae with high genetic diversity after two decades use of Hib vaccine in China. J Clin Lab Anal 2019; 34:e23145. [PMID: 31846125 PMCID: PMC7171301 DOI: 10.1002/jcla.23145] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The aim of this study was to analyze the microbiological characteristics of nasopharyngeal carriage Haemophilus influenzae isolates collected from children with respiratory infections in Beijing hospital and Youyang Hospital of China. METHODS The serotypes of all isolates were determined using latex agglutinated antisera (a-f). The minimum inhibitory concentrations (MICs) of 11 antibiotics were determined using E-test strips. For the beta-lactamase-negative ampicillin-resistant (BLNAR) isolates, ftsI gene was sequenced based on fragments amplified by PCR. STs of H influenzae isolates were determined by multi-locus sequence typing. RESULTS The overall carriage rate of H influenzae in the study population was 9.1% (362/3984). One hundred and ninety H influenzae isolates which were selected in our study were non-typeable (NTHi) and 44 (23.2%) of them were positive for β-lactamase. All isolates were susceptible to ceftriaxone and levofloxacin. Susceptibility rates to erythromycin and sulfamethoxazole-trimethoprim in Beijing were significantly higher than Youyang (P < .05). Thirty-six BLNAR isolates were identified. The MLST analysis showed 108 STs in 190 isolates, the most common of which were ST408 (11, 5.8%), ST914 (10, 5.3%), ST57 (9, 4.7%), and ST834 (6, 3.2%). Twelve STs were detected in both of the study sites, which covered 63 isolates. CONCLUSIONS All isolates in the present study were NTHi, which suggested widespread of this type in China. The BLNAR isolates were detected more frequently than before. Because high genetic diversity of NTHi isolates of H influenzae exists worldwide, it is important to continuously monitor these bacteria in the future.
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Affiliation(s)
- Qiaoli Dong
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, Beijing, China.,Department of Pediatrics, Affiliated Hospital of Hebei University, Baoding, China
| | - Wei Shi
- Key Laboratory of Major Diseases in Children, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xiaoping Cheng
- Youyang Hospital, People's Hospital of Chongqing Youyang County, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Changhui Chen
- Youyang Hospital, People's Hospital of Chongqing Youyang County, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghong Meng
- Key Laboratory of Major Diseases in Children, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Kaihu Yao
- Key Laboratory of Major Diseases in Children, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Suyun Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, Beijing, China
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Isolation and Antibiotic Susceptibility Testing of Haemophilus influenzae from Nasopharynx of Children under Five Years Attending Maternal and Child Health Clinic in Mbarara Regional Referral Hospital. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2019; 2019:6542919. [PMID: 30944683 PMCID: PMC6421742 DOI: 10.1155/2019/6542919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 12/31/2018] [Accepted: 02/11/2019] [Indexed: 11/23/2022]
Abstract
Background. H. influenzae remains an organism of a major public health challenge worldwide despite the availability of the Hib vaccine, particularly among children under 5 years. Information on the current carriage status and antibiotic susceptibility is key on proper health-care provision. Therefore, we conducted a study to determine H. influenzae carriage rate and antibiotic susceptibility testing of the isolates among the children. Methods. This was a cross-sectional study conducted between January and May 2018, among clinically healthy children under five years attending Maternal and Child Health (MCH) Clinic in Mbarara Regional Referral Hospital (MRRH). We carried out standard microbiology methods to culture, isolate, and identify H. influenzae, and then, we tested for their susceptibility to commonly used antibiotics following the CLSI standards. Results. Of the 248 participants included in the study, 116 (46.77%) were females and 132 (53.23%) males and 78 (31.45%) were below the age of 3 months. Fifty one of the study participants had H. influenzae in their nasopharynx, which represents 20.56% carriage (95% CI 15.49 to 25.63). There was a general high susceptibility of the isolates to the antimicrobial agents commonly used. There was 100% susceptibility to ciprofloxacin and imipenem antibiotic agents, though 6 (11.76%) and 4 (7.84%) of the isolates showed resistance to chloramphenicol and ampicillin, respectively. Conclusion. The high burden presented by H. influenzae and the resultant impact on child health require much attention to prevention of infections associated with the organism. A well-funded molecular study focusing on typing the isolates would determine the impact of the vaccine, given the carriage rates are still high.
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Jiang H, Huai Y, Chen H, Uyeki TM, Chen M, Guan X, Liu S, Peng Y, Yang H, Luo J, Zheng J, Huang J, Peng Z, Xiang N, Zhang Y, Klena JD, Hu DJ, Rainey JJ, Huo X, Xiao L, Xing X, Zhan F, Yu H, Varma JK. Invasive Streptococcus pneumoniae infection among hospitalized patients in Jingzhou city, China, 2010-2012. PLoS One 2018; 13:e0201312. [PMID: 30125283 PMCID: PMC6101356 DOI: 10.1371/journal.pone.0201312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 07/12/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Streptococcus pneumoniae (Sp) is a leading cause of bacterial pneumonia, meningitis, and sepsis and a major source of morbidity and mortality worldwide. Invasive pneumococcal disease (IPD) is defined as isolation of Sp from a normally sterile site, including blood or cerebrospinal fluid. The aim of this study is to describe outcomes as well as clinical and epidemiological characteristics of hospitalized IPD case patients in central China. METHODS We conducted surveillance for IPD among children and adults from April 5, 2010 to September 30, 2012, in four major hospitals in Jingzhou City, Hubei Province. We collected demographic, clinical, and outcome data for all enrolled hospitalized patients with severe acute respiratory infection (SARI) or meningitis, and collected blood, urine, and cerebrospinal fluid (CSF) for laboratory testing for Sp infections. Collected data were entered into Epidata software and imported into SPSS for analysis. RESULTS We enrolled 22,375 patients, including 22,202 (99%) with SARI and 173 (1%) with meningitis. One hundred and eighteen (118, 3%) with either SARI or meningitis were Sp positive, 32 (0.8%) from blood/CSF culture, and 87 (5%) from urine antigen testing. Of those 118 patients, 57% were aged ≥65 years and nearly 100% received antibiotics during hospitalization. None were previously vaccinated with 7-valent pneumococcal conjugate vaccine (PCV 7), 23-valent pneumococcal polysaccharide vaccine, or seasonal influenza vaccine. The main serotypes identified were 14, 12, 3, 1, 19F, 4, 5, 9V, 15 and 18C, corresponding to serotype coverage rates of 42%, 63%, and 77% for PCV7, PCV10, and PCV13, respectively. CONCLUSIONS Further work is needed to expand access to pneumococcal vaccination in China, both among children and potentially among the elderly, and inappropriate use of antibiotics is a widespread and serious problem in China.
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Affiliation(s)
- Hui Jiang
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Huai
- China-US Collaborative Program on Emerging and Re-Emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China
| | - Hui Chen
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Timothy M. Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, GA, United States of America
| | - Maoyi Chen
- Jingzhou Center for Disease Control and Prevention, Jingzhou, China
| | - Xuhua Guan
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Shali Liu
- Jingzhou Central Hospital, Jingzhou, China
| | - Youxing Peng
- Jingzhou First People’s Hospital, Jingzhou, China
| | - Hui Yang
- Jingzhou Second People’s Hospital, Jingzhou, China
| | - Jun Luo
- Jingzhou Maternal and Children’s Hospital, Jingzhou, China
| | - Jiandong Zheng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jigui Huang
- Jingzhou Center for Disease Control and Prevention, Jingzhou, China
| | - Zhibin Peng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Nijuan Xiang
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuzhi Zhang
- China-US Collaborative Program on Emerging and Re-Emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China
| | - John D. Klena
- China-US Collaborative Program on Emerging and Re-Emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China
| | - Dale J. Hu
- China-US Collaborative Program on Emerging and Re-Emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China
| | - Jeanette J. Rainey
- China-US Collaborative Program on Emerging and Re-Emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China
- Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Xixiang Huo
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Lin Xiao
- Jingzhou Center for Disease Control and Prevention, Jingzhou, China
| | - Xuesen Xing
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Faxian Zhan
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Hongjie Yu
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jay K. Varma
- China-US Collaborative Program on Emerging and Re-Emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China
- Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Yang Y, Pan X, Cheng W, Yang Y, Scherpbier RW, Zhu X, Chen Y, Zhou Y, Jiang Q. Haemophilus influenzae type b carriage and burden of its related diseases in Chinese children: Systematic review and meta-analysis. Vaccine 2017; 35:6275-6282. [DOI: 10.1016/j.vaccine.2017.09.057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/07/2017] [Accepted: 09/19/2017] [Indexed: 01/21/2023]
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Li Y, An Z, Yin D, Liu Y, Huang Z, Ma Y, Li H, Li Q, Wang H. Disease burden of community acquired pneumonia among children under 5 y old in China: A population based survey. Hum Vaccin Immunother 2017; 13:1681-1687. [PMID: 28414567 DOI: 10.1080/21645515.2017.1304335] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND To obtain the baseline data on the incidence and cost of community acquired pneumonia among under-5 children for future studies, and provide evidence for shaping China's strategies regarding pneumococcal conjugate vaccine (PCV). METHODS Three townships from Heilongjiang, Hebei and Gansu Province and one community in Shanghai were selected as study areas. A questionnaire survey was conducted to collect data on incidence and cost of pneumonia among children under 5 y old in 2012. RESULTS The overall incidence of clinically diagnosed pneumonia in children under 5 y old was 2.55%. The incidence in urban area was 7.97%, higher than that in rural areas (1.68%). However, no difference was found in the incidences of chest X-ray confirmed pneumonia between urban and rural areas (1.67% vs 1.23%). X-ray confirmed cases in rural and urban areas respectively accounted for 73.45% and 20.93% of all clinically diagnosed pneumonia. The hospitalization rate of all cases was 1.40%. Incidence and hospitalization rate of pneumonia decreased with age, with the highest rates found among children younger than one year and the lowest among children aged 4 (incidence: 4.25% vs 0.83%; hospitalization: 2.75% vs 0.36%). The incidence was slightly higher among boys (2.92% vs 2.08%). The total cost due to pneumonia for the participants was 1138 733 CNY. The average cost and median cost was 5722 CNY and 3540 CNY separately. Multivariate analysis showed that the only factor related to higher cost was hospitalization. CONCLUSIONS The disease burden was high for children under 5 y old, especially the infant. PCV has not been widely used among children, and thus further health economics evaluation on introducing PCV into National Immunization Program should be conducted.
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Affiliation(s)
- Yan Li
- a National Immunization Program , Chinese Center for Disease Control and Prevention , Beijing , China
| | - Zhijie An
- a National Immunization Program , Chinese Center for Disease Control and Prevention , Beijing , China
| | - Dapeng Yin
- a National Immunization Program , Chinese Center for Disease Control and Prevention , Beijing , China
| | - Yanmin Liu
- a National Immunization Program , Chinese Center for Disease Control and Prevention , Beijing , China
| | - Zhuoying Huang
- b Immunization Program Department , Shanghai Municipal Center for Disease Control and Prevention , Shanghai , China
| | - Yujie Ma
- c Immunization Program Department , Heilongjiang Provincial Center for Disease Control and Prevention , Haerbin , Heilongjiang , China
| | - Hui Li
- d Immunization Program Department , Gansu Provincial Center for Disease Control and Prevention , Lanzhou , Gansu , China
| | - Qi Li
- e Immunization Program Department , Hebei Provincial Center for Disease Control and Prevention , Shijiazhuang , Hebei , China
| | - Huaqing Wang
- a National Immunization Program , Chinese Center for Disease Control and Prevention , Beijing , China
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Kim JH, Kim E, Kwon JH, Seo WH, Yoo Y, Choung JT, Song DJ. Clinical characteristics of respiratory viral coinfection in pediatric Mycoplasma pneumoniaepneumonia. ALLERGY ASTHMA & RESPIRATORY DISEASE 2017. [DOI: 10.4168/aard.2017.5.1.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jong Hyun Kim
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Eunji Kim
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Jung Hyun Kwon
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Won Hee Seo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Young Yoo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
- Environmental Health Center, Korea University Anam Hospital, Seoul, Korea
| | - Ji Tae Choung
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
- Environmental Health Center, Korea University Anam Hospital, Seoul, Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
- Environmental Health Center, Korea University Anam Hospital, Seoul, Korea
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Maurer KA, Chen HF, Wagner AL, Hegde ST, Patel T, Boulton ML, Hutton DW. Cost-effectiveness analysis of pneumococcal vaccination for infants in China. Vaccine 2016; 34:6343-6349. [PMID: 27810315 DOI: 10.1016/j.vaccine.2016.10.051] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 10/15/2016] [Accepted: 10/19/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Although China has a high burden of pneumococcal disease among young children, the government does not administer publicly-funded pneumococcal conjugate vaccines (PCV) through its Expanded Program on Immunization (EPI). We evaluated the cost-effectiveness of publicly-funded PCV-7, PCV-10, and PCV-13 vaccination programs for infants in China. METHODS Using a Markov model, we simulated a cohort of 16 million Chinese infants to estimate the impact of PCV-7, PCV-10, and PCV-13 vaccination programs from a societal perspective. We extrapolated health states to estimate the effects of the programs over the course of a lifetime of 75years. Parameters in the model were derived from a review of the literature. RESULTS We found that PCV-7, PCV-10, and PCV-13 vaccination programs would be cost-effective compared to no vaccination. However, PCV-13 had the lowest incremental cost-effectiveness ratio ($11,464/QALY vs $16,664/QALY for PCV-10 and $18,224/QALY for PCV-7) due to a reduction in overall costs. Our sensitivity analysis revealed that the incremental cost-effectiveness ratios were most sensitive to the utility of acute otitis media, the cost of PCV-13, and the incidence of pneumonia and acute otitis media. CONCLUSIONS The Chinese government should take steps to reduce the burden of pneumococcal diseases among young children through the inclusion of a pneumococcal conjugate vaccine in its EPI. Although all vaccinations would be cost-effective, PCV-13 would save more costs to the healthcare system and would be the preferred strategy.
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Affiliation(s)
- Kristin A Maurer
- Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Huey-Fen Chen
- Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Sonia T Hegde
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Tejasi Patel
- Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Matthew L Boulton
- Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States; Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States; Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States.
| | - David W Hutton
- Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
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DeAntonio R, Yarzabal JP, Cruz JP, Schmidt JE, Kleijnen J. Epidemiology of community-acquired pneumonia and implications for vaccination of children living in developing and newly industrialized countries: A systematic literature review. Hum Vaccin Immunother 2016; 12:2422-40. [PMID: 27269963 PMCID: PMC5027706 DOI: 10.1080/21645515.2016.1174356] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This systematic review evaluated the epidemiology of community-acquired pneumonia in children <6 y of age within 90 developing and newly industrialized countries. Literature searches (1990–2011), based on MEDLINE, EMBASE, Cochrane, CAB Global Health, WHO, UNICEF, country-specific websites, conferences, health-technology-assessment agencies, and the reference lists of included studies, yielded 8,734 records; 62 of 340 studies were included in this review. The highest incidence rate among included studies was 0.51 episodes/child-year, for children <5 y of age in Bangladesh. The highest prevalence was in Chinese children <6 months of age (37.88%). The main bacterial pathogens were Streptococcus pneumoniae, Haemophilus influenzae and Mycoplasma pneumoniae and the main viral pathogens were respiratory syncytial virus, adenovirus and rhinovirus. Community-acquired pneumonia remains associated with high rates of morbidity and mortality. Improved and efficient surveillance and documentation of the epidemiology and burden of community-acquired pneumonia across various geographical regions is warranted.
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Affiliation(s)
| | | | | | | | - Jos Kleijnen
- d School for Public Health and Primary Care (CAPHRI), Maastricht University , Maastricht , The Netherlands.,e Kleijnen Systematic Reviews Ltd , York , United Kingdom
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Peltola H, Pelkonen T, Bernardino L, Monteiro L, Silvestre SDC, Anjos E, Cruzeiro ML, Pitkäranta A, Roine I. Vaccine-induced waning of Haemophilus influenzae empyema and meningitis, Angola. Emerg Infect Dis 2015; 20:1887-90. [PMID: 25340259 PMCID: PMC4214300 DOI: 10.3201/eid2011.140400] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In Angola during 2003–2012, we detected Haemophilus influenzae in 18% of 2,634 and 26% of 2,996 bacteriologically positive pleural or cerebrospinal fluid samples, respectively, from children. After vaccination launch in 2006, H. influenzae empyema declined by 83% and meningitis by 86%. Severe H. influenzae pneumonia and meningitis are preventable by vaccination.
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Zhu H, Wang A, Tong J, Yuan L, Gao W, Shi W, Yu S, Yao K, Yang Y. Nasopharyngeal carriage and antimicrobial susceptibility of Haemophilus influenzae among children younger than 5 years of age in Beijing, China. BMC Microbiol 2015; 15:6. [PMID: 25648185 PMCID: PMC4332420 DOI: 10.1186/s12866-015-0350-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 01/16/2015] [Indexed: 11/12/2022] Open
Abstract
Background Haemophilus influenzae is one of the main pathogens that cause community-acquired respiratory infections in children. Our previous study showed that H. influenzae is the second most common pathogen causing pneumonia and accounts for 30–50% of bacterial meningitis among Chinese children. H. influenzae carriage in children and its resistance to commonly used antimicrobials varies widely both geographically and over time. Results Surveys of the nasopharyngeal carriage of H. influenzae in children younger than 5 years of age with acute respiratory tract infection (ARI) were conducted in Beijing Children’s Hospital, China in 2000, 2002, 2010, and 2012. The overall annual carriage rates of H. influenzae among children younger than 5 years of age with ARI were 35.5%, 20.6%, 14.4%, and 18.7%, and the percentages of H. influenzae isolates producing β-lactamase were 4%, 13%, 27.1%, and 31%, respectively. The percentages of susceptibility to ampicillin progressively decreased from 96% (2000) to 87% (2002) to 63% (2010) to 61% (2012). All of the ampicillin-resistant isolates were found to be beta-lactamase producers. The susceptibility to tetracycline increased from 54% (2000) to 60% (2002) to 91.5% (2010) to 94.5% (2012). No statistically significant differences were observed in the susceptibility to cefaclor, cefuroxime, sulfamethoxazole, and chloramphenicol. Amoxicillin/clavulanic acid and ceftriaxone were the most effective antimicrobials for the isolates of H. influenzae across the 10-year period. Conclusions This report on the H. influenzae carriage rates in children and the susceptibility of these bacteria to commonly used antibiotics showed that H. influenzae carriage decreased from 2000 to 2012. Additionally, the percentage of β-lactamase-producing isolates increased while their susceptibility to ampicillin progressively decreased during this time. These results indicate that the appropriate empirical antimicrobial therapy should be changed for pediatric patients in China.
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Affiliation(s)
- Hongbin Zhu
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Nan Li Shi Road 56, Beijing, 100045, China. .,Department of Pediatrics, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing, 100020, China.
| | - Aihua Wang
- Department of Pediatrics, The Second Hospital of Lanzhou University, Lanzhou, 730030, China.
| | - Jingjing Tong
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Nan Li Shi Road 56, Beijing, 100045, China.
| | - Lin Yuan
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Nan Li Shi Road 56, Beijing, 100045, China.
| | - Wei Gao
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Nan Li Shi Road 56, Beijing, 100045, China.
| | - Wei Shi
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Nan Li Shi Road 56, Beijing, 100045, China.
| | - Sangjie Yu
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Nan Li Shi Road 56, Beijing, 100045, China.
| | - Kaihu Yao
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Nan Li Shi Road 56, Beijing, 100045, China.
| | - Yonghong Yang
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Nan Li Shi Road 56, Beijing, 100045, China.
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Chiu CY, Chen CJ, Wong KS, Tsai MH, Chiu CH, Huang YC. Impact of bacterial and viral coinfection on mycoplasmal pneumonia in childhood community-acquired pneumonia. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2015; 48:51-6. [DOI: 10.1016/j.jmii.2013.06.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 06/06/2013] [Accepted: 06/24/2013] [Indexed: 11/26/2022]
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Jun L, Yuguo C, Zhiguo W, Jinfeng L, Huawei M, Xiuhua L, Yonggui Z, Yanhua X, Kong Y, Hongtao L, Yuliang Z. Assessment of immunogenicity and safety following primary and booster immunisation with a CRM197 -conjugated Haemophilus influenzae type B vaccine in healthy Chinese infants. Int J Clin Pract 2013; 67:971-8. [PMID: 23964690 DOI: 10.1111/ijcp.12267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 07/23/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Invasive meningitis and pneumonia caused by Haemophilus influenzae type b (Hib) is an important cause of childhood mortality in countries where Hib vaccination is not routine. We evaluated the non-inferiority of a licensed Hib vaccine, PRP-CRM(197) compared with a second licensed Hib vaccine, PRP-T, following the recommended Chinese immunisation schedule for infants between 6 months and 1 year of age. METHODS In the first study phase, 6-12 month-old infants received two primary doses of either PRP-CRM(197) (n = 335) or PRP-T (n = 335) vaccine administered 1 month apart. In the second study phase 8 months later, the same children received a single booster dose of vaccine identical to that use for priming (PRP-CRM(197), n = 327; PRP-T, n = 333). Serum levels of anti-polyribosylribitol phosphate (PRP) antibodies were measured using enzyme-linked immunosorbent assay (ELISA). Non-inferiority of primary and booster doses was assessed in terms of percentages of subjects with anti-PRP antibody levels associated with providing short-term (≥ 0.15 μg/ml) and long-term (≥ 1.0 μg/ml) protection; the non-inferiority margin was set at -5%. RESULTS PRP-CRM(197) was demonstrated to be non-inferior to PRP-T. Anti-PRP antibodies levels ≥ 0.15 μg/ml and ≥ 1.0 μg/ml were achieved by 97% of infants in the PRP-CRM(197) group and 98% of infants in the PRP-T group 1 month after primary immunisation, and by all subjects (100%) in both vaccine groups 1 month after booster administration. Safety profiles for both vaccines were similar; no serious adverse events, deaths or adverse events leading to withdrawal occurred during the study. CONCLUSION PRP-CRM(197) was well-tolerated and immunologically non-inferior to a licensed comparator Hib vaccine in Chinese infants (Clinicaltrials.gov: NCT01044316 & NCT01226953).
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Affiliation(s)
- L Jun
- Hebei Centre for Disease Control and Prevention, Shijiazhuang, China
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13
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Abstract
BACKGROUND Pneumonia is the leading reason for hospitalization in children. The heptavalent pneumococcal conjugate vaccine was introduced in Taiwan in October 2005. There has been no comprehensive study of the etiology of childhood community-acquired pneumonia (CAP), either in the pre- or postpneumococcal conjugate vaccine era, in Taiwan. METHODS From August 2001 to July 2002, consecutive children admitted to a teaching hospital with radiologically confirmed CAP were prospectively enrolled. The following were considered indicative of infection when positive: blood or pleural effusion bacterial culture or urinary Streptococcus pneumoniae antigen test (Binax NOW), direct immunofluorescent antigen test for Chlamydia species and viruses, virus isolation and identification and viral, mycoplasmal or chlamydial serologic tests. RESULTS A total of 209 children were included, and 102 children (48.8%) were male. Patients' ages ranged from 7 months to 16 years with a median of 4 years and 3 months. The combined tests identified at least 1 etiologic agent in 85.6% of all cases, including typical bacterial pathogens in 88 cases (42.1%; 86 S. pneumoniae, 1 methicillin-resistant Staphylococcus aureus and 1 Mycobacterium tuberculosis), Mycoplasma pneumoniae in 77 cases (36.8%), Chlamydia species in 24 cases (11.5%), viral etiology in 86 cases (41.1%) and mixed viral-bacterial infections in 69 cases (33%). Children with S. pneumoniae infection were significantly younger than those with Mycoplasma pneumoniae infection (P = 0.0055) or unknown etiology (P = 0.0140). CONCLUSION S. pneumoniae, Mycoplasma pneumoniae and viruses were equally common etiologic agents of childhood CAP in Taiwan. Frequent coinfection increased the difficulty of both predicting the responsible organisms and choosing empiric antibiotics for the management of pediatric CAP.
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14
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Antibody persistence at 18–20months of age and safety and immunogenicity of a booster dose of a combined DTaP–IPV//PRP∼T vaccine compared to separate vaccines (DTaP, PRP∼T and IPV) following primary vaccination of healthy infants in the People's Republic of China. Vaccine 2011; 29:9337-44. [DOI: 10.1016/j.vaccine.2011.09.131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 08/26/2011] [Accepted: 09/30/2011] [Indexed: 11/24/2022]
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15
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Abstract
BACKGROUND Community-acquired pneumonia (CAP) is a major cause of morbidity in industrialized countries and morbidity/mortality in developing countries. In China, comprehensive studies of the etiology of CAP in children aged between 2 months and 14 years who are serious enough to require hospitalization are lacking. Previous studies have been limited in child age range, focused on fatal cases, and/or limited in etiologies sought. An understanding of the etiologies is needed for development of best prevention and management practices. OBJECTIVE The aim of this study was to prospectively determine during a 12-month period the etiology of CAP in hospitalized children in a center in Northwest China. DESIGN/METHODS A prospective 12-month study (2004-2005) of CAP cases in children who were 2 months to 14 years of age admitted to the Second Hospital of Lanzhou University, China. Testing included admission and 1-month postdischarge serum for viral and bacterial serologic analyses (respiratory syncytial virus, influenza A and B, paraflu 1-3, adenovirus; Streptococcus pneumoniae, Haemophilus influenza B, Mycoplasma, and Moraxella. catarrhalis), blood culture, a nasopharyngeal aspirate for viral antigen testing, and a chest radiograph on admission and 1 month postdischarge. The study was funded by Lanzhou University. The study was performed in compliance with the guidelines of the institutional review board of the Second Hospital of Lanzhou University. RESULTS CAP was the admitting diagnosis for 29% of all admissions during the 12-month study. Of the 884 CAP cases, 821 (93%) were enrolled and completed the study. The age range was 2 months to 14 years; mean age was 2.3 years; 40% were <1 year. The average length of stay was 9.2 days (range, 6-20) but varied by age and etiology. Fourteen percent had received antibiotics before admission and 14% had underlying illnesses; 12% required intensive care unit treatment and 5 died. A microbial etiology for CAP was identified in 547 (67%); viral 535 (43%), bacterial 228 (27%), mixed viral bacterial 107 (13%), mixed viral in 1%, and mixed bacterial in 1%. The etiology varied by age; respiratory syncytial virus was most common in <1 year, S. pneumoniae and Hib 1-3 years, and Mycoplasma 5 years. Three potentially vaccine preventable etiologies accounted for 35% of the cases: influenza 9%, Hib 12%, and S. pneumonia 14%. CONCLUSIONS CAP is a major cause of childhood admission in China. Given the etiologic findings in this study, potentially 25% to 35% of cases could be prevented if seasonal influenza vaccine and conjugated H. influenza b and conjugated pneumococcal vaccines were introduced into routine practice.
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16
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Streptococcus pneumoniae diseases in Chinese children: Past, present and future. Vaccine 2008; 26:4425-33. [DOI: 10.1016/j.vaccine.2008.06.052] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 05/01/2008] [Accepted: 06/13/2008] [Indexed: 11/23/2022]
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Morris SK, Moss WJ, Halsey N. Haemophilus influenzae type b conjugate vaccine use and effectiveness. THE LANCET. INFECTIOUS DISEASES 2008; 8:435-43. [PMID: 18582836 DOI: 10.1016/s1473-3099(08)70152-x] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Haemophilus influenzae type b (Hib) is an important cause of invasive bacterial disease in children, including meningitis and pneumonia. The introduction of Hib conjugate vaccines into routine vaccination schedules has contributed to a substantial reduction in the burden of Hib-related disease in many developed countries. However, introduction of Hib conjugate vaccines in developing countries has progressed more slowly. We review the worldwide use and effectiveness of Hib conjugate vaccines. At present, 119 countries have programmes for routine Hib immunisation. WHO estimates that in the developed world 92% of the eligible population is vaccinated against Hib; however, average coverage is 42% in developing countries and only 8% in the poorest countries. Africa and southeast Asia have the lowest rates of Hib vaccine introduction. Vaccine costs and debate about the burden of disease are obstacles to the global use of Hib conjugate vaccine. Even with new funding support, there are many ongoing challenges and vaccine use remains suboptimal, particularly in developing countries.
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Affiliation(s)
- Shaun K Morris
- Division of Infectious Diseases, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
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18
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Wang A, Yu S, Yao K, Zhang W, Yuan L, Wang Y, Wei J, Shen X, Yang Y. Antimicrobial susceptibility of Haemophilus influenzae strains and antibiotics usage patterns in pediatric outpatients: results from a children's hospital in China (2000-2004). Pediatr Pulmonol 2008; 43:457-62. [PMID: 18360841 DOI: 10.1002/ppul.20789] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate the nasopharyngeal carriage and antimicrobial susceptibility of H. influenzae among children younger than 5 years old and to assess antibiotics usage patterns in the outpatient department of Beijing Children's Hospital from 2000 to 2004. MATERIALS AND METHODS From 2000 to 2004, At least 100 strains of H. influenzae were isolated from the pediatric patients who were younger than 5 years and who presented with symptoms of acute upper respiratory tract infections during February to May in each of the study years. Antimicrobial susceptibilities were determined; and antibiotics usage was expressed as defined daily dose (DDD)/100 patient days. RESULTS The overall nasopharyngeal carriage rate of H. influenzae is 26.3% (562/2,137) in children younger than 5 years old with acute upper respiratory tract infection. The percentage of ampicillin-resistant isolates ranges from 4.0% (4/100) to 14.3% (17/119) from 2000 to 2004. All the ampicillin-resistant isolates are beta-lactamase producers. More than 80% of the isolates are susceptible to amoxicillin, cefaclor, and chloramphenicol; whereas, almost all (99-100%) of the isolates are sensitive to amoxicillin/clavulanic acid, ceftriaxone, and cefuroxime. For antibiotics utilization, macrolides are the predominantly used antibiotics, followed by cephalosporins and penicillins among pediatric patients in the outpatient department during the study period. CONCLUSION All amoxicillin-resistant isolates of H. influenzae are producing beta-Lactamase; and the rates of amoxicillin-resistant isolates are increasing over time. Amoxicillin/clavulanic acid and cephalosporins are highly sensitive to H. influenzae isolated from Chinese pediatric patients. Macrolides are the most used antibiotics in the outpatient department during the study period.
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Affiliation(s)
- Aihua Wang
- Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
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19
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Wang Y, Kong F, Yang Y, Gilbert GL. A multiplex PCR-based reverse line blot hybridization (mPCR/RLB) assay for detection of bacterial respiratory pathogens in children with pneumonia. Pediatr Pulmonol 2008; 43:150-9. [PMID: 18085683 DOI: 10.1002/ppul.20749] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To develop and evaluate a novel method for simultaneous identification of 12 potential bacterial pathogens in children with community-acquired pneumonia. METHODS A multiplex PCR-based reverse line blot (mPCR/RLB) assay was developed, to identify 12 respiratory bacterial pathogens, namely Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Moraxella catarrhalis, Haemophilus influenzae, Haemophilus influenzae type b, Bordetella pertussis, Klebsiella pneumoniae, Legionella pneumophila, Mycobacterium tuberculosis, Chlamydia pneumoniae, Mycoplasma pneumoniae, and single (uniplex) PCRs were used for S. pneumoniae and H. influenzae only. In a preliminary evaluation, we compared the results of mPCR/RLB with those of single (uniplex) PCRs and culture of nasopharyngeal aspirates (NPAs) from 100 children under 5 years, admitted to Beijing Children's Hospital between October 2004 and May 2005, with pneumonia. RESULTS Reference strains and clinical isolates of all 12 target species were correctly identified by mPCR/RLB. Potential pathogens were isolated from one blood culture and 26% of respiratory cultures. One or more pathogens were identified in 70% of respiratory specimens--by mPCR/RLB in 63%, uPCR only in another 3%, culture only in 2%, and culture plus uPCR in 2%. The species most commonly identified were S. pneumoniae (54%) and H. influenzae (38%, including type b, 4%). Cultures were not performed for B. pertussis, M. tuberculosis, C. pneumoniae or M. pneumoniae but each was identified by mPCR/RLB in between one and four specimens. Two or more potential pathogens were identified in 35% of specimens. Ten of 14 S. pneumoniae isolates belonged to serotypes represented in the 11-valent pneumococcal conjugate vaccine. CONCLUSIONS The mPCR/RLB assay is a sensitive tool for identification of respiratory pathogens, including mixed infections and bacteria requiring special culture methods.
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Affiliation(s)
- Yajuan Wang
- Beijing Children's Hospital, Affiliated to Capital Medical University, Beijing, People's Republic of China
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Yao K, Shen X, Yul S, Lu Q, Deng L, Ye Q, Zhang H, Deng Q, Hu Y, Yang Y. Antimicrobial resistance and serotypes of nasopharyngeal strains of Streptococcus pneumoniae in Chinese children with acute respiratory infections. J Int Med Res 2007; 35:253-67. [PMID: 17542413 DOI: 10.1177/147323000703500210] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This prospective, multicentre, nasal carriage study in Chinese children with upper respiratory infection was carried out over the period from 2000 to 2002. Overall, the prevalence of pneumococcal carriage was 24.9%. Antimicrobial susceptibility tests were performed for 887 isolates of Streptococcus pneumoniae of which 33.5% were intermediately susceptible to penicillin and 6.4% were resistant. Multidrug resistance was very common. Pneumococcal strains (n = 625) were serotyped, showing 72.2% were covered by the 23-valent pneumococcal polysaccharide vaccine and 57.6% by the seven-valent pneumococcal conjugate vaccine. Serogroups 19 and 23 were significantly associated with penicillin resistance, which is increasing in China. Erythromycin, tetracycline and sulphamethoxazole/trimethoprim cannot be recommended as first-line treatments for respiratory tract infection as in some other developing countries. These features of serotype distribution are of importance for surveillance in the era of the new conjugate vaccine. In particular, these features will allow for documentation of serotype replacement after the introduction of widespread vaccination.
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Affiliation(s)
- K Yao
- Department of Respiratory Diseases and Laboratory of Microbiology and Immunology, Beijing Children's Hospital Affiliated to Capital University of Medical Sciences, Beijing, China
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Watt JP, Levine OS, Santosham M. Global reduction of Hib disease: what are the next steps? Proceedings of the meeting Scottsdale, Arizona, September 22-25, 2002. J Pediatr 2003; 143:S163-87. [PMID: 14657805 DOI: 10.1067/s0022-3476(03)00576-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
On September 22 to 25, 2002, a group of infectious disease specialists, public health officials, and vaccine experts from 33 countries gathered in Scottsdale, Arizona, to discuss the epidemiology and control of disease caused by Haemophilus influenzae type b (Hib) in the era of Hib conjugate vaccines. This supplement is a synthesis of the major themes and key lessons identified at the meeting. The objectives of the conference were to review the 10-year experience with Hib conjugate vaccines, discuss strategies to reduce Hib disease rates to lowest possible levels in industrialized countries, review impediments to the introduction of Hib vaccine in developing countries, and discuss strategies for disseminating lessons learned from countries using to those not using Hib conjugate vaccines. Over 10 years of international experience with Hib conjugate vaccines has demonstrated that they are safe and effective. Routine use of Hib conjugate vaccine has consistently led to decreases in the incidence of invasive Hib disease of 90% or more across a wide range of epidemiologic situations in industrialized countries. In some countries, the vaccine has caused a near-disappearance of invasive Hib disease through a combination of direct protection and herd immunity. Developing countries that have implemented routine vaccination (eg, The Gambia, Chile) have also had substantial disease reduction. In countries where Hib conjugate vaccine is being used, reducing Hib disease incidence to the lowest possible level will depend on maintaining high vaccine coverage levels, conducting surveillance for Hib disease, and investigating Hib disease cases. The optimal Hib vaccination strategy will depend on many factors, including local epidemiology and programmatic considerations. In countries that are not using Hib conjugate vaccine, information on the local burden of Hib disease will be essential for leaders considering vaccine introduction. Where disease burden is high, a multifaceted approach is urgently needed to evaluate and overcome barriers to vaccine introduction. In areas where Hib disease burden is not well characterized, additional work will be needed to understand the epidemiology of Hib disease and to communicate the value of Hib conjugate vaccine.
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MESH Headings
- Child
- Developing Countries
- Global Health
- Haemophilus Infections/diagnosis
- Haemophilus Infections/epidemiology
- Haemophilus Infections/immunology
- Haemophilus Infections/prevention & control
- Haemophilus Vaccines/economics
- Haemophilus Vaccines/therapeutic use
- Haemophilus influenzae/immunology
- Humans
- Immunization Programs/organization & administration
- Meningitis, Haemophilus/diagnosis
- Meningitis, Haemophilus/epidemiology
- Meningitis, Haemophilus/immunology
- Meningitis, Haemophilus/prevention & control
- Pneumonia, Bacterial/diagnosis
- Pneumonia, Bacterial/epidemiology
- Pneumonia, Bacterial/immunology
- Pneumonia, Bacterial/prevention & control
- Vaccines, Combined/therapeutic use
- Vaccines, Conjugate/economics
- Vaccines, Conjugate/therapeutic use
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Affiliation(s)
- James P Watt
- Department of International Health, the Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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22
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Abstract
Pneumonia strikes the extremes of the age spectrum, causing maximal death and disability in children and the elderly. Despite its worldwide impact, there is a paucity of epidemiologic data regarding its incidence and the causative organisms. The two leading causes of bacterial pneumonia in childhood are Streptococcus pneumoniae (SP) and Haemophilus influenzae type b (Hib). SP is the major cause of pneumonia beyond the newborn period. In neonates, Group B Streptococcus (GBS) remains a major cause of sepsis and pneumonia despite recent reductions due to targeted perinatal antibiotic prophylaxis. Hib vaccine can prevent pneumonia in developing countries. SP conjugate vaccine prevents X-ray confirmed pneumonia in low incident populations, but protection appears more marginal in high incident populations. Non-vaccine SP serotypes have demonstrated increased carriage and mucosal disease, but not invasive disease following vaccination. GBS vaccines are in the early stages of clinical development as prenatal or antenatal vaccines.
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Affiliation(s)
- Fiona Mary Russell
- Centre for International Child Health, and Murdoch Childrens Research Institute, Royal Children's Hospital, Department of Paediatrics, University of Melbourne, Parkville, Melbourne, Australia
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