1
|
Xiao J, Su L, Huang S, Liu L, Ali K, Chen Z. Epidemic Trends and Biofilm Formation Mechanisms of Haemophilus influenzae: Insights into Clinical Implications and Prevention Strategies. Infect Drug Resist 2023; 16:5359-5373. [PMID: 37605758 PMCID: PMC10440118 DOI: 10.2147/idr.s424468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023] Open
Abstract
Haemophilus influenzae (H. influenzae) is a significant pathogen responsible for causing respiratory tract infections and invasive diseases, leading to a considerable disease burden. The Haemophilus influenzae type b (Hib) conjugate vaccine has notably decreased the incidence of severe infections caused by Hib strains, and other non-typable H. influenzae (NTHi) serotypes have emerged as epidemic strains worldwide. As a result, the global epidemic trends and antibiotic resistance characteristics of H. influenzae have been altered. Researches on the virulence factors of H. influenzae, particularly the mechanisms underlying biofilm formation, and the development of anti-biofilm strategies hold significant clinical value. This article provides a summary of the epidemic trends, typing methods, virulence factors, biofilm formation mechanisms, and prevention strategies of H. influenzae. The increasing prevalence of NTHi strains and antibiotic resistance among H. influenzae, especially the high β-lactamase positivity and the emergence of BLNAR strains have increased clinical difficulties. Understanding its virulence factors, especially the formation mechanism of biofilm, and formulating effective anti-biofilm strategies may help to reduce the clinical impact. Therefore, future research efforts should focus on developing new approaches to prevent and control H. influenzae infections.
Collapse
Affiliation(s)
- Jiying Xiao
- Department of Pulmonology, Hangzhou Children’s Hospital, Hangzhou, Zhejiang, 310015, People’s Republic of China
| | - Lin Su
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310052, People’s Republic of China
- National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, Zhejiang, 310052, People’s Republic of China
| | - Shumin Huang
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310052, People’s Republic of China
- National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, Zhejiang, 310052, People’s Republic of China
| | - Lingyue Liu
- Department of Pulmonology, Hangzhou Children’s Hospital, Hangzhou, Zhejiang, 310015, People’s Republic of China
| | - Kamran Ali
- Department of Oncology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, People’s Republic of China
| | - Zhimin Chen
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310052, People’s Republic of China
- National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, Zhejiang, 310052, People’s Republic of China
| |
Collapse
|
2
|
Wen S, Mai Y, Chen X, Xiao K, Lin Y, Xu Z, Yang L. Molecular Epidemiology and Antibiotic Resistance Analysis of Non-Typeable Haemophilus influenzae (NTHi) in Guangzhou: A Representative City of Southern China. Antibiotics (Basel) 2023; 12:antibiotics12040656. [PMID: 37107018 PMCID: PMC10135204 DOI: 10.3390/antibiotics12040656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 02/20/2023] [Accepted: 03/09/2023] [Indexed: 03/30/2023] Open
Abstract
This study aimed to investigate the molecular epidemiology and antibiotic resistance of Haemophilus influenzae in Guangzhou, China. A total of 80 H. influenzae isolates were collected from the First Affiliated Hospital of Guangzhou Medical University from January 2020 to April 2021. Species identification, antimicrobial susceptibility, molecular capsular typing, multilocus sequence typing and the clinical characteristics analysis of patients were performed. For all recruited isolates, the majority of H. influenzae strains from patients with respiratory symptoms were found to be non-typeable H. influenzae (NTHi). The isolates were relative susceptible to third- and fourth-generation cephalosporins, quinolones and chloramphenicol, despite having a high ampicillin resistance rate (>70%). The genotyping results reveal a total of 36 sequence types (STs), with ST12 being the most prevalent ST. Remarkably, the 36 STs identified from 80 NTHi isolates within a short period of 15 months and in a single medical setting have revealed a high genetic diversity in NTHi isolates. In comparison, it is noteworthy that the most prevalent STs found in the present study have rarely been found to overlap with those from previous studies. This is the first study on the molecular epidemiology of NTHi isolates in Guangzhou, a city that is representative of southern China.
Collapse
Affiliation(s)
- Shuxian Wen
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Ying Mai
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Xu Chen
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Kun Xiao
- Department of Laboratory Medicine, People’s Hospital of HUAIJI, Zhaoqing 526400, China
| | - Yongping Lin
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Zhenbo Xu
- School of Food Science and Engineering, Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, South China University of Technology, Guangzhou 510640, China
- Department of Laboratory Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
- Correspondence: (Z.X.); (L.Y.)
| | - Ling Yang
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
- Correspondence: (Z.X.); (L.Y.)
| |
Collapse
|
3
|
Abe Y, Takano C, Tie J, Isobe E, Ohirabaru A, Isahai I, Nishiyama H, Jike T, Masuda S, Okuda T. Sudden death of a child associated with invasive non-typeable Haemophilus influenzae infection with underlying IgG 2 subclass deficiency. Leg Med (Tokyo) 2023; 62:102240. [PMID: 36958272 DOI: 10.1016/j.legalmed.2023.102240] [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: 11/30/2022] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
Haemophilus influenzae can be divided into typeable and non-typeable strains. Although non-typeable Haemophilus influenzae (NTHi) is less likely to be a fatal bacterium, invasive NTHi infection has been reported to increase worldwide. This study presents a case of sudden death of a child with invasive NTHi infection and underlying immunoglobulin G2 (IgG2) deficiency. A two years seven months male child with a high fever was found unresponsive in bed, lying face down on a soft pillow. Later, the hospital declared the subject dead. An autopsy revealed that the only noteworthy finding was tissue congestion. The histopathological findings disclosed neutrophils within blood vessels of major organs. Meanwhile, the formation of the micro abscess was not visible, which indicated bacteremia. The bacterial blood culture was positive for Haemophilus Influenzae. Polymerase chain reaction assay revealed the absence of an entire capsule locus. The transmission electron microscopy showed that the colonies did not have polysaccharide capsules. Based on the above findings, the strain was identified as NTHi. Furthermore, the value of serum IgG2 was deficient, indicating the presence of IgG2 subclass deficiency. The subject eventually died from asphyxia by smothering due to a comorbid condition with a high fever brought on by NTHi-induced bacteremia and lying face down. IgG2 subclass deficiency contributed to the development of invasive NTHi infection. The invasive NTHi infection might present a risk of sudden death, particularly for immunocompromised children. As forensic pathologists and pediatricians may encounter such a problematic clinical condition, they should be aware of this.
Collapse
Affiliation(s)
- Yuriko Abe
- Division of Medical Education, Nihon University School of Medicine, Tokyo, Japan; Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Chika Takano
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan; Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Jian Tie
- Department of Legal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Eiji Isobe
- Department of Legal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Ayumi Ohirabaru
- Department of Legal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Isamu Isahai
- Department of Legal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Hiroyuki Nishiyama
- Department of Clinical Laboratory, Nihon University Itabashi Hospital, Tokyo, Japan
| | - Toyoharu Jike
- Research Institute of Medical Research Support Center Electron Microscope Laboratory, Nihon University School of Medicine, Tokyo, Japan
| | - Shinobu Masuda
- Division of Oncologic Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Takahisa Okuda
- Department of Legal Medicine, Nihon University School of Medicine, Tokyo, Japan; Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan.
| |
Collapse
|
4
|
Zhou Y, Wang Y, Cheng J, Zhao X, Liang Y, Wu J. Molecular epidemiology and antimicrobial resistance of Haemophilus influenzae in Guiyang, Guizhou, China. Front Public Health 2022; 10:947051. [PMID: 36530676 PMCID: PMC9751421 DOI: 10.3389/fpubh.2022.947051] [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: 05/18/2022] [Accepted: 11/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background The widespread use of antimicrobials and Haemophilus influenzae type b (Hib) vaccine worldwide has altered the epidemiological patterns of invasive H. influenzae. Nonetheless, little is currently known on the epidemiological characteristics of H. influenzae in Guiyang, Guizhou, China. Objective To determine the serotype distribution, antimicrobial resistance and Multilocus Sequence Typing (MLST) of H. influenzae in hospitalized patients in Guiyang City. Methods A total of 196 clinical isolates from hospitalized patients were collected. Serotypes were determined according to the specific capsule gene, bexA, amplified by PCR. According to the guidelines of Clinical and Laboratory Standards Institute (CLSI) 2020 drug susceptibility tested, and the results determined. The chromogenic cephalosporin nitrocefin method was used to detect β-lactamase production, β-lactamase negative, ampicillin-resistant (BLNAR) strains were detected by PCR amplification and sequencing of the penicillin-binding protein 3 (PBP3) locus of ftsI. Multilocus Sequence Typing was performed for molecular typing. Results All isolates studied were non-typeable H. influenzae (NTHi). Most patients originated from the pediatrics department (78.6%, 154/196), and suffered from lung with respiratory tract infection (pneumonia and bronchitis, 68.4%, 134/196). The resistance rates of ampicillin, cefaclor and azithromycin were 71.4% (140/196), 36.7% (72/196) and 34.2% (67/196), respectively. 40.3% (79/196) of strains were β-lactamase positive ampicillin-resistant (BLPAR). All BLPAR carried the TEM-1 gene. 9.2% (18/196) were β-lactamase negative ampicillin-resistant strains (BLNAR). The PBP3 mutation was detected in the ampicillin-resistant strains (n = 113), of which 18 belonged to group IIa. A total of 49 sequence types (ST) and 23 clonal complexes (CC) were detected, among which CC107 (ST107, n = 27; ST1002, n = 5; ST1218, n = 5) was the most frequent clonal complexes. BLPAR isolates mostly belonged to ST107 (20/79), while BLNAR was predominantly distributed in ST12 (5/18). Conclusion H. influenzae infections are predominately caused by genetically diverse NTHi among hospitalized patients in Guiyang. The prevalence of β-lactamase production and PBP3 mutation may contribute to the high local ampicillin resistance rate.
Collapse
Affiliation(s)
- Yuhong Zhou
- The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Yu Wang
- Department of Clinical Laboratory, The First People's Hospital of Guiyang, Guiyang, China,*Correspondence: Yu Wang
| | - Jinzhi Cheng
- School of Basic Medical Sciences, Guizhou Medical University, Guiyang, China
| | - Xue Zhao
- Department of Clinical Laboratory, The First People's Hospital of Guiyang, Guiyang, China
| | - Yuedong Liang
- Guiyang Public Health Treatment Center, Guiyang, China
| | - Jiahong Wu
- School of Basic Medical Sciences, Guizhou Medical University, Guiyang, China,Jiahong Wu
| |
Collapse
|
5
|
The natural history and genetic diversity of Haemophilus influenzae infecting the airways of adults with cystic fibrosis. Sci Rep 2022; 12:15765. [PMID: 36131075 PMCID: PMC9492733 DOI: 10.1038/s41598-022-19240-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/26/2022] [Indexed: 12/04/2022] Open
Abstract
Haemophilus influenzae is a Gram-negative pathobiont, frequently recovered from the airways of persons with cystic fibrosis (pwCF). Previous studies of H. influenzae infection dynamics and transmission in CF predominantly used molecular methods, lacking resolution. In this retrospective cohort study, representative yearly H. influenzae isolates from all pwCF attending the Calgary Adult CF Clinic with H. influenzae positive sputum cultures between 2002 and 2016 were typed by pulsed-field gel electrophoresis. Isolates with shared pulsotypes common to ≥ 2 pwCF were sequenced by Illumina MiSeq. Phylogenetic and pangenomic analyses were used to assess genetic relatedness within shared pulsotypes, and epidemiological investigations were performed to assess potential for healthcare associated transmission. H. influenzae infection was observed to be common (33% of patients followed) and dynamic in pwCF. Most infected pwCF exhibited serial infections with new pulsotypes (75% of pwCF with ≥ 2 positive cultures), with up to four distinct pulsotypes identified from individual patients. Prolonged infection by a single pulsotype was only rarely observed. Intra-patient genetic diversity was observed at the single-nucleotide polymorphism and gene content levels. Seven shared pulsotypes encompassing 39% of pwCF with H. influenzae infection were identified, but there was no evidence, within our sampling scheme, of direct patient-to-patient infection transmission.
Collapse
|
6
|
Hachisu Y, Tamura K, Murakami K, Fujita J, Watanabe H, Tanabe Y, Kuronuma K, Kubota T, Oshima K, Maruyama T, Kasahara K, Nishi J, Abe S, Nakamura M, Kubota M, Hirai S, Ishioka T, Ikenoue C, Fukusumi M, Sunagawa T, Suzuki M, Akeda Y, Oishi K. Invasive Haemophilus influenzae disease among adults in Japan during 2014-2018. Infection 2022; 51:355-364. [PMID: 35902511 DOI: 10.1007/s15010-022-01885-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/30/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE We describe the epidemiology of invasive Haemophilus influenzae disease (IHD) among adults in Japan. METHODS Data for 200 adult IHD patients in 2014-2018 were analyzed. The capsular type of H. influenzae was determined by bacterial agglutination and polymerase chain reaction (PCR), and non-typeable Haemophilus influenzae (NTHi) was identified by PCR. RESULTS The annual incidence of IHD (cases per 100,000 population) was 0.12 for age 15-64 years and 0.88 for age ≥ 65 years in 2018. The median age was 77 years, and 73.5% were aged ≥ 65 years. About one-fourth of patients were associated with immunocompromising condition. The major presentations were pneumonia, followed by bacteremia, meningitis and other than pneumonia or meningitis (other diseases). The case fatality rate (CFR) was 21.2% for all cases, and was significantly higher in the ≥ 65-year group (26.1%) than in the 15-64-year group (7.5%) (p = 0.013). The percentage of cases with pneumonia was significantly higher in the ≥ 65-year group than in the 15-64-year group (p < 0.001). The percentage of cases with bacteremia was significantly higher in the 15-64-year group than in the ≥ 65-year group (p = 0.027). Of 200 isolates, 190 (95.0%) were NTHi strains, and the other strains were encapsulated strains. 71 (35.5%) were resistant to ampicillin, but all were susceptible to ceftriaxone. CONCLUSION The clinical presentations of adult IHD patients varied widely; about three-fourths of patients were age ≥ 65 years and their CFR was high. Our findings support preventing strategies for IHD among older adults, including the development of NTHi vaccine.
Collapse
Affiliation(s)
- Yushi Hachisu
- Chiba Prefectural Institute of Public Health, Chiba, Japan
- Field Epidemiology Training Program, Infectious Diseases Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kosuke Tamura
- Toyama Institute of Health, 17-1, Nakataikouyama, Imizu, Toyama, 939-0363, Japan
| | - Koichi Murakami
- Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, Tokyo, Japan
| | - Jiro Fujita
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hiroshi Watanabe
- Department of Infection Control and Prevention, Kurume University School of Medicine, Fukuoka, Japan
| | - Yoshinari Tanabe
- Department of Respiratory Medicine, Niigata Prefectural Shibata Hospital, Niigata, Japan
| | - Koji Kuronuma
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Tetsuya Kubota
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kengo Oshima
- Department of Infectious Diseases, Tohoku University Hospital, Miyagi, Japan
| | | | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Junichiro Nishi
- Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shuichi Abe
- Department of Infectious Disease and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Masahiko Nakamura
- Toyama Institute of Health, 17-1, Nakataikouyama, Imizu, Toyama, 939-0363, Japan
| | - Mayumi Kubota
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shinichiro Hirai
- Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, Tokyo, Japan
| | - Taisei Ishioka
- Department of Applied Biological Science, Faculty of Agriculture, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Chiaki Ikenoue
- Field Epidemiology Training Program, Infectious Diseases Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
- Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Munehisa Fukusumi
- Field Epidemiology Training Program, Infectious Diseases Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
- Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomimasa Sunagawa
- Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoi Suzuki
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yukihiro Akeda
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazunori Oishi
- Toyama Institute of Health, 17-1, Nakataikouyama, Imizu, Toyama, 939-0363, Japan.
| |
Collapse
|
7
|
Sun C. A rhizobial non-coding RNA has an effect on symbiotic nodulation by regulating an ABC transporter. Biochem Biophys Res Commun 2022; 603:82-87. [DOI: 10.1016/j.bbrc.2022.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/03/2022] [Indexed: 11/02/2022]
|
8
|
Napolean M, Rosemol V, John M, Varghese AM, Periyasamy J, Balaji V, Naina P. Nasopharyngeal colonization of otopathogens in South Indian children with acute otitis media - A case control pilot study. J Otol 2021; 16:220-224. [PMID: 34548867 PMCID: PMC8438633 DOI: 10.1016/j.joto.2021.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 11/28/2022] Open
Abstract
Background Acute otitis media (AOM) is an inflammatory disease of the middle ear causing significant morbidity in early childhood. A pilot study was undertaken to identify the role of various risk factors South Indian children with AOM, especially the role of nasopharyngeal otopathogens. Methodology A prospective case control pilot study was conducted in children aged below six years, presenting to a single tertiary care from 2018 to 2019. Fifty cases with AOM and 45 age and gender matched controls were recruited. Two nasopharyngeal swabs were collected, one was processed for bacterial culture. The other swab was processed according to the CDC recommended broth enrichment method to identify carriage of S. pneumoniae. Subsequent serotyping was done by Quellung method and conventional sequential multiplex PCR. Result Otalgia was the major presentation seen in 92% of the children with AOM. None of the clinical and demographic characteristics were found to be statistically significant between the cases and controls. The most common otopathogen was S. pneumoniae (55%) followed by H. influenza (29%). The common S. pneumoniae serotypes encountered were 11A and 19F.Nasopharyngeal colonization with S. pneumoniae [OR 6.57, p < 0.003] and H. influenzae [OR14.18, p < 0.003] were significant risk factors for AOM in children. The risk increased with co-colonization (OR 13.89,p < 0.003). Conclusion This study strengthens the significant association between nasopharyngeal colonization of otopathogens and AOM as a risk factor that is enhanced by co-colonization.S. pneumoniae was the main otopathogen in this population, serotypes 11A and 19F being the most common.
Collapse
Affiliation(s)
- M Napolean
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
| | - V Rosemol
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - M John
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
| | - A M Varghese
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
| | - J Periyasamy
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - V Balaji
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - P Naina
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
| |
Collapse
|
9
|
Uddén F, Filipe M, Slotved HC, Yamba-Yamba L, Fuursted K, Pintar Kuatoko P, Larsson M, Bjurgert J, Månsson V, Pelkonen T, Reimer Å, Riesbeck K. Pneumococcal carriage among children aged 4 - 12 years in Angola 4 years after the introduction of a pneumococcal conjugate vaccine. Vaccine 2020; 38:7928-7937. [PMID: 33143954 DOI: 10.1016/j.vaccine.2020.10.060] [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: 07/17/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 10/23/2022]
Abstract
Children in Angola are affected by a high burden of disease caused by pneumococcal infections. The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the childhood immunization programme in 2013 but the serotype distribution of Streptococcus pneumoniae and antimicrobial susceptibility patterns are unknown. We did a cross-sectional nasopharyngeal carriage study in Luanda and Saurimo, Angola (PCV13 3rd dose coverage 67% and 84%, respectively) during November to December 2017 comprising 940 children aged 4-12 years. The main objective was to assess vaccine serotype coverage and antimicrobial susceptibility rates for S. pneumoniae. Our secondary aim was to characterize colonizinig strains of Haemophilus influenzae and Moraxella catarrhalis. Pneumococcal colonization was found in 35% (95% CI 32-39%) of children (n = 332), with 41% of serotypes covered by PCV13. The most common serotypes were 3 (8%), 18C (6%), 23F (6%), 11A (6%), 34 (6%), 19F (5%) and 16 (5%). Carriage of H. influenzae and M. catarrhalis was detected in 13% (95% CI 11-15%) and 15% (95% CI 13-17%) of children, respectively. Non-susceptibility to penicillin was common among pneumococci (40%), particularly among PCV13-included serotypes (50% vs. 33%; p = 0.003), although the median minimal inhibitory concentration was low (0.19 µg/mL, IQR 0.13-0.25 µg/mL). Most pneumococci and H. influenzae were susceptible to amoxicillin (99% and 88%, respectively). Furthermore, resistance to trimethoprim-sulfamethoxazole was>70% among all three species. Multidrug-resistant pneumococci (non-susceptible to ≥ 3 antibiotics; 7% [n = 24]) were further studied with whole genome sequencing to investigate clonality as an underlying cause for this phenotype. No clearly dominating clone(s) were, however, detected. The results indicate that continued use of PCV13 may have positive direct and herd effects on pneumococcal infections in Angola as carriage of vaccine serotypes was common in the non-vaccinated age group. Finally, amoxicillin is assessed to be a feasible empirical treatment of respiratory tract infections in Angola.
Collapse
Affiliation(s)
- Fabian Uddén
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden.
| | - Matuba Filipe
- ORL-department, Hospital Josina Machel, Luanda, Angola; Faculty of Medicine, Agostinho Neto University, Luanda, Angola
| | - Hans-Christian Slotved
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
| | - Linda Yamba-Yamba
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden.
| | - Kurt Fuursted
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
| | - Palmira Pintar Kuatoko
- ORL-department, Hospital Josina Machel, Luanda, Angola; Faculty of Medicine, Agostinho Neto University, Luanda, Angola
| | - Måns Larsson
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden
| | - Jonas Bjurgert
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden
| | - Viktor Månsson
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden.
| | - Tuula Pelkonen
- Children's Hospital, Helsinki University Hospital, Helsinki, Finland; University of Helsinki, Helsinki, Finland
| | - Åke Reimer
- ENT-Outpatient Department, Slottsstadens Läkarhus, Malmö, Sweden
| | - Kristian Riesbeck
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden.
| |
Collapse
|
10
|
Otake S, Yamaguchi T, Imuta N, Nishi J, Kasai M. A case of polymicrobial bacteremia due to lung abscess after respiratory syncytial virus infection. Pediatr Int 2020; 62:994-996. [PMID: 32744365 DOI: 10.1111/ped.14220] [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: 01/20/2020] [Revised: 03/01/2020] [Accepted: 03/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Shogo Otake
- Division of Infectious Disease, Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan
| | - Takahiro Yamaguchi
- Division of Microbiology, Osaka Institute of Public Health, Osaka, Japan
| | - Naoko Imuta
- Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Junichiro Nishi
- Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masashi Kasai
- Division of Infectious Disease, Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan
| |
Collapse
|
11
|
McElligott M, Meyler K, Bennett D, Mulhall R, Drew RJ, Cunney R. Epidemiology of Haemophilus influenzae in the Republic of Ireland, 2010–2018. Eur J Clin Microbiol Infect Dis 2020; 39:2335-2344. [DOI: 10.1007/s10096-020-03971-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/28/2020] [Indexed: 11/24/2022]
|
12
|
Wen S, Feng D, Chen D, Yang L, Xu Z. Molecular epidemiology and evolution of Haemophilus influenzae. INFECTION GENETICS AND EVOLUTION 2020; 80:104205. [DOI: 10.1016/j.meegid.2020.104205] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
|
13
|
Harama D, Kobayashi K, Toda T, Sugita K, Ikeda H. Infective endocarditis caused by non-typeable Haemophilus influenzae. Pediatr Int 2020; 62:114-115. [PMID: 31880034 DOI: 10.1111/ped.14046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 09/14/2019] [Accepted: 11/01/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Daisuke Harama
- Department of Pediatrics, Yamanashi Kosei Hospital, Yamanashi, Japan.,Department of Pediatrics, Graduate School, University of Yamanashi, Yamanashi, Japan
| | - Koji Kobayashi
- Department of Pediatrics, Yamanashi Kosei Hospital, Yamanashi, Japan
| | - Takako Toda
- Department of Pediatrics, Graduate School, University of Yamanashi, Yamanashi, Japan
| | - Kanji Sugita
- Department of Pediatrics, Graduate School, University of Yamanashi, Yamanashi, Japan
| | - Hisatake Ikeda
- Department of Pediatrics, Yamanashi Kosei Hospital, Yamanashi, Japan
| |
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
Wang XL, Xie J, Guo YB, Zhu BQ, Shao ZJ, Guo HM, Yang LL, Liu HW, Wang ZH, Hu J, Huang LF. Lower respiratory tract isolates of non-typeable Haemophilus influenzae in Western Sichuan, China: Antimicrobial susceptibility, mechanisms of β-lactam resistance and decade changes. J Glob Antimicrob Resist 2019; 21:324-330. [PMID: 31704169 DOI: 10.1016/j.jgar.2019.10.026] [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: 07/16/2019] [Revised: 10/08/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES The aims of this study were to analyse the serotypes of epidemic Haemophilus influenzae and changes in mechanisms of β-lactam resistance over the past decade. RESULTS Haemophilus influenzae isolates in Western Sichuan from 2013-2014 were non-typeable H. influenzae (NTHi). β-Lactam MICs for NTHi isolated during 2013-2014 were significantly higher than those from 2003-2004 (P < 0.05). Of 274 NTHi, 141 (51.5%) were β-lactamase-positive (TEM-1 type). There were 35 amino acid (AA) substitutions in ftsI among NTHi isolated from 2013-2014. However, NTHi isolates from 2003-2004 had only nine AA substitutions. Ordered multiple classification logistic regression analysis showed that different AA substitution patterns in ftsI had different effects on β-lactam MICs. The main factors affecting the ampicillin MIC were the mutations R517H (OR = 6.999), L389F (OR = 7.128), N526K (OR = 4.660) and D350N (OR = 0.450). The main factor influencing the amoxicillin/clavulanic acid MIC was an N526K mutation (OR = 9.349). The main factors affecting the cefuroxime MIC were the mutations S357N (OR = 37.453) and N526K (OR = 14.816). Compared with 2003-2004, gBLNAR and gBLPAR isolated from 2013-2014 increased significantly from 13.0% (7/54) and 9.3% (5/54) to 38.2% (84/220) and 45.5% (100/220), respectively (P < 0.001). In the 'others' group of ftsI gene mutations, 13 NTHi had the same ftsI gene mutation pattern and 24 AA substitutions. CONCLUSION These results confirm that β-lactam-resistant NTHi isolates increased rapidly. AA substitutions in ftsI were more complex and diversified in 2013-2014.
Collapse
Affiliation(s)
- Xiao Lei Wang
- Affiliated Hospital of South West Jiao Tong University & The Third People's Hospital of Chengdu, Chengdu 610031, China.
| | - Jiang Xie
- Affiliated Hospital of South West Jiao Tong University & The Third People's Hospital of Chengdu, Chengdu 610031, China
| | - Yuan Biao Guo
- Affiliated Hospital of South West Jiao Tong University & The Third People's Hospital of Chengdu, Chengdu 610031, China
| | - Bing Qing Zhu
- Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhu Jun Shao
- Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Hui Min Guo
- Affiliated Hospital of South West Jiao Tong University & The Third People's Hospital of Chengdu, Chengdu 610031, China
| | - Li Li Yang
- Affiliated Hospital of South West Jiao Tong University & The Third People's Hospital of Chengdu, Chengdu 610031, China
| | - Hua Wei Liu
- Affiliated Hospital of South West Jiao Tong University & The Third People's Hospital of Chengdu, Chengdu 610031, China
| | - Zhan Hao Wang
- Affiliated Hospital of South West Jiao Tong University & The Third People's Hospital of Chengdu, Chengdu 610031, China
| | - Jun Hu
- Affiliated Hospital of South West Jiao Tong University & The Third People's Hospital of Chengdu, Chengdu 610031, China
| | - Lu Fei Huang
- Affiliated Hospital of South West Jiao Tong University & The Third People's Hospital of Chengdu, Chengdu 610031, China
| |
Collapse
|
16
|
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).
Collapse
|
17
|
Månsson V, Gilsdorf JR, Kahlmeter G, Kilian M, Kroll JS, Riesbeck K, Resman F. Capsule Typing of Haemophilus influenzae by Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry. Emerg Infect Dis 2019; 24:443-452. [PMID: 29460728 PMCID: PMC5823330 DOI: 10.3201/eid2403.170459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Encapsulated Haemophilus influenzae strains belong to type-specific genetic lineages. Reliable capsule typing requires PCR, but a more efficient method would be useful. We evaluated capsule typing by using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. Isolates of all capsule types (a−f and nontypeable; n = 258) and isogenic capsule transformants (types a−d) were investigated. Principal component and biomarker analyses of mass spectra showed clustering, and mass peaks correlated with capsule type-specific genetic lineages. We used 31 selected isolates to construct a capsule typing database. Validation with the remaining isolates (n = 227) showed 100% sensitivity and 92.2% specificity for encapsulated strains (a−f; n = 61). Blinded validation of a supplemented database (n = 50) using clinical isolates (n = 126) showed 100% sensitivity and 100% specificity for encapsulated strains (b, e, and f; n = 28). MALDI-TOF mass spectrometry is an accurate method for capsule typing of H. influenzae.
Collapse
|
18
|
Kanno K, Yamaguchi H, Imuta N, Nishi J, Kasai M. Non-typeable Haemophilus influenzae purulent pericarditis in a healthy child. Pediatr Int 2018; 60:886-887. [PMID: 30255980 DOI: 10.1111/ped.13650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/20/2018] [Accepted: 05/24/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Koji Kanno
- Department of Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Hiroshi Yamaguchi
- Department of Neurology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.,Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoko Imuta
- Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Junichiro Nishi
- Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masashi Kasai
- Department of Infectious Disease Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| |
Collapse
|
19
|
Suga S, Ishiwada N, Sasaki Y, Akeda H, Nishi J, Okada K, Fujieda M, Oda M, Asada K, Nakano T, Saitoh A, Hosoya M, Togashi T, Matsuoka M, Kimura K, Shibayama K. A nationwide population-based surveillance of invasive Haemophilus influenzae diseases in children after the introduction of the Haemophilus influenzae type b vaccine in Japan. Vaccine 2018; 36:5678-5684. [PMID: 30122645 DOI: 10.1016/j.vaccine.2018.08.029] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/09/2018] [Accepted: 08/10/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Haemophilus influenzae type b (Hib) vaccine was introduced as a voluntary vaccine in December 2008 and was included in the national routine immunization program in April 2013 in Japan. Currently, no nationwide data are available to evaluate the effectiveness of Hib vaccine in Japan. METHODS To evaluate the effectiveness of Hib vaccine in Japan, nationwide active population-based surveillance of culture-proven invasive infections caused by H. influenzae in children was performed in 2008-2017 in 10 prefectures in Japan (covering approximately 23% of the total Japanese population). Clinical data were recorded on a standardized case report form. Capsular type and antimicrobial susceptibility of the H. influenzae isolates were examined. The incidence rate ratio (IRR) and its confidence interval (CI) were calculated to compare data from 5 years before and that from after the introduction of the national routine Hib vaccine immunization program. RESULTS During the 10-year study period, 566 invasive H. influenzae disease cases including 336 meningitis cases were identified. The average number of invasive H. influenzae disease cases among children <5 years of age during 2013-2017 decreased by 93% (IRR: 0.07, 95%CI 0.05-0.10, p < 0.001) compared with those occurring during 2008-2012. Hib strains have not been isolated from invasive H. influenzae disease cases since 2014; however, non-typeable H. influenzae and H. influenzae type f isolates have been noted as causes of invasive H. influenzae diseases among children <5 years in the post-Hib vaccine era. CONCLUSIONS After the governmental subsidization of the Hib vaccine, invasive Hib disease cases decreased dramatically in the study population, as per our surveillance. Continuous surveillance is necessary to monitor the effectiveness of Hib vaccine and for detecting any emerging invasive capsular types.
Collapse
Affiliation(s)
- Shigeru Suga
- Infectious Disease Center and Department of Clinical Research, National Hospital Organization Mie Hospital, Mie, Japan
| | - Naruhiko Ishiwada
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan.
| | - Yuko Sasaki
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hideki Akeda
- Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan
| | - Junichiro Nishi
- Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | | | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Megumi Oda
- Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Kazutoyo Asada
- Infectious Disease Center and Department of Clinical Research, National Hospital Organization Mie Hospital, Mie, Japan
| | - Takashi Nakano
- Department of Pediatrics, Kawasaki Medical School, Okayama, Japan
| | - Akihiko Saitoh
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | | | - Mayumi Matsuoka
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kouji Kimura
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| |
Collapse
|
20
|
Cleary DW, Devine VT, Morris DE, Osman KL, Gladstone RA, Bentley SD, Faust SN, Clarke SC. Pneumococcal vaccine impacts on the population genomics of non-typeable Haemophilus influenzae. Microb Genom 2018; 4. [PMID: 30080135 PMCID: PMC6202451 DOI: 10.1099/mgen.0.000209] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The implementation of pneumococcal conjugate vaccines (PCVs) has led to a decline in vaccine-type disease. However, there is evidence that the epidemiology of non-typeable Haemophilus influenzae (NTHi) carriage and disease can be altered as a consequence of PCV introduction. We explored the epidemiological shifts in NTHi carriage using whole genome sequencing over a 5-year period that included PCV13 replacement of PCV7 in the UK’s National Immunization Programme in 2010. Between 2008/09 and 2012/13 (October to March), nasopharyngeal swabs were taken from children <5 years of age. Significantly increased carriage post-PCV13 was observed and lineage-specific associations with Streptococcus pneumoniae were seen before but not after PCV13 introduction. NTHi were characterized into 11 discrete, temporally stable lineages, congruent with current knowledge regarding the clonality of NTHi. The increased carriage could not be linked to the expansion of a particular clone and different co-carriage dynamics were seen before PCV13 implementation when NTHi co-carried with vaccine serotype pneumococci. In summary, PCV13 introduction has been shown to have an indirect effect on NTHi epidemiology and there exists both negative and positive, distinct associations between pneumococci and NTHi. This should be considered when evaluating the impacts of pneumococcal vaccine design and policy.
Collapse
Affiliation(s)
- David W Cleary
- 1Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.,2NIHR Southampton Biomedical Research Centre, University Hospital Southampton Foundation NHS Trust, Southampton, UK
| | - Vanessa T Devine
- 3Northern Ireland Centre for Stratified Medicine and Clinical Translational Research Innovation Centre, Londonderry, UK
| | - Denise E Morris
- 1Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Karen L Osman
- 1Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | | | | | - Saul N Faust
- 1Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.,5NIHR Southampton Clinical Research Facility, University Hospital Southampton Foundation NHS Trust, Southampton, UK
| | - Stuart C Clarke
- 2NIHR Southampton Biomedical Research Centre, University Hospital Southampton Foundation NHS Trust, Southampton, UK.,1Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.,6Global Health Research Institute, University of Southampton, Southampton, UK
| |
Collapse
|
21
|
Myers AL, Jackson MA, Zhang L, Swanson DS, Gilsdorf JR. Haemophilus influenzae Type b Invasive Disease in Amish Children, Missouri, USA, 2014. Emerg Infect Dis 2018; 23:112-114. [PMID: 27983486 PMCID: PMC5176238 DOI: 10.3201/eid2301.160593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
During 5 months in 2014, three Amish children in Missouri, USA, were diagnosed with invasive Haemophilus influenzae type b infection. Two were rural neighbors infected with a genetically similar rare strain, sequence type 45. One child had recently traveled, raising the possibility of maintenance of this strain among unvaccinated carriers in Amish communities.
Collapse
|
22
|
Kaneko M, Bando Y, Fujita T, Hirose Y, Suganuma E, Ishii M, Takahashi T. Encapsulated pleural effusion due to Haemophilus influenzae biotype II in a child with trisomy 21: A case report and literature review. IDCases 2017; 10:93-96. [PMID: 29062709 PMCID: PMC5645171 DOI: 10.1016/j.idcr.2017.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 09/23/2017] [Accepted: 09/25/2017] [Indexed: 11/19/2022] Open
Abstract
This is the second case report of pediatric encapsulated pleural effusion (EPE) due to Haemophilus influenzae. We represent typical images of chest X-P, CT, echography to find the EPE. Nontypeable H. influenzae was isolated from the throat after the discharge.
Haemophilus influenzae (Hi) can colonize in the upper respiratory tract and cause severe pulmonary infections, especially among immunocompromised children. Herein, we report a case of left encapsulated pleural effusion (EPE) due to Hi in a 24-month-old girl with trisomy 21. She was already vaccinated against Hi type b. The Hi biotype II was isolated from both the blood and aspirated sputum obtained upon admission. Ampicillin/sulbactam 180 mg/kg/day was administered intravenously for 34 days with oxygen supplementation for 4 days. She clinically recovered without undergoing thoracic drainage. One month after discharge, the girl developed acute otitis media, and the throat swab was cultured. Nontypeable Hi with the same biotype II was isolated, and the infection was controlled by administering antimicrobials. In this report, a literature review regarding the EPE due to Hi in children is also summarized. Pediatric clinicians should be aware of the possibility of Hi-related EPE because of its rapid progression, although it is rare in clinical settings. In addition, they need to consider the possibility of repetitive respiratory infections with Hi in a child with trisomy 21.
Collapse
Affiliation(s)
- Masanori Kaneko
- Department of Pediatrics, Kitasato University Medical Center, 6-100 Arai, Kitamoto, Saitama 364-8501, Japan
| | - Yuki Bando
- Department of Pediatrics, Kitasato University Medical Center, 6-100 Arai, Kitamoto, Saitama 364-8501, Japan
- Department of Infection Control and Prevention, Kitasato University Medical Center, 6-100 Arai, Kitamoto, Saitama 364-8501, Japan
- Corresponding author at: Department of Pediatrics, Kitasato University Medical Center, 6-100 Arai, Kitamoto, Saitama 364-8501, Japan.Department of PediatricsKitasato University Medical Center6-100 AraiKitamotoSaitama364-8501Japan
| | - Tomohiro Fujita
- Department of Clinical Laboratory, Kitasato University Medical Center, 6-100 Arai, Kitamoto, Saitama 364-8501, Japan
| | - Yoneji Hirose
- Department of Clinical Laboratory, Kitasato University Medical Center, 6-100 Arai, Kitamoto, Saitama 364-8501, Japan
| | - Eisuke Suganuma
- Division of Infectious Diseases and Immunology, Saitama Children’s Medical Center, 1-2 Shintoshin, Chuuou-ku, Saitama, Saitama 330-8777, Japan
| | - Masahiro Ishii
- Department of Pediatrics, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
| | - Takashi Takahashi
- Laboratory of Infectious Diseases, Kitasato Institute for Life Sciences & Graduate School of Infection Control Sciences, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan
| |
Collapse
|
23
|
Best EJ, Walls T, Souter M, Neeff M, Anderson T, Salkeld L, Ahmad Z, Mahadevan M, Walker C, Murdoch D, Mills N. Pneumococcal vaccine impact on otitis media microbiology: A New Zealand cohort study before and after the introduction of PHiD-CV10 vaccine. Vaccine 2016; 34:3840-7. [DOI: 10.1016/j.vaccine.2016.05.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 05/04/2016] [Accepted: 05/23/2016] [Indexed: 11/24/2022]
|
24
|
Abstract
These infections are emerging worldwide, especially in young children and the elderly. The incidence of severe Haemophilus influenza infections, such as sepsis and meningitis, has declined substantially since the introduction of the H. influenzae serotype b vaccine. However, the H. influenzae type b vaccine fails to protect against nontypeable H. influenzae strains, which have become increasingly frequent causes of invasive disease, especially among children and the elderly. We summarize recent literature supporting the emergence of invasive nontypeable H. influenzae and describe mechanisms that may explain its increasing prevalence over the past 2 decades.
Collapse
|
25
|
Complete Deletion of the Fucose Operon in Haemophilus influenzae Is Associated with a Cluster in Multilocus Sequence Analysis-Based Phylogenetic Group II Related to Haemophilus haemolyticus: Implications for Identification and Typing. J Clin Microbiol 2015; 53:3773-8. [PMID: 26378279 DOI: 10.1128/jcm.01969-15] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 09/09/2015] [Indexed: 11/20/2022] Open
Abstract
Nonhemolytic variants of Haemophilus haemolyticus are difficult to differentiate from Haemophilus influenzae despite a wide difference in pathogenic potential. A previous investigation characterized a challenging set of 60 clinical strains using multiple PCRs for marker genes and described strains that could not be unequivocally identified as either species. We have analyzed the same set of strains by multilocus sequence analysis (MLSA) and near-full-length 16S rRNA gene sequencing. MLSA unambiguously allocated all study strains to either of the two species, while identification by 16S rRNA sequence was inconclusive for three strains. Notably, the two methods yielded conflicting identifications for two strains. Most of the "fuzzy species" strains were identified as H. influenzae that had undergone complete deletion of the fucose operon. Such strains, which are untypeable by the H. influenzae multilocus sequence type (MLST) scheme, have sporadically been reported and predominantly belong to a single branch of H. influenzae MLSA phylogenetic group II. We also found evidence of interspecies recombination between H. influenzae and H. haemolyticus within the 16S rRNA genes. Establishing an accurate method for rapid and inexpensive identification of H. influenzae is important for disease surveillance and treatment.
Collapse
|
26
|
Bagherzadeh Khodashahri S, Siadat SD, Rahbar M, Abdollahpour-Alitappeh M, Vaziri F, Rahnamaye-Farzami M, Mohammadzadeh M, Davari M, Fateh A, Masoumi M. Genotyping of Haemophilus influenzae type b strains and their incidence in the clinical samples isolated from Iranian patients. IRANIAN JOURNAL OF MICROBIOLOGY 2015; 7:136-43. [PMID: 26668700 PMCID: PMC4676982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND AND OBJECTIVE Haemophilus influenzae type b (Hib) is divided into two distinct genotypes, type I and type II, based on the structure of capsular polysaccharides. The capsulation locus of Haemophilus influenzae type b consists of three functionally distinct regions, designated regions 1 to 3. Region III contains hcsA and hcsB genes; however, notable sequence variation in this region can be used to recognize different Hib genotypes. The purpose of this study was to investigate the prevalence and genotype of the Hib strains isolated from patients with invasive disease in Iran. MATERIALS AND METHODS In the present study, 8 pairs of primers were used for identification and serotyping of encapsulated Haemophilus influenzae strains, as well as confirmation of species identification. Additionally, in order to identify the capsular genotypes of Haemophilus influenzae type b (type I and II), two additional primer pairs were used to amplify the hcsA gene. RESULTS Out of 50 isolates of H. influenzae, four were found to be type b. Interestingly, among these 4 Hib isolates, 2 strains belonged to the type-II category. CONCLUSION Our study shows that the prevalence of both Hib types I and II seems to be high in Iran.
Collapse
Affiliation(s)
| | - Seyed Davar Siadat
- Department of Mycobacteriology & Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.,Corresponding author: Seyed Davar Siadat PHD. Address: Department of Mycobacteriology & Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran. Tel: +98-21-66968853, Postal Address: 1316943551, E-mail:
| | - Mohammad Rahbar
- Department of Microbiology, Reference Health Laboratories Research Center, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Farzam Vaziri
- Department of Mycobacteriology & Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| | - Mrjan Rahnamaye-Farzami
- Department of Laboratory Tecnhnology, Reference Health Laboratories Research Center, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Mehdi Davari
- Department of Mycobacteriology & Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| | - Abolfazl Fateh
- Department of Mycobacteriology & Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| | - Morteza Masoumi
- Department of Mycobacteriology & Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| |
Collapse
|
27
|
Identification of Haemophilus influenzae Type b Isolates by Use of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry. J Clin Microbiol 2015; 53:2215-24. [PMID: 25926500 DOI: 10.1128/jcm.00137-15] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 04/27/2015] [Indexed: 01/22/2023] Open
Abstract
Haemophilus influenzae type b (Hib) is, in contrast to non-type b H. influenzae, associated with severe invasive disease, such as meningitis and epiglottitis, in small children. To date, accurate H. influenzae capsule typing requires PCR, a time-consuming and cumbersome method. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) provides rapid bacterial diagnostics and is increasingly used in clinical microbiology laboratories. Here, MALDI-TOF MS was evaluated as a novel approach to separate Hib from other H. influenzae. PCR-verified Hib and non-Hib reference isolates were selected based on genetic and spectral characteristics. Mass spectra of reference isolates were acquired and used to generate different classification algorithms for Hib/non-Hib differentiation using both ClinProTools and the MALDI Biotyper software. A test series of mass spectra from 33 Hib and 77 non-Hib isolates, all characterized by PCR, was used to evaluate the algorithms. Several algorithms yielded good results, but the two best were a ClinProTools model based on 22 separating peaks and subtyping main spectra (MSPs) using MALDI Biotyper. The ClinProTools model had a sensitivity of 100% and a specificity of 99%, and the results were 98% reproducible using a different MALDI-TOF MS instrument. The Biotyper subtyping MSPs had a sensitivity of 97%, a specificity of 100%, and 93% reproducibility. Our results suggest that it is possible to use MALDI-TOF MS to differentiate Hib from other H. influenzae. This is a promising method for rapidly identifying Hib in unvaccinated populations and for the screening and surveillance of Hib carriage in vaccinated populations.
Collapse
|
28
|
Gilsdorf JR. What the pediatrician should know about non-typeable Haemophilus influenzae. J Infect 2015; 71 Suppl 1:S10-4. [PMID: 25917803 DOI: 10.1016/j.jinf.2015.04.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 11/25/2022]
Abstract
Non-typeable Haemophilus influenzae (NTHi) live exclusively in the pharynges of humans and are increasingly recognized as pathogens that cause both localized infections of the respiratory tract (middle ear spaces, sinuses, and bronchi) and systemic infections such as bacteraemia and pneumonia. Only one vaccine antigen of NTHi, Protein D, has been extensively studied in humans and its efficacy in preventing NTHi otitis media is modest. Recent genetic analyses reveal that NTHi are closely related to Haemophilus haemolyticus (Hh), previously thought to be a non-pathogenic commensal of the pharynx. This review discusses the differences between the pathogenic potential of encapsulated and non-typeable Hi. In addition, information on the lifestyles and bacterial characteristics of NTHi and Hh as they pertain to their pathogenic capacities and the value of the Haemophilus taxonomy to clinicians are presented. Further, the epidemiology and mechanisms of NTHi antibiotic resistance, which include production of β-lactamase and alterations of penicillin-binding protein 3, are reviewed, as are the challenges of vaccine antigen discovery in NTHi.
Collapse
Affiliation(s)
- Janet R Gilsdorf
- D5101 Medical Professional Building SPC 5718, Ann Arbor, MI 48109-5718, United States.
| |
Collapse
|
29
|
Comparative Profile of Heme Acquisition Genes in Disease-Causing and Colonizing Nontypeable Haemophilus influenzae and Haemophilus haemolyticus. J Clin Microbiol 2015; 53:2132-7. [PMID: 25903577 DOI: 10.1128/jcm.00345-15] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 04/16/2015] [Indexed: 02/07/2023] Open
Abstract
Nontypeable Haemophilus influenzae (NTHI) are Gram-negative bacteria that colonize the human pharynx and can cause respiratory tract infections, such as acute otitis media (AOM). Since NTHI require iron from their hosts for aerobic growth, the heme acquisition genes may play a significant role in avoiding host nutritional immunity and determining virulence. Therefore, we employed a hybridization-based technique to compare the prevalence of five heme acquisition genes (hxuA, hxuB, hxuC, hemR, and hup) between 514 middle ear strains from children with AOM and 235 throat strains from healthy children. We also investigated their prevalences in 148 Haemophilus haemolyticus strains, a closely related species that colonizes the human pharynx and is considered to be nonpathogenic. Four out of five genes (hxuA, hxuB, hxuC, and hemR) were significantly more prevalent in the middle ear strains (96%, 100%, 100%, and 97%, respectively) than in throat strains (80%, 92%, 93%, and 85%, respectively) of NTHI, suggesting that strains possessing these genes have a virulence advantage over those lacking them. All five genes were dramatically more prevalent in NTHI strains than in H. haemolyticus, with 91% versus 9% hxuA, 98% versus 11% hxuB, 98% versus 11% hxuC, 93% versus 20% hemR, and 97% versus 34% hup, supporting their potential role in virulence and highlighting their possibility to serve as biomarkers to distinguish H. influenzae from H. haemolyticus. In summary, this study demonstrates that heme acquisition genes are more prevalent in disease-causing NTHI strains isolated from the middle ear than in colonizing NTHI strains and H. haemolyticus isolated from the pharynx.
Collapse
|
30
|
Nielsen SM, de Gier C, Dimopoulou C, Gupta V, Hansen LH, Nørskov-Lauritsen N. The capsule biosynthesis locus of Haemophilus influenzae shows conspicuous similarity to the corresponding locus in Haemophilus sputorum and may have been recruited from this species by horizontal gene transfer. MICROBIOLOGY-SGM 2015; 161:1182-8. [PMID: 25794502 DOI: 10.1099/mic.0.000081] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The newly described species Haemophilus sputorum has been cultured from the upper respiratory tract of humans and appears to have little pathogenic potential. The species encodes a capsular biosynthesis locus of approximately 12 kb composed of three distinct regions. Region I and III genes, involved in export and processing of the capsular material, show high similarity to the corresponding genes in capsulate lineages of the pathogenic species Haemophilus influenzae; indeed, standard bexA and bexB PCRs for detection of capsulated strains of H. influenzae give positive results with strains of H. sputorum. Three ORFs are present in region II of the sequenced strain of H. sputorum, of which a putative phosphotransferase showed homology with corresponding genes from H. influenzae serotype c and f. Phylogenetic analysis of housekeeping genes from 24 Pasteurellaceae species showed that H. sputorum was only distantly related to H. influenzae. In contrast to H. influenzae, the capsule locus in H. sputorum is not associated with transposases or other transposable elements. Our data suggest that the capsule locus of capsulate lineages of H. influenzae may have been recruited relatively recently from the commensal species H. sputorum by horizontal gene transfer.
Collapse
Affiliation(s)
- Signe M Nielsen
- 1Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
| | - Camilla de Gier
- 1Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Vikas Gupta
- 3Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Lars H Hansen
- 2Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | | |
Collapse
|
31
|
Mills N, Best EJ, Murdoch D, Souter M, Neeff M, Anderson T, Salkeld L, Ahmad Z, Mahadevan M, Barber C, Brown C, Walker C, Walls T. What is behind the ear drum? The microbiology of otitis media and the nasopharyngeal flora in children in the era of pneumococcal vaccination. J Paediatr Child Health 2015; 51:300-6. [PMID: 25175818 PMCID: PMC4406153 DOI: 10.1111/jpc.12710] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/11/2014] [Indexed: 11/26/2022]
Abstract
AIM This study aims to describe the microbiology of middle ear fluid (MEF) in a cohort of children vaccinated with Streptococcus pneumoniae conjugate vaccine (PCV7) having ventilation tube insertion. Nasopharyngeal (NP) carriage of otopathogens in these children is compared with children without history of otitis media. METHODS Between May and November 2011, MEF and NP samples from 325 children aged <3 years were collected in three major centres in New Zealand at the time of ventilation tube insertion. An age-matched non-otitis-prone comparison group of 137 children had NP samples taken. A questionnaire was completed by both groups. RESULTS Immunisation coverage with at least one dose of PCV7 was 97%. Haemophilus influenzae was cultured in 19.4% of MEF and was polymerase chain reaction (PCR) positive in 43.4%. S. pneumoniae and Moraxella catarrhalis were cultured in <10% of MEF samples but were PCR positive for 23.1% and 38.7%, respectively. H. influenzae was the most common organism isolated from NP samples (60%) in the grommet group, while M. catarrhalis (56%) was the most common in the non-otitis prone group. S. pneumoniae was more commonly found in the nasopharynx of children with ear disease (41% vs. 29%). 19F was the most prominent S. pneumoniae serotype in NP samples of both groups, but no serotype dominated in MEF. Ninety-five per cent of H. influenzae isolates were confirmed to be non-typeable H. influenzae. CONCLUSION In this cohort of children with established ear disease requiring surgical intervention, non-typeable H. influenzae is the dominant pathogen in both the nasopharynx and MEF.
Collapse
Affiliation(s)
- Nikki Mills
- Auckland District Health Board, Starship Children's HospitalAuckland, New Zealand
| | - Emma J Best
- Auckland District Health Board, Starship Children's HospitalAuckland, New Zealand,Department of Paediatrics, University of AucklandAuckland, New Zealand
| | - David Murdoch
- Canterbury Health Laboratories, Christchurch Hospital, University of OtagoChristchurch, New Zealand,Department of Pathology, University of OtagoChristchurch, New Zealand
| | - Melanie Souter
- Canterbury District Health Board, Christchurch Hospital, University of OtagoChristchurch, New Zealand
| | - Michel Neeff
- Auckland District Health Board, Starship Children's HospitalAuckland, New Zealand
| | - Trevor Anderson
- Canterbury Health Laboratories, Christchurch Hospital, University of OtagoChristchurch, New Zealand
| | - Lesley Salkeld
- Auckland District Health Board, Starship Children's HospitalAuckland, New Zealand,Counties Manukau District Health Board, Manukau SuperclinicAuckland, New Zealand
| | - Zahoor Ahmad
- Counties Manukau District Health Board, Manukau SuperclinicAuckland, New Zealand
| | - Murali Mahadevan
- Auckland District Health Board, Starship Children's HospitalAuckland, New Zealand
| | - Colin Barber
- Auckland District Health Board, Starship Children's HospitalAuckland, New Zealand
| | - Colin Brown
- Auckland District Health Board, Starship Children's HospitalAuckland, New Zealand
| | - Cameron Walker
- Engineering, University of AucklandAuckland, New Zealand
| | - Tony Walls
- Canterbury District Health Board, Christchurch Hospital, University of OtagoChristchurch, New Zealand,Paediatrics, University of OtagoChristchurch, New Zealand
| |
Collapse
|
32
|
Van Eldere J, Slack MPE, Ladhani S, Cripps AW. Non-typeable Haemophilus influenzae, an under-recognised pathogen. THE LANCET. INFECTIOUS DISEASES 2014; 14:1281-92. [PMID: 25012226 DOI: 10.1016/s1473-3099(14)70734-0] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Non-typeable Haemophilus influenzae (NTHi) is a major cause of mucosal infections such as otitis media, sinusitis, conjunctivitis, and exacerbations of chronic obstructive pulmonary disease. In some regions, a strong causal relation links this pathogen with infections of the lower respiratory tract. In the past 20 years, a steady but constant increase has occurred in invasive NTHi worldwide, with perinatal infants, young children, and elderly people most at risk. Individuals with underlying comorbidities are most susceptible and infection is associated with high mortality. β-lactamase production is the predominant mechanism of resistance. However, the emergence and spread of β-lactamase-negative ampicillin-resistant strains in many regions of the world is of substantial concern, potentially necessitating changes to antibiotic treatment guidelines for community-acquired infections of the upper and lower respiratory tract and potentially increasing morbidity associated with invasive NTHi infections. Standardised surveillance protocols and typing methodologies to monitor this emerging pathogen should be implemented. International scientific organisations need to raise the profile of NTHi and to document the pathobiology of this microbe.
Collapse
Affiliation(s)
- Johan Van Eldere
- Department of Microbiology and Immunology, Catholic University Leuven, Belgium; Clinical Department of Laboratory Medicine, University Hospital Leuven, Belgium.
| | - Mary P E Slack
- WHO Collaborating Centre for Haemophilus influenzae, Respiratory and Vaccine Preventable Bacteria Reference Unit, Microbiology Services, Public Health England, Colindale, London, UK
| | - Shamez Ladhani
- Immunisation, Hepatitis and Blood Safety Department, Health Protection Services, Public Health England, Colindale, London, UK
| | - Allan W Cripps
- School of Medicine, Griffith Health Institute, Griffith University, Gold Coast, QLD, Australia
| |
Collapse
|
33
|
Nørskov-Lauritsen N. Classification, identification, and clinical significance of Haemophilus and Aggregatibacter species with host specificity for humans. Clin Microbiol Rev 2014; 27:214-40. [PMID: 24696434 PMCID: PMC3993099 DOI: 10.1128/cmr.00103-13] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The aim of this review is to provide a comprehensive update on the current classification and identification of Haemophilus and Aggregatibacter species with exclusive or predominant host specificity for humans. Haemophilus influenzae and some of the other Haemophilus species are commonly encountered in the clinical microbiology laboratory and demonstrate a wide range of pathogenicity, from life-threatening invasive disease to respiratory infections to a nonpathogenic, commensal lifestyle. New species of Haemophilus have been described (Haemophilus pittmaniae and Haemophilus sputorum), and the new genus Aggregatibacter was created to accommodate some former Haemophilus and Actinobacillus species (Aggregatibacter aphrophilus, Aggregatibacter segnis, and Aggregatibacter actinomycetemcomitans). Aggregatibacter species are now a dominant etiology of infective endocarditis caused by fastidious organisms (HACEK endocarditis), and A. aphrophilus has emerged as an important cause of brain abscesses. Correct identification of Haemophilus and Aggregatibacter species based on phenotypic characterization can be challenging. It has become clear that 15 to 20% of presumptive H. influenzae isolates from the respiratory tracts of healthy individuals do not belong to this species but represent nonhemolytic variants of Haemophilus haemolyticus. Due to the limited pathogenicity of H. haemolyticus, the proportion of misidentified strains may be lower in clinical samples, but even among invasive strains, a misidentification rate of 0.5 to 2% can be found. Several methods have been investigated for differentiation of H. influenzae from its less pathogenic relatives, but a simple method for reliable discrimination is not available. With the implementation of identification by matrix-assisted laser desorption ionization-time of flight mass spectrometry, the more rarely encountered species of Haemophilus and Aggregatibacter will increasingly be identified in clinical microbiology practice. However, identification of some strains will still be problematic, necessitating DNA sequencing of multiple housekeeping gene fragments or full-length 16S rRNA genes.
Collapse
|
34
|
Su YC, Resman F, Hörhold F, Riesbeck K. Comparative genomic analysis reveals distinct genotypic features of the emerging pathogen Haemophilus influenzae type f. BMC Genomics 2014; 15:38. [PMID: 24438474 PMCID: PMC3928620 DOI: 10.1186/1471-2164-15-38] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 01/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of invasive disease caused by encapsulated Haemophilus influenzae type f (Hif) has increased in the post-H. influenzae type b (Hib) vaccine era. We previously annotated the first complete Hif genome from a clinical isolate (KR494) that caused septic shock and necrotizing myositis. Here, the full genome of Hif KR494 was compared to sequenced reference strains Hib 10810, capsule type d (Hid) Rd Kw20, and finally nontypeable H. influenzae 3655. The goal was to identify possible genomic characteristics that may shed light upon the pathogenesis of Hif. RESULTS The Hif KR494 genome exhibited large regions of synteny with other H. influenzae, but also distinct genome rearrangements. A predicted Hif core genome of 1390 genes was shared with the reference strains, and 6 unique genomic regions comprising half of the 191 unique coding sequences were revealed. The majority of these regions were inserted genetic fragments, most likely derived from the closely-related Haemophilus spp. including H. aegyptius, H. haemolyticus and H. parainfluenzae. Importantly, the KR494 genome possessed several putative virulence genes that were distinct from non-type f strains. These included the sap2 operon, aef3 fimbriae, and genes for kanamycin nucleotidyltranserase, iron-utilization proteins, and putative YadA-like trimeric autotransporters that may increase the bacterial virulence. Furthermore, Hif KR494 lacked a hisABCDEFGH operon for de novo histidine biosynthesis, hmg locus for lipooligosaccharide biosynthesis and biofilm formation, the Haemophilus antibiotic resistance island and a Haemophilus secondary molybdate transport system. We confirmed the histidine auxotrophy and kanamycin resistance in Hif by functional experiments. Moreover, the pattern of unique or missing genes of Hif KR494 was similar in 20 Hif clinical isolates obtained from different years and geographical areas. A cross-species comparison revealed that the Hif genome shared more characteristics with H. aegyptius than Hid and NTHi. CONCLUSIONS The genomic comparative analyses facilitated identification of genotypic characteristics that may be related to the specific virulence of Hif. In relation to non-type f H. influenzae strains, the Hif genome contains differences in components involved in metabolism and survival that may contribute to its invasiveness.
Collapse
Affiliation(s)
| | | | | | - Kristian Riesbeck
- Medical Microbiology, Department of Laboratory Medicine Malmö, Lund University, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden.
| |
Collapse
|
35
|
Vuong J, Wang X, Theodore JM, Whitmon J, Gomez de Leon P, Mayer LW, Carlone GM, Romero-Steiner S. Absence of high molecular weight proteins 1 and/or 2 is associated with decreased adherence among non-typeable Haemophilus influenzae clinical isolates. J Med Microbiol 2013; 62:1649-1656. [DOI: 10.1099/jmm.0.058222-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
High molecular weight (Hmw) proteins 1 and 2, type IV pilin protein (PilA), outer-membrane protein P5 (OmpP5), Haemophilus protein D (Hpd) and Haemophilus adhesive protein (Hap) are surface proteins involved in the adherence of non-typeable Haemophilus influenzae. One hundred clinical isolates were evaluated for the presence of the genes encoding these proteins by PCR and for their adherence capacity (AC) to Detroit 562 nasopharyngeal cells (D562). The majority of isolates were from blood (77/100); other sites were also represented. Confluent D562 monolayers (1.2×105 cells per well) were inoculated with standardized minimal infective doses (m.o.i.) of 102, 103 or 104 c.f.u. per well. The AC was categorized as low (<10 %) or high (≥10 %) depending on the percentage of c.f.u. adhering per well. All the isolates evaluated showed adherence: 69/100 (69 %) demonstrated high adherence, while 31/100 (31 %) showed low adherence. Of all the genes evaluated, hmw1A and/or hmw2A were detected in 69/100 (69 %) of isolates. The presence of hmw1A and/or hmw2A was associated with increased adherence to D562 cells (P≤0.001). Dot immunoblots were performed to detect protein expression using mAbs 3D6, AD6 and 10C5. Among the high-adherence isolates (n = 69), 72 % reacted with 3D6 and 21 % with 10C5. Our data indicate that the absence of Hmw1 and/or Hmw2 was associated with decreased adherence to D562 cells.
Collapse
Affiliation(s)
- Jeni Vuong
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Xin Wang
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Jordan M. Theodore
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Jennifer Whitmon
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Patricia Gomez de Leon
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico
| | - Leonard W. Mayer
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - George M. Carlone
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Sandra Romero-Steiner
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| |
Collapse
|
36
|
Langereis JD, van Dongen TMA, Stol K, Venekamp RP, Schilder AGM, Hermans PWM. Resistance to complement-mediated killing and IgM binding to non-typeable Haemophilus influenzae is not altered when ascending from the nasopharynx to the middle ears in children with otitis media. Med Microbiol Immunol 2013; 202:407-15. [PMID: 23775521 DOI: 10.1007/s00430-013-0302-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 06/03/2013] [Indexed: 12/18/2022]
Abstract
We have previously found that non-typeable Haemophilus influenzae (NTHi) collected from the middle ear of children with otitis media (OM) exhibit increased levels of complement resistance compared to NTHi collected from the nasopharynx. However, it is unknown whether bacteria develop complement resistance in the middle ear, or whether resistance is present when residing in the nasopharynx. The objective of this study was to investigate whether the levels of complement resistance of isolates collected from the middle ear were similar to those of isolates from the nasopharynx with an identical MLST type. We included 62 children with recurrent acute OM, chronic OM with effusion or acute tympanostomy tube otorrhea. NTHi was simultaneously isolated from the nasopharynx and middle ear fluid. MLST, resistance to complement-mediated killing, IgG binding, IgM binding and phosphorylcholine expression was determined. In 41 children, NTHi isolated from the middle ear and nasopharynx showed to have an identical MLST type. Isolates collected from the middle ear showed a highly similar level of complement resistance and IgM binding with isolates collected from the nasopharynx, whereas this was not the case for IgG binding and phosphorylcholine incorporation into lipooligosaccharide. Resistance to complement-mediated killing and IgM binding of NTHi isolates with an identical MLST type collected from the middle ear and nasopharynx of children with OM was highly similar.
Collapse
Affiliation(s)
- Jeroen D Langereis
- Laboratory of Pediatric Infectious Diseases, Radboud University Medical Centre, Internal Post 224, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands,
| | | | | | | | | | | |
Collapse
|
37
|
Fukushima K, Doi H, Hamaguchi S, Tomono K. Fulminant pneumonia caused by nontypable haemophilus influenzae. Intern Med 2013; 52:1755. [PMID: 23903516 DOI: 10.2169/internalmedicine.52.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Kiyoharu Fukushima
- Department of General Internal Medicine, Kanagawa Prefectural Ashigara-kami Hospital, Japan.
| | | | | | | |
Collapse
|
38
|
Urease operon and urease activity in commensal and disease-causing nontypeable Haemophilus influenzae. J Clin Microbiol 2012; 51:653-5. [PMID: 23224103 DOI: 10.1128/jcm.03145-12] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The ure operon was significantly more prevalent in Haemophilus influenzae isolates causing otitis media and chronic obstructive pulmonary disease (COPD)-associated bronchitis than in those from throats of healthy individuals (97% versus 78.1%, P < 0.001). Strains lacking the ure operon are over 8 times more likely to be from the throat than either otitis media or COPD isolates.
Collapse
|
39
|
Wroblewski D, Halse TA, Hayes J, Kohlerschmidt D, Musser KA. Utilization of a real-time PCR approach for Haemophilus influenzae serotype determination as an alternative to the slide agglutination test. Mol Cell Probes 2012. [PMID: 23195602 DOI: 10.1016/j.mcp.2012.11.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Our laboratory has developed a simple two-step multiplex real-time PCR for use on isolates of Haemophilus influenzae for molecular serotype identification and the detection of capsular gene targets. The assay consists of a 2-plex real-time PCR targeting the capsule transport gene (bexA), and serotype b specific gene (bcsB), and a 5-plex real-time PCR detecting serotypes a, c, d, e, and f targeting Region II serotype-specific genes. Both real-time PCR assays are highly sensitive (<8 CFU) for all serotypes and 100% specific when tested by a panel of more than 40 bacterial organisms. A retrospective study of 214 isolates received between 1998 and 2011 were tested and compared against the traditional slide agglutination test (SAT) resulting in 100% concordance. We demonstrate that this two-step real-time PCR approach is more sensitive than previously published PCR assays and provides a simple alternative to the SAT. Reliable, rapid and sensitive H. influenzae serotyping is critical for identifying new emerging strains for epidemiological surveillance.
Collapse
Affiliation(s)
- Danielle Wroblewski
- Wadsworth Center, New York State Department of Health, PO Box 22002, Albany, NY 12201-2002, USA
| | | | | | | | | |
Collapse
|
40
|
Zhang L, Xie J, Patel M, Bakhtyar A, Ehrlich GD, Ahmed A, Earl J, Marrs CF, Clemans D, Murphy TF, Gilsdorf JR. Nontypeable Haemophilus influenzae genetic islands associated with chronic pulmonary infection. PLoS One 2012; 7:e44730. [PMID: 22970300 PMCID: PMC3435294 DOI: 10.1371/journal.pone.0044730] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 08/07/2012] [Indexed: 11/19/2022] Open
Abstract
Background Haemophilus influenzae (Hi) colonizes the human respiratory tract and is an important pathogen associated with chronic obstructive pulmonary disease (COPD). Bacterial factors that interact with the human host may be important in the pathogenesis of COPD. These factors, however, have not been well defined. The overall goal of this study was to identify bacterial genetic elements with increased prevalence among H. influenzae strains isolated from patients with COPD compared to those isolated from the pharynges of healthy individuals. Methodology/Principal Findings Four nontypeable H. influenzae (NTHi) strains, two isolated from the airways of patients with COPD and two from a healthy individual, were subjected to whole genome sequencing using 454 FLX Titanium technology. COPD strain-specific genetic islands greater than 500 bp in size were identified by in silico subtraction. Open reading frames residing within these islands include known Hi virulence genes such as lic2b, hgbA, iga, hmw1 and hmw2, as well as genes encoding urease and other enzymes involving metabolic pathways. The distributions of seven selected genetic islands were assessed among a panel of 421 NTHi strains of both disease and commensal origins using a Library-on-a-Slide high throughput dot blot DNA hybridization procedure. Four of the seven islands screened, containing genes that encode a methyltransferase, a dehydrogenase, a urease synthesis enzyme, and a set of unknown short ORFs, respectively, were more prevalent in COPD strains than in colonizing strains with prevalence ratios ranging from 1.21 to 2.85 (p≤0.0002). Surprisingly, none of these sequences show increased prevalence among NTHi isolated from the airways of patients with cystic fibrosis. Conclusions/Significance Our data suggest that specific bacterial genes, many involved in metabolic functions, are associated with the ability of NTHi strains to survive in the lower airways of patients with COPD.
Collapse
Affiliation(s)
- Lixin Zhang
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|