1
|
Tuyama M, Corrêa-Antônio J, Schlackman J, Marsh JW, Rebelo MC, Cerqueira EO, Nehab M, Kegele F, Carmo GF, Thielmann DC, Barroso PF, Harrison LH, Barroso DE. Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil. Mem Inst Oswaldo Cruz 2017; 112:196-202. [PMID: 28225904 PMCID: PMC5319370 DOI: 10.1590/0074-02760160391] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/23/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Haemophilus influenzae (Hi) serotype b (Hib) conjugate vaccine was incorporated into the infant immunisation schedule in Brazil in 1999, where Hib was one of the major etiologic sources of community-acquired bacterial meningitis. OBJECTIVES The purpose of this study is to describe the molecular epidemiology of invasive Hi disease in Rio de Janeiro state, Brazil, before and after vaccine introduction. METHODS Surveillance data from 1986 to 2014 were analysed. Hi isolates recovered from cerebrospinal fluid (CSF) or blood from 1993 to 2014 were serotyped by slide agglutination, genotyped by multilocus sequence typing (MLST), and the capsule type evaluation, differentiation of serologically non-typeable isolates, and characterisation of the capsule (cap) locus was done by polymerase chain reaction. Antimicrobial susceptibility testing was performed using E-test. FINDINGS From 1986 to 1999 and from 2000 to 2014, 2580 and 197 (42% without serotype information) confirmed cases were reported, respectively. The case fatality rate was 17% and did not correlate with the strain. Hib and b- variant isolates belonged to ST-6, whereas serotype a isolates belonged to the ST-23 clonal complex. Serotype a appeared to emerge during the 2000s. Non-encapsulated isolates were non-clonal and distinct from the encapsulated isolates. Ampicillin-resistant isolates were either of serotype b or were non-encapsulated, and all of them were β-lactamase-positive but amoxicillin-clavulanic acid susceptible. MAIN CONCLUSIONS Although Hi meningitis became a relatively rare disease in Rio de Janeiro after the introduction of the Hib conjugate vaccine, the isolates recovered from patients have become more diverse. These results indicate the need to implement an enhanced surveillance system to continue monitoring the impact of the Hib conjugate vaccine.
Collapse
Affiliation(s)
- Mari Tuyama
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, RJ, Brasil.,Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brasil
| | - Jessica Corrêa-Antônio
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, RJ, Brasil
| | - Jessica Schlackman
- University of Pittsburgh, School of Medicine and Graduate School of Public Health, Infectious Diseases Epidemiology Research Unit, Pittsburgh, PA, United States of America
| | - Jane W Marsh
- University of Pittsburgh, School of Medicine and Graduate School of Public Health, Infectious Diseases Epidemiology Research Unit, Pittsburgh, PA, United States of America
| | - Maria C Rebelo
- Secretaria de Estado de Saúde do Rio de Janeiro, Assessoria de Meningites, Rio de Janeiro, RJ, Brasil
| | - Elaine O Cerqueira
- Secretaria de Estado de Saúde do Rio de Janeiro, Assessoria de Meningites, Rio de Janeiro, RJ, Brasil
| | - Márcio Nehab
- Fundação Oswaldo Cruz-Fiocruz, Instituto Fernandes Figueira, Rio de Janeiro, RJ, Brasil
| | - Fabíola Kegele
- Fundação Oswaldo Cruz-Fiocruz, Instituto Fernandes Figueira, Rio de Janeiro, RJ, Brasil
| | | | | | - Paulo F Barroso
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brasil
| | - Lee H Harrison
- University of Pittsburgh, School of Medicine and Graduate School of Public Health, Infectious Diseases Epidemiology Research Unit, Pittsburgh, PA, United States of America
| | - David E Barroso
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, RJ, Brasil
| |
Collapse
|
2
|
Tian G, Zhang L, Li M, Wang X, Zheng Y, Li X, Huang C, Li X, Xie Y, Xu L, Ren H, Shao Z. Genotypic characteristics of Haemophilus influenzae isolates from pediatric pneumonia patients in Chengdu city, Sichuan, China. J Microbiol 2009; 47:494-7. [PMID: 19763425 DOI: 10.1007/s12275-009-0002-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2008] [Accepted: 04/06/2009] [Indexed: 11/25/2022]
Abstract
Two hundred and seventy-three Haemophilus influenzae strains isolated from pediatric pneumonia patients in China were studied. We used Multilocus Sequence Typing (MLST) to analyze genotypic characteristics. All strains were biotyped and serotyped. Relatedness and patterns of genes among isolates were determined by the analysis of MLST and eBURST. H. influenzae primarily causes acute pneumonia in children under 1 year old. Nontypeable H. influenzae was responsible for most cases of pediatric pneumonia. All 273 strains were classified into eight biotypes. They mostly belonged to the I, II, and III biotypes (17.6%, 43.6%, and 22.7%, respectively). 62 strains (22.7%) produced beta-lactamase. We found 28 novel alleles. Fifty different STs were found by MLST, of which 39 were novel. These were ST477 through ST508 and ST521 through ST527. Group 17 and predicted founders 503 were new groups in this study. No STs correlated with strains from Korea, which is adjacent to China. The H. influenzae strains from China appeared to have heterogeneous ST types patterns which may be the reason no outbreaks or epidemics of H. influenzae infections have occurred in Chengdu city, Sichuan, China.
Collapse
Affiliation(s)
- Guozhong Tian
- State Key Laboratory for Infectious Diseases Control and Prevention, National Institute for Communicable Disease Control and Prevention, Chinese Center for Diseases Control and Prevention, P.O. Box 5, Beijing 102206, P. R. China
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Satola SW, Collins JT, Napier R, Farley MM. Capsule gene analysis of invasive Haemophilus influenzae: accuracy of serotyping and prevalence of IS1016 among nontypeable isolates. J Clin Microbiol 2007; 45:3230-8. [PMID: 17699642 PMCID: PMC2045354 DOI: 10.1128/jcm.00794-07] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We evaluated the accuracy of serologic capsule typing by analyzing capsule genes and related markers among invasive Haemophilus influenzae isolates before and after the introduction of H. influenzae serotype b (Hib) conjugate vaccines. Three hundred and sixty invasive H. influenzae isolates were collected as part of Active Bacterial Core surveillance within the Georgia Emerging Infections Program between 1 January 1989 and 31 July 1998. All isolates were biotyped, serotyped by slide agglutination serotyping (SAST), and evaluated using PCR capsule typing. Nontypeable H. influenzae (NTHi) isolates were probed with Hib cap-gene-containing plasmid pUO38 and with IS1016; a subset was examined with phosphoglucose isomerase (pgi) genotyping and pulsed-field gel electrophoresis (PFGE). Discrepancies between SAST and PCR capsule typing were found for 64/360 (17.5%) of the isolates; 48 encapsulated by SAST were NTHi by PCR, 8 NTHi by SAST were encapsulated by PCR, 6 encapsulated by SAST were a different capsule type by PCR, and 2 encapsulated by SAST were capsule-deficient Hib variants (Hib-minus). None of the PCR-confirmed NTHi isolates demonstrated homology with residual capsule gene sequences; 19/201 (9.5%) had evidence of IS1016, an insertion element associated with division I H. influenzae capsule serotypes. The majority of IS1016-positive NTHi were biotypes I and V and showed some genetic relatedness by PFGE. In conclusion, PCR capsule typing was more accurate than SAST and Hib-minus variants were rare. IS1016 was present in 9.5% of NTHi isolates, suggesting that this subset may be more closely related to encapsulated organisms. A better understanding of NTHi may contribute to vaccine development.
Collapse
Affiliation(s)
- Sarah W Satola
- Atlanta Veterans Affairs Medical Center, Medical Research Service 151, 1670 Clairmont Rd., Decatur, GA 30033, USA
| | | | | | | |
Collapse
|