[Systemic infections due to type b Haemophilus influenzae. A retrospective study of 114 cases].
The choice of treatment, the importance of chemoprophylaxis in household contacts and the potential impact of immunization with vaccines against Haemophilus influenzae type b (Hib) currently under investigation are discussed on the basis of the patients hospitalized for invasive Hib infections at the University Children's Hospital Geneva from 1976 to 1985. Among 122 culture-proven infections due to Hib, there were 41% of cases of meningitis, 37.7% of epiglottitis, 9.8% of pneumonia, 5.7% of septicemia, 3.3% of cellulitis and 2.4% of septic arthritis. From 1981 to 1983, one strain of Hib produced beta-lactamase, but between 1984 and 1985, 5 strains (19.2%) produced beta-lactamase. Only one case of possible horizontal transmission of the infection was found in this 10-year period. We conclude that 1. the appearance of beta-lactamase producing strains of Hib requires that treatment be initiated with an antimicrobial agent resistant to beta-lactamase when a Hib infection is suspected; 2. in our region, only one case of an invasive Hib infection could theoretically have been prevented by chemoprophylaxis; and 3. the calculated theoretical impact of vaccination with the new types of vaccines against Hib could have prevented 106 of 122 cases of invasive Hib infections.
Gervaix
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A
Clinique universitaire de Pédiatrie, Hôpital cantonal universitaire de Genève.
Suter
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D000667:Ampicillin / Q000627:therapeutic use; D016667:Bacterial Capsules; D001428:Bacterial Vaccines / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D018073:Haemophilus Vaccines; D006193:Haemophilus influenzae / Q000187:drug effects / Q000201:enzymology; D006801:Humans; D007223:Infant; D008297:Male; D010403:Penicillin Resistance; D011135:Polysaccharides, Bacterial; D012189:Retrospective Studies; D013557:Switzerland; D001618:beta-Lactamases / Q000096:biosynthesis
D001428:Bacterial Vaccines; D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; D011135:Polysaccharides, Bacterial; D000667:Ampicillin; D001618:beta-Lactamases
Infections systémiques à haemophilus influenzae du type b. Etude rétrospective de 114 cas.