Population-based study of non-typable Haemophilus influenzae invasive disease in children and neonates.
The extent of non-capsulate, non-serotypable Haemophilus influenzae (NST) as a cause of serious invasive disease in children has not been fully defined. We describe the epidemiology of these childhood infections from cases identified during a continuing prospective survey of invasive H influenzae disease in the Oxford region, UK. 408 strains of H influenzae were isolated from cases of invasive disease. 383 (94%) were H influenzae type b (Hib), 24 (6%) were NST strains, and 1 was a type f strain. 3 of the NST strains were non-capsulate type b mutants (b-), but the remaining 21 strains were from the phylogenetically distinct and heterogeneous population of non-capsulate H influenzae (NC). 10 of the NC strains were isolated from neonates with sepsis; crude mortality rate was 40%, with an incidence of 4.6 cases per 100,000 livebirths. 11 NC strains were isolated from children after the neonatal period and under 10 years of age, 4 (36%) of which had severe, unrelated, predisposing conditions. The incidence of NC invasive diseases in these children was 0.5 per 100,000 per year. The attributable mortality for these infections was 10%. Infections due to these H influenzae strains are, after the implementation of Hib vaccines, likely to persist and represent a substantial proportion of the serious infections caused by this species.
Falla
T J
TJ
Public Health Laboratory, John Radcliffe Hospital, Headington, Oxford, UK.
Dobson
S R
SR
Crook
D W
DW
Kraak
W A
WA
Nichols
W W
WW
Anderson
E C
EC
Jordens
J Z
JZ
Slack
M P
MP
Mayon-White
D
D
Moxon
E R
ER
D015139:Blotting, Southern; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D006192:Haemophilus Infections / Q000453:epidemiology* / Q000382:microbiology; D006193:Haemophilus influenzae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies; D012703:Serotyping