Pharyngeal colonization with Haemophilus influenzae type b among healthy Turkish infants and children.
BACKGROUND
An absence of Haemophilus influenzae type b (Hib) disease surveillance and epidemiological data on the pharyngeal carriage of Turkish children causes delay in the introduction of conjugated Hib vaccination into proposed national vaccination programs.


METHODS
Oropharyngeal cultures were obtained from 1404 healthy infants and children. Six healthy child clinic (HCC), 11 day-care centers (DCC) and seven elementary schools (ES) were randomly selected in seven different counties at the Anatolian side of Istanbul between January and April 2000.


RESULTS
Haemophilus influenzae was isolated from 315 (22.8%) of all participants and 98 (31%) isolates were serotype b. The carriage rate for Hib was higher in children at DCC (43 out of 448, 9.6%) and ES (46 out of 504, 9.1%) compared to infants 0-24 months of age (nine out of 430, 2.1%) presented to HCC. All Hib isolates were susceptible to azithromycin, chloramphenicol and cefotaxime. Beta-lactamase production was detected in only one isolate. Trimethoprim-sulfamethoxazole resistance was found in 8.5% of Hib isolates. Multivariate analysis showed that DCC and ES attendance were independent predictors of Hib carriage.


CONCLUSIONS
A significant proportion of healthy Turkish children was shown to be colonized with Hib. The burden of invasive Hib infections should be determined in order to evaluate the Hib conjugated vaccine as a part of a routine immunization program in Turkey.
Department of Pediatric Infectious Diseases, Marmara University School of Medicine, Istanbul, Turkey. bakirm@superonline.com
Mustafa
M
Bakir
Aysegul
A
Yagci
Nurver
N
Ulger
Cengiz
C
Akbenlioglu
Arzu
A
Ilki
Guner
G
Soyletir
Mujdat
M
Basaran
D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D019741:Haemophilus influenzae type b / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D010614:Pharynx / Q000382:microbiology*; D014421:Turkey