title: Invasive Haemophilus influenzae in Manitoba, Canada, in the postvaccination era.
abstract: Fifty-two Haemophilus influenzae isolates from patients with invasive disease in the province of Manitoba, Canada, were examined for serotype, biotype, genotype, and antibiotic susceptibility. Half of the 52 isolates were found to be serotype a, and 38.5% (20 isolates) were found to be nonserotypeable (NST). There were only three serotype b strains and one each for serotypes c, d, and f. All 26 serotype a isolates belonged to biotype II and demonstrated identical or highly similar DNA fingerprints by pulsed-field gel electrophoresis. An analysis of these isolates by multilocus sequence typing showed that they belong to the clonal complex ST-23. While 69% (18 of 26) of the serotype a cases were found in males, only 9 (45%) of the 20 patients with NST isolates were males. Twenty (77%) of the 26 serotype a isolates were from patients who were </=24 months old. Twelve (63%) of the NST isolates were from adult or adolescent patients. In contrast to the clonal nature of serotype a isolates, the 20 NST isolates were found to belong to 18 different sequence types. Most of these 18 different sequence types were unrelated to each other, with the exception of 7 sequence types grouped into three clonal groups. Two (6.25%) out of 32 serotypeable isolates (1 serotype a and 1 serotype b) and 6 (30%) of 20 NST isolates were resistant to ampicillin due to beta-lactamase production. These results suggest a change in the epidemiology of H. influenzae disease, with the majority of invasive H. influenzae isolates being associated with serotype a and NST strains.
authors.affiliation: Vaccine Preventable Bacterial Disease Section, National Microbiology Laboratory, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2. raymond_tsang@phac-aspc.gc.ca
authors.forename: Raymond S W
authors.initials: RS
authors.lastname: Tsang
authors.forename: Samira
authors.initials: S
authors.lastname: Mubareka
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Sill
authors.forename: John
authors.initials: J
authors.lastname: Wylie
authors.forename: Stuart
authors.initials: S
authors.lastname: Skinner
authors.forename: Dennis K S
authors.initials: DK
authors.lastname: Law
mesh_terms: D015373:Bacterial Typing Techniques; D002170:Canada / Q000453:epidemiology; D004352:Drug Resistance, Microbial; D006192:Haemophilus Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D018073:Haemophilus Vaccines / Q000008:administration & dosage* / Q000276:immunology; D006193:Haemophilus influenzae / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D008350:Manitoba / Q000453:epidemiology; D010802:Phylogeny; D012703:Serotyping
chemical_list: D018073:Haemophilus Vaccines