Clinical characteristics of 84 children with invasive <italic>Haemophilus influenzae</italic> infection from 2014 to 2018

Gaoliang Wang; Chunzhen Hua; Linhai Yang; Huiling Deng; Hongmei XU; Hui YU; Shifu Wang; Conghui Zhang

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Clinical characteristics of 84 children with invasive Haemophilus influenzae infection from 2014 to 2018

VernacularTitle: 2014—2018年儿童侵袭性流感嗜血杆菌感染84例临床特点分析
Author: Gaoliang WANG ¹ ; Chunzhen HUA ¹ ; Linhai YANG ² ; Huiling DENG ³ ; Hongmei XU ⁴ ; Hui YU ⁵ ; Shifu WANG ⁶ ; Conghui ZHANG ⁷
Author Information

1. Department of Infectious Diseases, the Children′s Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
2. Department of Cardiovascular Diseases and Rheumatology and Immunology, Shanxi Children′s Hospital, Taiyuan 030013, China
3. Department of Infectious Diseases, Xi′an Children′s Hospital, Xi′an 710043, China
4. Department of Infectious Diseases, Children′s Hospital Affiliated to Chongqing Medical University, Chongqing 400014, China
5. Department of Infectious Diseases, Pediatrics Hospital Affiliated to Fudan University, Shanghai 201102, China
6. Clinical Laboratory, Qilu Children′s Hospital, Shandong University, Jinan 250022, China
7. Department of Infectious Diseases, Children′s Hospital of Kaifeng City, Kaifeng 475000, China
Publication Type:Journal Article
Keywords: Haemophilus influenzae; Child; Invasive, infection
From: Chinese Journal of Pediatrics 2019;57(8):592-596
CountryChina
Language:Chinese
Abstract: Objective:To investigate the clinical characteristics of invasive Haemophilus influenzae (HI) infection in children.
Methods:The clinical manifestations, laboratory examinations and treatment outcomes of 84 children with HI infection confirmed by bacterial culture in 7 tertiary children′s hospitals from 2014 to 2018 were analyzed retrospectively.
Results:Among the 84 cases, 50 were males. The age was 1.54 years (ranged from 5 days to 13 years).Twenty cases (24%) had underlying diseases and 48 cases (57%) had not received antibiotics before collecting specimens. Eighty-two cases (98%) had fever and 75 cases (89%) had clear infection foci, among which 31 cases (37%) had meningitis and 27 cases (32%) had pneumonia. Blood culture was positive in 62 cases (74%), cerebrospinal fluid culture was positive in 10 cases (12%), blood culture and cerebrospinal fluid culture were both positive in 11 cases (13%). Antibiotics susceptibility test showed that 27% (22/82) of all HI strains produced β-lactamases and 48% (37/77) strains were resistant to ampicillin. The drug resistance rates to cefuroxime, ampicillin-sulbactam, trimethoprim-sulfamethoxazole and azithromycin were 25% (20/80) , 20% (9/45) , 71% (44/62) and 19%(11/58), respectively. All strains were sensitive to meropenem, levofloxacin and ceftriaxone. After sensitive antibiotic therapy, 83% (70/84) of all patients were cured and improved, the mortality rate and loss of follow-up rate were 13% (11/84) and 4% (3/84) respectively.
Conclusions:Meningitis and pneumonia are common presentation of invasive HI infections in children. Mortality in HI meningitis children is high and the third generation of cephalosporins, such as ceftriaxone can be used as the first choice for the treatment of invasive HI infection.