The study was conducted to compare the molecular differences of Haemophilus influenzae type b (Hib) strains causing meningitis in young children with H. influenzae strains causing acute upper respiratory tract infection, 44 Hib strains and 37 H. influenzae strains were analysed by pulsed field gel electrophoresis (PFGE) with SmaI restriction enzyme. The results: 44 Hib strains were mainly distributed into 4 DNA restriction patterns (PFGE patterns) whereas 37 H. influenzae strains were distributed into 22 patterns and 81% of them were not encapsulated. The genome of Hib strains causing bacterial meningitis showed less variation than that of H. influenzae causing acute upper respiratory infection. PFGE is a useful tool for epidemiological research.
Haemophilus influenza ; Child

Some techniques of detection of Hib were compared, including classic techniques such as bacterial culture and modern techniques such as PCR method. The results were as follows: 21% (+) culture with Hib compared to the total of clinically diagnosed cases, Hib-latex agglutination with 95% sensitivity and 99.6% specificity, counter immunophoresis assay to detect Hib by 97% sensitivity and 100% specificity. PCR increased the number of positive cases of Hib meningitis by 42.8% compared to culture alone. Blood culture gave a highly significant value to diagnose (51% Hib-possitive culture)
Haemophilus influenza type b ; Meningitis ; methods ; diagnosis

The molecular characteristics of 44 H. influenzae strains were isolated from children with bacterial meningitis and 37 strains were isolated from children with acute respiratory infection were investigated. Of the 37 H. influenzae isolates from nasopharyngeal aspirates (NA), the serotype of 30 isolates were nontypeable, 4 were type b, 2 were type c and one was type a. Whereas those of 44 isolates from cerebrospinal fluid (CSF) were all type b. Twenty-six (70.3%) from NA and 23 strains from CSF were beta lactamase-producing, and the remaining strains were beta lactamase negative. PCR analysis to identify the resistant genes indicates 25 strains from NA and 21 strains from CSF had TEM-l-type-beta lactamase gene, 11 strains from NA and 22 strains from CSF lack all resistant genes, and each strain from NA and CSF had TEM-l-type beta lactamase gene and fts I gene with the same substitution as the low -betalactamase-negative ampicillin resistant (low-BLNAR) strain. No BLNAR strain was found. The MICs against 16 antibiotics between isolates from NA and CSF were similar except for penicillin G and ampicillin.
Haemophilus influenza ; Pediatrics ; Meningitis ; Bacterial Infections

Haemophilus influenzae type b(Hib) is one of the most common cause of invasive bacterial disease in children. In Korea, However, the proportion occupied by Hib as a cause of pediatric pathogen is less compared to those of western countries. Natural immunity to Haemophilus influenzae type b was determined on 308 Korean children. The titration of antibody to capsular polysaccharide (PRP) was performed by the radioantigen binding assay. Forty percent of the total subjects and 31% of children under 5 years had an antibody level considered to be protective( 0.15 g/ml).Seropositivity was 13.6% in 12~17 month age group, and increased progressively to 19% in 5~10 year age group. In the age groups under 36 months of age, the geometric mean titers of anti-PRP antibody were below the protective level. These data indicate that a lot of Korean children under 5 years of age do not have antibody levels considered to be protective against H. influenzae type b, and do not explain the apparent low risk of Korean children to Hib Further studies including comparative antibody response to polysa-charide and protein antigens with other racial groups are needed.
Antibody Formation ; Child* ; Haemophilus influenzae type b* ; Haemophilus influenzae* ; Haemophilus* ; Humans ; Immunity, Innate ; Influenza, Human ; Korea

Among the fifty-three clinical isolates of Haemophilus influenzae, nineteen isolates including eight isolates of each biotype I-VIII, six of serotype b (Hib) strains and five of nontypeable strains were characterized by SDS-PAGE about outer membrane protein (OMP), restriction enzyme analysis (REA) and rRNA gene restriction pattems. OMP patterns showed to common band patterns in each H. influenzae isolate. Based on the two major proteins, 31KDa-38KDa, isolated strains were classified into 7 subtypes. In the OMP patterns about biotype and serotype, the specific pattern of each biotype was not distinguishable, but all of the serotype b strains were shown identical unique pattern, therefore it made distinctive difference with nontypeable strains. The digested genomic DNAs with EcoRI were identical result with rRNA gene restriction. It was more subdivided into 10 ribotypes. The most common ribotype I and serotype 1 accounted for 6 strains (31.6%) and 7 strains (36.8%) of the 19 clinical isolates, respectively. Hib isolates that were both OMP subtype 1 and ribotype I accounted for 2 strains (10.5%). In the epidemiologically unrelated strains, the putative association between the subtypes could not be confirmed. According to these results, the three methods were discriminatory and appropriate techniques for epidemiological studies of H. influenzae.
DNA ; Electrophoresis, Polyacrylamide Gel* ; Genes, rRNA* ; Haemophilus influenzae type b ; Haemophilus influenzae* ; Haemophilus* ; Influenza, Human ; Membrane Proteins ; Restriction Mapping* ; Ribotyping

Haemophilus influenzae grows both aerobically and anaerobically and is an exclusively human pathogen. We present a case of septicemia originating from unilateral sphenoid sinusitis caused by non-typeable H. influenzae. No reports of sinusitis presenting as septicemia in a healthy young immunocompetent adult in South Korea have previously been published.
Adult ; Haemophilus influenzae* ; Haemophilus* ; Humans ; Influenza, Human ; Korea ; Sepsis* ; Sinusitis ; Sphenoid Sinus* ; Sphenoid Sinusitis*

Since the implementation of conjugate Haemophilus influenzae serotype b (Hib) vaccine, the rate of infections caused by Hib has dramatically decreased, and the proportion of infections caused by non-type b H. influenzae has increased. Cerebral venous sinus thrombosis (CVST) is rare; however, it should be considered as a potential complication of bacterial meningitis. Herein, we report about a child who developed CVST after being diagnosed with H. influenzae serotype f meningitis.
Bacteremia ; Central Nervous System Infections ; Cerebrospinal Fluid ; Child ; Haemophilus influenzae type b ; Haemophilus influenzae ; Haemophilus ; Humans ; Influenza, Human ; Meningitis ; Meningitis, Bacterial ; Meningitis, Haemophilus ; Sepsis ; Serogroup ; Sinus Thrombosis, Intracranial

Vertebral osteomyelitis is primarily seen in middle-aged individuals, with a mean age of presentation of ~60 years. Recent trends suggest an increase in the incidence of vertebral osteomyelitis due to longer life expectancy of patients with chronic debilitating diseases. Haemophilus influenzae is a small, fastidious, gram-negative bacillus, which is known to cause infections in young children. While invasive H. influenzae infections have become increasingly common in adult populations, bone infections caused by this organism remain extremely rare. The existing medical literature includes only 11 reports of vertebral osteomyelitis caused by H. influenzae since 1978, with no reports of H. influenzae-associated vertebral osteomyelitis observed in Korea. Here, we present the case of a 72-year old patient with hematogenous vertebral osteomyelitis and psoas abscess caused by non-typeable H. influenzae.
Adult ; Bacillus ; Bacteremia* ; Child ; Haemophilus ; Haemophilus influenzae* ; Humans ; Incidence ; Influenza, Human ; Korea ; Life Expectancy ; Osteomyelitis* ; Psoas Abscess*

Vertebral osteomyelitis is primarily seen in middle-aged individuals, with a mean age of presentation of ~60 years. Recent trends suggest an increase in the incidence of vertebral osteomyelitis due to longer life expectancy of patients with chronic debilitating diseases. Haemophilus influenzae is a small, fastidious, gram-negative bacillus, which is known to cause infections in young children. While invasive H. influenzae infections have become increasingly common in adult populations, bone infections caused by this organism remain extremely rare. The existing medical literature includes only 11 reports of vertebral osteomyelitis caused by H. influenzae since 1978, with no reports of H. influenzae-associated vertebral osteomyelitis observed in Korea. Here, we present the case of a 72-year old patient with hematogenous vertebral osteomyelitis and psoas abscess caused by non-typeable H. influenzae.
Adult ; Bacillus ; Bacteremia* ; Child ; Haemophilus ; Haemophilus influenzae* ; Humans ; Incidence ; Influenza, Human ; Korea ; Life Expectancy ; Osteomyelitis* ; Psoas Abscess*

OBJECTIVETo analyze the occurrence feature of adverse events following immunization (AEFI) of Hib conjugate vaccine (HibCV) and to evaluate the safety of HibCV in postmarketing.

METHODS2008-2013 HibCV AEFI data were collected through national AEFI information management system, which were downloaded in March 18, 2014.The demographic information and inoculation quantity of HibCV were from Immunization information management system in Jiangsu province. The incidence rate and 95% CI value of AEFI, common vaccine reaction and rare vaccine reaction following immunization of HibCV were calculated. The differences in the incidence rate of common vaccine reaction and rare vaccine reaction among sex, months of age, and number of injections were compared by means of (χ² tests.

RESULTSA total of 6.16 million doses of vaccine were administered in Jiangsu province during 2008-2013, and 4 718 vaccinees reported having adverse event, for a rate of 76.60/100 000 (95% CI: 74.42/100 000-78.79/100 000). The incidence rate of common vaccine reaction and rare vaccine reaction was 71.10/100 000 (95% CI: 68.99/100 000-73.20/100 000) and 5.16/100 000 (95% CI: 4.60/100 000-5.73/100 000), respectively. The main symptoms of common vaccine reactions were fever, swelling, indurations and gastrointestinal reactions. The incidence rates of them were 40.54/100 000, 35.09/100 000, 12.94/100 000 and 0.36/100 000 in turn. The main symptoms of rare vaccine reactions were anaphylactic rashes and angioedema, the incidence rates of which were 4.77/100 000 and 0.15/100 000 respectively. 91.39% (4 002/4 379) of common vaccine reactions and 88.36% (281/318) of rare vaccine reactions happened within 1 d after vaccination. Anaphylactic shock (3 cases) and laryngeal edema (1 case) all happened within 1 d after vaccination. The incidence rate of common vaccine reactions among boys (79.72/100 000, 2 641/3 313 071) was higher than that of girls (61.07/100 000, 1 738/2 846 001) (χ² = 74.92, P < 0.001). The incidence rate of common vaccine reactions among children aged ≥ 12 month-old (86.82/100 000, 2 200/2 533 949) was higher than that among children aged 2-11 month-old (60.11/100 000, 2 179/3 625 123) (χ² = 149.79, P < 0.001). The incidence rate of common vaccine reactions in children vaccinated the first dose (78.93/100 000, 2 666/3 377 614) was higher than that in children vaccinated the second or third or fourth dose (61.59/100 000, 1 713/2 781 458) (χ² = 64.59, P < 0.001). The incidence rate of rare vaccine reactions in children vaccinated the first dose (6.69/100 000, 226/3 377 614) was higher than that in children vaccinated the second or third or fourth dose (3.31/100 000, 92/2 781 458) (χ² = 33.82, P < 0.001).

CONCLUSIONThe safety of HibCV among children was relative good. However, the surveillance should still focus on the anaphylactoid reactions of anaphylactic shock and laryngeal edema after HibCV immunization.

Angioedema ; Bacterial Capsules ; Child ; Female ; Fever ; Haemophilus Infections ; Haemophilus Vaccines ; adverse effects ; Haemophilus influenzae type b ; Humans ; Hypersensitivity ; Immunization ; Influenza, Human ; Male ; Safety ; Vaccination ; Vaccines, Conjugate