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Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil
BACKGROUND: Haemophilus influenzae (Hi) serotype b (Hib) conjugate vaccine was incorporated into the infant immunisation schedule in Brazil in 1999, where Hib was one of the major etiologic sources of community-acquired bacterial meningitis. OBJECTIVES: The purpose of this study is to describe the m...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Instituto Oswaldo Cruz, Ministério da Saúde
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319370/ https://www.ncbi.nlm.nih.gov/pubmed/28225904 http://dx.doi.org/10.1590/0074-02760160391 |
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author | Tuyama, Mari Corrêa-Antônio, Jessica Schlackman, Jessica Marsh, Jane W Rebelo, Maria C Cerqueira, Elaine O Nehab, Márcio Kegele, Fabíola Carmo, Getúlio F Thielmann, Dominique CA Barroso, Paulo F Harrison, Lee H Barroso, David E |
author_facet | Tuyama, Mari Corrêa-Antônio, Jessica Schlackman, Jessica Marsh, Jane W Rebelo, Maria C Cerqueira, Elaine O Nehab, Márcio Kegele, Fabíola Carmo, Getúlio F Thielmann, Dominique CA Barroso, Paulo F Harrison, Lee H Barroso, David E |
author_sort | Tuyama, Mari |
collection | PubMed |
description | BACKGROUND: Haemophilus influenzae (Hi) serotype b (Hib) conjugate vaccine was incorporated into the infant immunisation schedule in Brazil in 1999, where Hib was one of the major etiologic sources of community-acquired bacterial meningitis. OBJECTIVES: The purpose of this study is to describe the molecular epidemiology of invasive Hi disease in Rio de Janeiro state, Brazil, before and after vaccine introduction. METHODS: Surveillance data from 1986 to 2014 were analysed. Hi isolates recovered from cerebrospinal fluid (CSF) or blood from 1993 to 2014 were serotyped by slide agglutination, genotyped by multilocus sequence typing (MLST), and the capsule type evaluation, differentiation of serologically non-typeable isolates, and characterisation of the capsule (cap) locus was done by polymerase chain reaction. Antimicrobial susceptibility testing was performed using E-test. FINDINGS: From 1986 to 1999 and from 2000 to 2014, 2580 and 197 (42% without serotype information) confirmed cases were reported, respectively. The case fatality rate was 17% and did not correlate with the strain. Hib and b(-) variant isolates belonged to ST-6, whereas serotype a isolates belonged to the ST-23 clonal complex. Serotype a appeared to emerge during the 2000s. Non-encapsulated isolates were non-clonal and distinct from the encapsulated isolates. Ampicillin-resistant isolates were either of serotype b or were non-encapsulated, and all of them were β-lactamase-positive but amoxicillin-clavulanic acid susceptible. MAIN CONCLUSIONS: Although Hi meningitis became a relatively rare disease in Rio de Janeiro after the introduction of the Hib conjugate vaccine, the isolates recovered from patients have become more diverse. These results indicate the need to implement an enhanced surveillance system to continue monitoring the impact of the Hib conjugate vaccine. |
format | Online Article Text |
id | pubmed-5319370 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Instituto Oswaldo Cruz, Ministério da Saúde |
record_format | MEDLINE/PubMed |
spelling | pubmed-53193702017-03-01 Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil Tuyama, Mari Corrêa-Antônio, Jessica Schlackman, Jessica Marsh, Jane W Rebelo, Maria C Cerqueira, Elaine O Nehab, Márcio Kegele, Fabíola Carmo, Getúlio F Thielmann, Dominique CA Barroso, Paulo F Harrison, Lee H Barroso, David E Mem Inst Oswaldo Cruz Articles BACKGROUND: Haemophilus influenzae (Hi) serotype b (Hib) conjugate vaccine was incorporated into the infant immunisation schedule in Brazil in 1999, where Hib was one of the major etiologic sources of community-acquired bacterial meningitis. OBJECTIVES: The purpose of this study is to describe the molecular epidemiology of invasive Hi disease in Rio de Janeiro state, Brazil, before and after vaccine introduction. METHODS: Surveillance data from 1986 to 2014 were analysed. Hi isolates recovered from cerebrospinal fluid (CSF) or blood from 1993 to 2014 were serotyped by slide agglutination, genotyped by multilocus sequence typing (MLST), and the capsule type evaluation, differentiation of serologically non-typeable isolates, and characterisation of the capsule (cap) locus was done by polymerase chain reaction. Antimicrobial susceptibility testing was performed using E-test. FINDINGS: From 1986 to 1999 and from 2000 to 2014, 2580 and 197 (42% without serotype information) confirmed cases were reported, respectively. The case fatality rate was 17% and did not correlate with the strain. Hib and b(-) variant isolates belonged to ST-6, whereas serotype a isolates belonged to the ST-23 clonal complex. Serotype a appeared to emerge during the 2000s. Non-encapsulated isolates were non-clonal and distinct from the encapsulated isolates. Ampicillin-resistant isolates were either of serotype b or were non-encapsulated, and all of them were β-lactamase-positive but amoxicillin-clavulanic acid susceptible. MAIN CONCLUSIONS: Although Hi meningitis became a relatively rare disease in Rio de Janeiro after the introduction of the Hib conjugate vaccine, the isolates recovered from patients have become more diverse. These results indicate the need to implement an enhanced surveillance system to continue monitoring the impact of the Hib conjugate vaccine. Instituto Oswaldo Cruz, Ministério da Saúde 2017-02-16 2017-03 /pmc/articles/PMC5319370/ /pubmed/28225904 http://dx.doi.org/10.1590/0074-02760160391 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Articles Tuyama, Mari Corrêa-Antônio, Jessica Schlackman, Jessica Marsh, Jane W Rebelo, Maria C Cerqueira, Elaine O Nehab, Márcio Kegele, Fabíola Carmo, Getúlio F Thielmann, Dominique CA Barroso, Paulo F Harrison, Lee H Barroso, David E Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil |
title | Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil |
title_full | Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil |
title_fullStr | Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil |
title_full_unstemmed | Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil |
title_short | Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil |
title_sort | invasive haemophilus influenzae disease in the vaccine era in rio de janeiro, brazil |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319370/ https://www.ncbi.nlm.nih.gov/pubmed/28225904 http://dx.doi.org/10.1590/0074-02760160391 |
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