PMID- 18280571
OWN - NLM
STAT- MEDLINE
DCOM- 20080313
LR  - 20201209
IS  - 1532-2742 (Electronic)
IS  - 0163-4453 (Linking)
VI  - 56
IP  - 3
DP  - 2008 Mar
TI  - Haemophilus influenzae type-b and non-b-type invasive diseases in urban children 
      (<5years) of Bangladesh: implications for therapy and vaccination.
PG  - 191-6
LID - 10.1016/j.jinf.2007.12.008 [doi]
AB  - OBJECTIVE: To prospectively study the epidemiology and antibiotic resistance of 
      Haemophilus infuenzae isolates from invasive infections in children. METHODS: 
      Children (<5years) with pneumonia, meningitis and septicemia from three hospitals 
      in Dhaka, Bangladesh were enrolled (1999-2003); clinical and laboratory data, and 
      blood for cultures were collected. Cerebrospinal fluid (CSF) of meningitis cases 
      was analyzed (Gram stain, culture and biochemical tests). Hib antigen was 
      detected by latex agglutination (LA) in culture-negative pyogenic CSF and PCR was 
      done for bexA gene in culture- and LA-negative pyogenic CSF. Antibiotic 
      susceptibility was determined by E-Tests and beta-lactamase by nitrocefin stick. 
      RESULTS: Seventy-three cases of H. influenzae infections (46 of 293 meningitis 
      cases, 25 of 1493 pneumonia cases, 2 of 48 septicemia cases) were detected; 63%, 
      34% and 3% of them had meningitis, pneumonia and septicemia respectively. H. 
      influenzae type b (Hib) caused infections in 80.8% of cases (60.3% meningitis, 
      20.5% pneumonia). Most (86%) infections clustered in 4-12month infants. The 
      case-fatality in pneumonia was 8% compared to 19% in meningitis. H. influenzae 
      isolates from pneumonia and meningitis children were equally resistant to 
      antibiotics (46% vs 43%). Of 10 drugs tested, isolates were resistant to 
      ampicillin (31%), chloramphenicol (42%), trimethoprim-sulfamethoxazole (44%) and 
      azithromycin (1.4%). Multidrug-resistant (MDR) strains were equally prevalent in 
      Hib (31%) and non-b-type (29%) isolates, and in pneumonia (31%) and meningitis 
      (34%) cases. None was resistant to amoxicillin-clavulanate, ceftriaxone, 
      ciprofloxacin, levofloxacin, moxifloxacin, and gatifloxacin. Of all H. influenzae 
      infections, 40%, 4.4% and 100% of pneumonia, meningitis and septicemia cases were 
      caused by other serotypes or non-typeable strains. All 
      ampicillin-resistant-strains produced beta-lactamase without detection of 
      beta-lactamase-negative-ampicillin-resistant (BLNAR) strains. CONCLUSION: Hib is 
      a leading cause of invasive bacterial infections in infants. Multidrug-resistant 
      H. influenzae is common and requires amoxicillin-clavulanate, ceftriaxone or 
      azithromycin as empirical therapy with specific recommendation for use of 
      ceftriaxone for treatment of meningitis particularly MDR cases. New 
      fluoroquinolines has potential utility. An effective national Hib vaccination 
      programme is essential in Bangladesh although non-Hib infections will remain an 
      issue.
FAU - Rahman, Mahbubur
AU  - Rahman M
AD  - International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh. 
      mahbubur@icddrb.org
FAU - Hossain, Shahadat
AU  - Hossain S
FAU - Baqui, Abdullah Hel
AU  - Baqui AH
FAU - Shoma, Shereen
AU  - Shoma S
FAU - Rashid, Harunur
AU  - Rashid H
FAU - Nahar, Nazmun
AU  - Nahar N
FAU - Zaman, Mohammed Khalequ
AU  - Zaman MK
FAU - Khatun, Farida
AU  - Khatun F
LA  - eng
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - England
TA  - J Infect
JT  - The Journal of infection
JID - 7908424
RN  - 0 (ATP-Binding Cassette Transporters)
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Antigens, Bacterial)
RN  - 0 (Bacterial Proteins)
RN  - 0 (DNA, Bacterial)
RN  - 117629-04-6 (bexA protein, Haemophilus influenzae)
SB  - IM
MH  - ATP-Binding Cassette Transporters/genetics
MH  - Anti-Bacterial Agents/pharmacology/therapeutic use
MH  - Antigens, Bacterial/blood/cerebrospinal fluid
MH  - Bacterial Proteins/genetics
MH  - Bangladesh/epidemiology
MH  - Blood/microbiology
MH  - Blood Chemical Analysis
MH  - Cerebrospinal Fluid/chemistry/microbiology
MH  - Child, Preschool
MH  - DNA, Bacterial/genetics
MH  - Drug Resistance, Multiple, Bacterial
MH  - Haemophilus Infections/*epidemiology/*microbiology/mortality
MH  - Haemophilus influenzae/classification/*drug effects/*isolation & purification
MH  - Haemophilus influenzae type b/classification/*drug effects/*isolation & 
      purification
MH  - Humans
MH  - Infant
MH  - Latex Fixation Tests
MH  - Meningitis/epidemiology/microbiology/mortality
MH  - Microbial Sensitivity Tests
MH  - Pneumonia, Bacterial/epidemiology/microbiology/mortality
MH  - Polymerase Chain Reaction
MH  - Prospective Studies
MH  - Sepsis/epidemiology/microbiology/mortality
EDAT- 2008/02/19 09:00
MHDA- 2008/03/14 09:00
CRDT- 2008/02/19 09:00
PHST- 2007/03/21 00:00 [received]
PHST- 2007/11/15 00:00 [revised]
PHST- 2007/12/17 00:00 [accepted]
PHST- 2008/02/19 09:00 [pubmed]
PHST- 2008/03/14 09:00 [medline]
PHST- 2008/02/19 09:00 [entrez]
AID - S0163-4453(08)00006-6 [pii]
AID - 10.1016/j.jinf.2007.12.008 [doi]
PST - ppublish
SO  - J Infect. 2008 Mar;56(3):191-6. doi: 10.1016/j.jinf.2007.12.008.