Clinical Characterization of Invasive Disease Caused by Haemophilus influenzae Serotype b in a High Vaccination Coverage Setting

2018 ◽  
Vol 8 (3) ◽  
pp. 261-264
Author(s):  
Susana Monge ◽  
Liesbeth Mollema ◽  
Hester de Melker ◽  
Elisabeth Sanders ◽  
Arie van der Ende ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Haemophilus Influenzae ◽  
Vaccination Coverage ◽  
Invasive Disease ◽  
National Study ◽  
Healthy Children ◽  
Disease Course ◽  
Serotype B

Abstract This national study characterized invasive Haemophilus influenzae serotype b infections. Vaccinated (n = 41) and nonvaccinated (n = 10) cases were similar regarding presentation as meningitis (68.8% vs 90.0%; P = .25), predisposing factors (29.3% vs 20.0%; P = .76), admission to intensive care unit or death (22.0% vs 10.0%; P = 1.00), or sequelae (21.6% vs 10.0%; P = .81). Haemophilus influenzae serotype b occurred in vaccinated, healthy children with comparable disease course.

scholarly journals Fatal, Fulminant and Invasive Non-Typeable Haemophilus influenzae Infection in a Preterm Infant: A Re-Emerging Cause of Neonatal Sepsis

2020 ◽  
Vol 5 (1) ◽  
pp. 30 ◽  
Author(s):  
Sudipta Roy Chowdhury ◽  
Srabani Bharadwaj ◽  
Suresh Chandran
Keyword(s):  
Haemophilus Influenzae ◽  
Preterm Infant ◽  
Neonatal Sepsis ◽  
Group B Streptococcus ◽  
Invasive Disease ◽  
Preventative Measures ◽  
Increased Risk ◽  
Extremely Preterm ◽  
Serotype B ◽  
Group B

Early-onset neonatal sepsis (EOS) is a major cause of neonatal death and long-term neurodevelopmental disabilities among survivors. The common pathogens causing EOS are group B streptococcus (GBS) and Escherichia coli. Haemophilus influenzae (H. influenzae) is a Gram-negative coccobacillus that can cause severe invasive disease and can be divided into either typeable or non-typeable strains. H. influenzae serotype b (Hib) is the most virulent and the major cause of bacterial meningitis in young children prior to routine immunization against Hib. Hib infection rates have dramatically reduced since then. However, a number of studies have reported an increasing incidence of non-typeable H. influenzae (NTHi) sepsis in neonates worldwide and concluded that pregnant women may have an increased risk to invasive NTHi disease with poor pregnancy outcomes. We present a case of fulminant neonatal sepsis caused by NTHi in an extremely preterm infant and discuss potential preventative measures to reduce its re-emergence.

scholarly journals Characterization of Dexmedetomidine Dosing and Safety in Neonates and Infants

2015 ◽  
Vol 20 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Lauren M. Estkowski ◽  
Jennifer L. Morris ◽  
Elizabeth A. Sinclair
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Systolic Blood Pressure ◽  
Vital Signs ◽  
Pediatric Intensive Care ◽  
Neonates And Infants ◽  
To Receive

OBJECTIVES: To describe and compare off-label use and cardiovascular (CV) adverse effects of dexmedetomidine in neonates and infants in the pediatric intensive care unit (PICU). METHODS: Patients younger than 12 months with corrected gestational ages of at least 37 weeks who were receiving continuous infusion of dexmedetomidine at a tertiary pediatric referral center between October 2007 and August 2012 were assessed retrospectively. Patients were excluded if dexmedetomidine was used for procedural sedation, postoperative CV surgery, or if postanesthesia infusion weaning orders existed at the time of PICU admission. RESULTS: The median minimum dexmedetomidine dose was similar between infants and neonates at 0.2 mcg/kg/hr (IQR, 0.17–0.3) versus 0.29 mcg/kg/hr (IQR, 0.2–0.31), p = 0.35. The median maximum dose was higher for infants than neonates (0.6 mcg/kg/hr [IQR, 0.4–0.8] vs. 0.4 mcg/kg/hr [IQR, 0.26–0.6], p < 0.01). Additional sedative use was more common in infants than neonates (75/99 [76%] vs. 15/28 [54%], p = 0.02). At least 1 episode of hypotension was noted in 34/127 (27%) patients and was similar between groups. An episode of bradycardia was identified more frequently in infants than neonates (55/99 [56%] vs. 2/28 [7%], p < 0.01). Significant reduction in heart rate and systolic blood pressure was noted when comparing baseline vital signs to lowest heart rate and systolic blood pressure during infusion (p < 0.01). CONCLUSIONS: Dexmedetomidine dose ranges were similar to US Food and Drug Administration–labeled dosages for intensive care unit sedation in adults. More infants than neonates experienced a bradycardia episode, but infants were also more likely to receive higher dosages of dexmedetomidine and additional sedatives.

Application of Multilocus Enzyme Electrophoresis to Epidemiologic Investigations ofXanthomonas Maltophilia

1991 ◽  
Vol 12 (3) ◽  
pp. 163-167 ◽  
Author(s):  
Barbara Schable ◽  
Margarita E. Villarino ◽  
Martin S. Favero ◽  
J. Michael Miller
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Epidemiological Data ◽  
Case Definition ◽  
Enzyme Electrophoresis ◽  
Typing Method ◽  
Multilocus Enzyme Electrophoresis ◽  
General Community ◽  
Suspected Outbreak

AbstractObjective:To test the utility of a newly developed multilocus enzyme electrophoresis typing method for Xanthomonas maltophilia.Design:Isolates were first screened by slide agglutination, which served as the standard to characterize the outbreak strains. All isolates were then subjected to multilocus enzyme elec-trophoresis and the results analyzed based on epidemiological data.Setting:This outbreak occurred in a shock-trauma intensive care unit of a large general community hospital.Patients:Patients admitted to the shock-trauma intensive care unit who had X maltophilia isolated from any site > 24 hours after admission met the case definition. Specimens from patients who fit the case definition were characterized, as were specimens from other patients that were used as controls for nonoutbreak isolates. Environmental samples were also evaluated for X maltophilia.Results:Most of the 64 isolates received during this outbreak were serotype 10, and when they were subjected to multilocus enzyme electro-phoresis, one electrophoretic type predominated and correlated to most outbreak isolates. Unrelated isolates of serotype 10 from other institutions all exhibited unique electrophoretic types.Conclusion:Application of multilocus enzyme electrophoresis to X maltophilia outbreaks is a valuable addition to the characterization of suspected outbreak strains.

scholarly journals Emergence of Non-Serotype b EncapsulatedHaemophilus influenzaeas a Cause of Pediatric Meningitis in Northwestern Ontario

2013 ◽  
Vol 24 (1) ◽  
pp. 13-16 ◽  
Author(s):  
Pouya Sadeghi-Aval ◽  
Raymond SW Tsang ◽  
Frances B Jamieson ◽  
Marina Ulanova
Keyword(s):  
Bacterial Meningitis ◽  
Haemophilus Influenzae ◽  
Present Article ◽  
Genetic Background ◽  
Antibiotic Sensitivity ◽  
Invasive Disease ◽  
Northwestern Ontario ◽  
Clonal Nature ◽  
Serotype B ◽  
Meningitis In Children

Before the introduction of the conjugate vaccine,Haemophilus influenzaeserotype b (Hib) was the leading cause of bacterial meningitis in children. Although successful in reducing Hib cases, the vaccine confers no protection against other serotypes ofH influenzae, such as a (Hia), or f (Hif). The emergence of invasive disease caused by non-Hib in northwestern Ontario (38 cases between 2002 and 2008) with predominance of Hia was previously reported by the authors. At that time, no cases of pediatric meningitis caused byH influenzaewere recorded in the region. Continued surveillance identified 12 new cases of invasive non-Hib between January 2009 and July 2011. Among these cases, three young children developed meningitis with severe complications caused by Hia or Hif. The present article describes these cases along with the characteristics of recentH influenzaeisolates from the region, (ie, their genetic background and antibiotic sensitivity). The findings point to the clonal nature of circulating Hia strains as well as to an increase in frequency and severity of pediatric invasiveH influenzaeinfections in northwestern Ontario.

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