Invasive Haemophilus influenzae Type b Disease in the Post Hexavalent Era: Ten Years of Molecular Surveillance in Tuscany.
Bronchoalveolar Lavage Fluid
/ microbiology
Child, Preschool
Epidemiological Monitoring
Haemophilus Infections
/ blood
Haemophilus Vaccines
/ immunology
Haemophilus influenzae type b
/ genetics
Humans
Immunization Schedule
Incidence
Infant
Infant, Newborn
Italy
/ epidemiology
Retrospective Studies
Vaccines, Combined
/ immunology
Journal
The Pediatric infectious disease journal
ISSN: 1532-0987
Titre abrégé: Pediatr Infect Dis J
Pays: United States
ID NLM: 8701858
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
pubmed:
8
2
2020
medline:
10
2
2021
entrez:
8
2
2020
Statut:
ppublish
Résumé
The epidemiologic characteristics of invasive Haemophilus influenzae type b disease (HIBD) have markedly changed since the introduction of the Haemophilus influenzae type b (Hib) conjugate vaccine worldwide. The immunization schedule against Haemophilus influenzae type b differs in Europe. This is a retrospective observational study which evaluates all the data included in the molecular surveillance register for invasive infectious diseases at the Laboratory of Molecular Diagnosis at Meyer Children's University Hospital from December 2008 to December 2018 with a diagnosis of invasive HIBD in children <5 years of age. We identified 4 cases of HIBD: all the cases presented signs or symptoms of invasive infection and the H. influenzae type b was identified in cerebrospinal fluid, or blood or bronchoalveolar lavage by molecular test. The crude incidence for Hib invasive disease in Tuscany is 0.26/100,000 p-y in children younger than 5 years, significantly different from the incidence rate before the introduction of the Hib vaccination. Vaccination effectiveness can be estimated at 97.9% and the impact of hexavalent (2p+1) vaccine at 99.6%. This work confirms the high impact of the hexavalent vaccine 2p+1 schedule for HIBD in children <5 years, emphasizing the role of molecular test for HIBD diagnosis and surveillance.
Sections du résumé
BACKGROUND
The epidemiologic characteristics of invasive Haemophilus influenzae type b disease (HIBD) have markedly changed since the introduction of the Haemophilus influenzae type b (Hib) conjugate vaccine worldwide. The immunization schedule against Haemophilus influenzae type b differs in Europe.
METHODS
This is a retrospective observational study which evaluates all the data included in the molecular surveillance register for invasive infectious diseases at the Laboratory of Molecular Diagnosis at Meyer Children's University Hospital from December 2008 to December 2018 with a diagnosis of invasive HIBD in children <5 years of age.
RESULTS
We identified 4 cases of HIBD: all the cases presented signs or symptoms of invasive infection and the H. influenzae type b was identified in cerebrospinal fluid, or blood or bronchoalveolar lavage by molecular test. The crude incidence for Hib invasive disease in Tuscany is 0.26/100,000 p-y in children younger than 5 years, significantly different from the incidence rate before the introduction of the Hib vaccination. Vaccination effectiveness can be estimated at 97.9% and the impact of hexavalent (2p+1) vaccine at 99.6%.
CONCLUSIONS
This work confirms the high impact of the hexavalent vaccine 2p+1 schedule for HIBD in children <5 years, emphasizing the role of molecular test for HIBD diagnosis and surveillance.
Identifiants
pubmed: 32032175
doi: 10.1097/INF.0000000000002588
pii: 00006454-202004000-00007
doi:
Substances chimiques
Haemophilus Vaccines
0
Vaccines, Combined
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
294-297Références
Centers for Disease Control and Prevention. Active Bacterial Core Surveillance (ABCs) [online]. Available from: https://www.cdc.gov/hi-disease/clinicians.html. Accessed September 10, 2019.
Peltola H. Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century: global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates. Clin Microbiol Rev. 2000;13:302–317.
Orsi A, Azzari C, Bozzola E, et al. Hexavalent vaccines: characteristics of available products and practical considerations from a panel of Italian experts. J Prev Med Hyg. 2018;59:E107–E119.
ECDC. European Centre for Disease Prevention and Control. Surveillance of invasive bacterial diseases in Europe [online]. Available from: https://vaccine-schedule.ecdc.europa.eu. Accessed September 10, 2019.
Baldo P, Bonanni M, Castro G, et al. Combined hexavalent diphtheria-tetanus-acellular pertussis, hepatitis, B, inactivated poliovirus, Haemophilus influenzae type b vaccine; Infanrix™ hexa: twelve years of experience in Italy. Hum Vaccin Immunother. 2014;10:129–137.
Public Health Agency of the Tuscany Region [online]. Available from: https://www.ars.toscana.it/2-articoli/4043-la-sorveglianza-delle-malattie-infettive-in-toscana.html. Accessed September 10, 2019.
Giufrè M, Cardines R, Caporali MG, et al. Ten years of Hib vaccination in Italy: prevalence of non-encapsulated Haemophilus influenzae among invasive isolates and the possible impact on antibiotic resistance. Vaccine. 2011;29:3857–3862.
Martinelli D, Azzari C, Bonanni P, et al. Impact of Haemophilus influenzae type b conjugate vaccination on hospitalization for invasive disease in children fifteen years after its introduction in Italy. Vaccine. 2017;35:6297–6301.
Azzari C, Nieddu F, Moriondo M, et al. Underestimation of invasive meningococcal disease in Italy. Emerg Infect Dis. 2016;22:469–475.
Italian National Statistics Institute [online]. Available from:http://dati.istat.it/Index.aspx?QueryId=18561#. Accessed September 10, 2019.
Meyler KL, Meehan M, Bennett D, et al. Development of a diagnostic real-time polymerase chain reaction assay for the detection of invasive Haemophilus influenzae in clinical samples. Diagn Microbiol Infect Dis. 2012;74:356–362.
Maaroufi Y, De Bruyne JM, Heymans C, et al. Real-time PCR for determining capsular serotypes of Haemophilus influenzae. J Clin Microbiol. 2007;45:2305–2308.
Ciofi degli Atti ML, Cerquetti M, Tozzi AE, et al.; Haemophilus influenzae Study Group. Haemophilus influenzae invasive disease in Italy, 1997-1998. Eur J Clin Microbiol Infect Dis. 2001;20:436–437.
Wang S, Tafalla M, Hanssens L, et al. A review of Haemophilus influenzae disease in Europe from 2000–2014: challenges, successes and the contribution of hexavalent combination vaccines. Expert Rev Vaccines. 2017; 16:1095–1105
ECDC. European Centre for Disease Prevention and Control. Surveillance of invasive bacterial diseases in Europe [online]. Available from: https://atlas.ecdc.europa.eu/public/index.aspx. Accessed September 10, 2019.
Heinsbroek E, Ladhani S, Gray S, et al. Added value of PCR-testing for confirmation of invasive meningococcal disease in England. J Infect. 2013;67:385–390.
Ricci S, Montemaggi A, Nieddu F, et al. Is primary meningococcal arthritis in children more frequent than we expect? Two pediatric case reports revealed by molecular test. BMC Infect Dis. 2018;18:703.
Azzari C, Serranti D, Nieddu F, et al. Significant impact of pneumococcal conjugate vaccination on pediatric parapneumonic effusion: Italy 2006-2018. Vaccine. 2019;37:2704–2711
Dunne EM, Mantanitobua S, Singh SP, et al. Real-time qPCR improves meningitis pathogen detection in invasive bacterial-vaccine preventable disease surveillance in Fiji. Sci Rep. 2016;6:39784.
Ladhani S, Oeser C, Sheldon J, et al. Immunoglobulin deficiency in children with Hib vaccine failure. Vaccine. 2011;29:9137–9140.
Heath PT, Booy R, Griffiths H, et al. Clinical and immunological risk factors associated with Haemophilus influenzae type b conjugate vaccine failure in childhood. Clin Infect Dis. 2000;31:973–980.
Esposito S, Serra D, Gualtieri L, et al. Vaccines and preterm neonates: why, when, and with what. Early Hum Dev. 2009;85(10 suppl):S43–S45.
Omeñaca F, Vázquez L, Garcia-Corbeira P, et al. Immunization of preterm infants with GSK’s hexavalent combined diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus-Haemophilus influenzae type b conjugate vaccine: a review of safety and immunogenicity. Vaccine. 2018;36:986–996.
Omeñaca F, Garcia-Sicilia J, García-Corbeira P, et al. Antipolyribosyl ribitol phosphate response of premature infants to primary and booster vaccination with a combined diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated polio virus/Haemophilus influenzae type b vaccine. Pediatrics. 2007;119:e179–e185.
Heath P, Booy R, McVernon J., et al. Hib vaccination in infants born prematurely. Arch Dis Child. 2003; 88: 206–210