Haemophilus influenzae Type b Vaccine Failure in Portugal: A Nationwide Multicenter Pediatric Survey.
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:
01 09 2023
01 09 2023
Historique:
medline:
23
8
2023
pubmed:
5
7
2023
entrez:
5
7
2023
Statut:
ppublish
Résumé
Despite the high effectiveness of the Haemophilus influenzae type b (Hib) vaccine in preventing invasive disease (ID) in children, Hib vaccine failures (VFs) cases may still occur. This study aimed to characterize the Hib-VF cases in Portugal in a 12-year period and trying to identify the possible associated risk factors. Prospective descriptive nationwide surveillance study. Bacteriologic and molecular studies were performed at the same Reference Laboratory. Clinical data were collected by the referring pediatrician. Hib was identified in 41 children with ID and 26 (63%) were considered VF. Nineteen (73%) cases occurred in children less than 5 years old; 12 (46%) occurred before the Hib vaccine booster dose at 18 months of age. Comparing the first and the last 6-year periods of the study, the incidence rate of Hib, VF and total H. influenzae (Hi) ID significantly raised ( P < 0.05). VF cases corresponded, respectively, to 13.5% (7/52) and 22% (19/88) of total Hi-ID cases ( P = 0.232). Two children died due to epiglottitis and 1 acquired sensorineural hearing loss. Only 1 child had an inborn error of immunity. The immunologic workup performed in 9 children revealed no significant abnormalities. All 25 Hib-VF strains analyzed belonged to the same clonal complex 6. In Portugal, more than 95% of children are vaccinated against Hib, but severe Hib-ID cases still occur. No predisposing factors were clearly identified to justify the increased number of VF in recent years. Along with continued Hi-ID surveillance, Hib colonization and serologic studies should be implemented.
Sections du résumé
BACKGROUND
Despite the high effectiveness of the Haemophilus influenzae type b (Hib) vaccine in preventing invasive disease (ID) in children, Hib vaccine failures (VFs) cases may still occur. This study aimed to characterize the Hib-VF cases in Portugal in a 12-year period and trying to identify the possible associated risk factors.
METHODS
Prospective descriptive nationwide surveillance study. Bacteriologic and molecular studies were performed at the same Reference Laboratory. Clinical data were collected by the referring pediatrician.
RESULTS
Hib was identified in 41 children with ID and 26 (63%) were considered VF. Nineteen (73%) cases occurred in children less than 5 years old; 12 (46%) occurred before the Hib vaccine booster dose at 18 months of age. Comparing the first and the last 6-year periods of the study, the incidence rate of Hib, VF and total H. influenzae (Hi) ID significantly raised ( P < 0.05). VF cases corresponded, respectively, to 13.5% (7/52) and 22% (19/88) of total Hi-ID cases ( P = 0.232). Two children died due to epiglottitis and 1 acquired sensorineural hearing loss. Only 1 child had an inborn error of immunity. The immunologic workup performed in 9 children revealed no significant abnormalities. All 25 Hib-VF strains analyzed belonged to the same clonal complex 6.
CONCLUSIONS
In Portugal, more than 95% of children are vaccinated against Hib, but severe Hib-ID cases still occur. No predisposing factors were clearly identified to justify the increased number of VF in recent years. Along with continued Hi-ID surveillance, Hib colonization and serologic studies should be implemented.
Identifiants
pubmed: 37406244
doi: 10.1097/INF.0000000000004011
pii: 00006454-202309000-00021
doi:
Substances chimiques
Haemophilus Vaccines
0
Vaccines, Conjugate
0
Types de publication
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
824-828Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Howard Hughes Medical Institute
Pays : United States
Investigateurs
Celia Bettencourt
(C)
Arminda Maria Jorge
(AM)
Maria Conceição Faria
(MC)
Carla Zilhão
(C)
Laura Marques
(L)
Conceição Casanova
(C)
Cristiana Pereira
(C)
Fernando Fonseca
(F)
Cláudia Monteiro
(C)
Mariana Bettencourt
(M)
Diana Moreira
(D)
Fernanda Rodrigues
(F)
Henrique Oliveira
(H)
Catarina Sousa
(C)
Graciete Pinheiro
(G)
Sara Diogo Santos
(SD)
Adília Vicente
(A)
Tiago Milheiro
(T)
Margarida Pinto
(M)
Graça Seves
(G)
Rosa Bento
(R)
M ª João Virtuoso
(MªJ)
Rita Fonseca
(R)
Maria Dinah Carvalho
(MD)
Luís Lito
(L)
Carla Cruz
(C)
Adriana Coutinho
(A)
Paula Correia
(P)
Luísa Sancho
(L)
Elzara Aliyeva
(E)
Cristina Freitas
(C)
Nuno Canhoto
(N)
Ana Filipa Nunes
(AF)
Ana Maria Queiroz
(AM)
José Diogo
(J)
Maria Manuel Flores
(MM)
Paula Reis
(P)
Elmano Ramalheira
(E)
Maria Manuel Zarcos
(MM)
Sofia Lima
(S)
Susana Castilho
(S)
Catarina Lacerda
(C)
Luísa Teixeira
(L)
Ana Maria Jesus
(AM)
Sofia Maia Aroso
(S)
Margarida Tavares
(M)
Bonito Vitor
(B)
Angélica Ramos
(A)
Manuela Costa Alves
(MC)
Isabel Cunha
(I)
Alberta Faustino
(A)
Álvaro Sousa
(Á)
Margarida Rodrigues
(M)
Idalina Maciel
(I)
Sandra Vieira
(S)
Jorge Rodrigues
(J)
Elisabete Santos
(E)
Alexandra Costa
(A)
Filomena Martins
(F)
Carlos Escobar
(C)
Pedro Flores
(P)
Maria Favila Menezes
(MF)
João Calado Nunes
(JC)
Ana Neto
(A)
Marina Soares
(M)
Rita Mouro Pinto
(RM)
Diana Almeida
(D)
Isabel Brito
(I)
Hermínia Costa
(H)
Fátima Silva
(F)
Joana Cardoso
(J)
Magalys Pereira
(M)
Luís Gonçalves
(L)
João Tavares
(J)
Sofia Botelho Moniz
(SB)
Eurico Jorge Gaspar
(EJ)
Joana Carvalho
(J)
Ana Paula Castro
(AP)
Álvaro Sousa
(Á)
Catarina Francisco
(C)
João Farela Neves
(J)
Paulo Paixão
(P)
Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
Bajanca P, Caniça M; Multicenter Study Group. Emergence of nonencapsulated and encapsulated non-b-type invasive Haemophilus influenzae isolates in Portugal (1989-2001). J Clin Microbiol. 2004;42:807–810.
Bajanca-Lavado MP, Simões AS, Betencourt CR, et al.; Portuguese Group for Study of Haemophilus influenzae invasive infection. Characteristics of Haemophilus influenzae invasive isolates from Portugal following routine childhood vaccination against H. influenzae serotype b (2002-2010). Eur J Clin Microbiol Infect Dis. 2014;33:603–610.
Heliodoro CIM, Bettencourt CR, Bajanca-Lavado MP; Portuguese Group for the Study of Haemophilus influenzae invasive infection. Molecular epidemiology of invasive Haemophilus influenzae disease in Portugal: an update of the post-vaccine period, 2011-2018. Eur J Clin Microbiol Infect Dis. 2020;39:1471–1480.
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.
Ladhani S, Heath PT, Slack MPE, et al.; Participants of the European Union Invasive Bacterial Infections Surveillance Network. Haemophilus influenzae serotype b conjugate vaccine failure in twelve countries with established national childhood immunization programmes. Clin Microbiol Infect. 2010;16:948–954.
Purohit P, Al-Obaid IA, Omar NG. The first reported case of possible Haemophilus influenzae type b vaccine failure from Kuwait and literature-review. J Infect Public Health. 2014;7:99–105.
Meyler K, Meehan M, Bennett D, et al. Spontaneous capsule loss in Haemophilus influenzae serotype b associated with Hib conjugate vaccine failure and invasive disease. Clin Microbiol Infect. 2019;25:390–391.
Hong E, Terrade A, Denizon M, et al. Haemophilus influenzae type b (Hib) seroprevalence in France: impact of vaccination schedules. BMC Infect Dis. 2021;21:715.
Rouers EDM, Bruijning-Verhagen PCJ, van Gageldonk PGM, et al. Association of routine infant vaccinations with antibody levels among preterm infants. JAMA. 2020;324:1068–1077.
Steens AS, Stanoeva KR, Knol MJ, et al. Increase in invasive disease caused by Haemophilus influenzae b, the Netherlands, 2020 to 2021. Euro Surveill. 2021;26:2100956.
Collins S, Litt D, Almond R, et al. Haemophilus influenzae type b (Hib) seroprevalence and current epidemiology in England and Wales. J Infect. 2017;76:335–341.
Akeda Y, Koizumi Y, Takanami Y, et al. Comparison of serum bactericidal and antibody titers induced by two Haemophilus influenzae type b conjugate vaccines: a phase III randomized double-blind study. Vaccine. 2018;36:1528–1532.
Falla TJ, Crook DW, Brophy LN, et al. PCR for capsular typing of Haemophilus influenzae. J Clin Microbiol. 1994;32:2382–2386.
Meats E, Feil EJ, Stringer S, et al. Characterization of encapsulated and noncapsulated Haemophilus influenzae and determination of phylogenetic relationships by multilocus sequence typing. J Clin Microbiol. 2003;41:1623–1636.
PubMLST. H. influenzae MLST. Available at: https://pubmlst.org/organisms/haemophilus-influenzae/ . Accessed November 17, 2022.
Direção-Geral da Saúde. Programa Nacional de Vacinação, Boletim nº 5. 2022. Available at: https://www.dgs.pt/documentos-e-publicacoes/boletim-n-5-do-programa-nacional-de-vacinacao-abril-2022-pdf.aspx . Accessed January 26, 2023.
Chandran A, Watt JP, Santosham M. Haemophilus influenzae vacines. In: Plotkin SA, Orenstein WA, Offit PA, eds. Vaccines. 6th ed. Elsevier Saunders; 2013:167–187.
Bamberger EE, Ben-Shimol S, Abu-Raya B, et al. Pediatric invasive Haemophilus influenzae infections in Israel in the era of Haemophilus influenzae type b vaccine: a nationwide prospective study. Pediatr Infect Dis J. 2014;33:477–481.
Giufrè M, Cardines R, Accogli M, et al. Identification of Haemophilus influenzae clones associated with invasive disease a decade after introduction of H. influenzae serotype b vaccination in Italy. Clin Vaccine Immunol. 2013;20:1223–1229.
Pinto M, González-Díaz A, Machado MP, et al. Insights into the population structure and pan-genome of Haemophilus influenzae . Infect Genet Evol. 2019;67:126–135.
Cerquetti M, Cardines R, Ciofi Degli Atti ML, et al. Presence of multiple copies of the capsulation b locus in invasive Haemophilus influenzae type b (Hib) strains isolated from children with Hib conjugate vaccine failure. J Infect Dis. 2005;192:819–823.
Efron A, Nápoli D, Neyro S, et al.; Argentinean H. influenzae Working Group. Laboratory surveillance of invasive Haemophilus influenzae disease in Argentina, 2011-2019. Rev Argent Microbiol. 2023;55:133–142.
Deghmane A-E, Taha M-K. Changes in invasive Neisseria meningitidis and Haemophilus influenzae infections in France during the COVID-19 pandemic. Microorganisms. 2022;10:907.
Steens A, Knol MJ, Freudenburg-de Graaf W, et al. Pathogen- and type-specific changes in invasive bacterial disease epidemiology during the first year of the COVID-19 pandemic in the Netherlands. Microorganisms. 2022;10:972.
Direção-Geral da Saúde. Programa Nacional de Vacinação, Boletim nº 2. 2019. Available at: https://www.dgs.pt/documentos-e-publicacoes/boletim-n-2-do-programa-nacional-de-vacinacao-maio-2019-pdf.aspx . Accessed May 7, 2023.
Zimmermann P, Perrett KP, Messina NL, et al. The effect of maternal immunisation during pregnancy on infant vaccine responses. EClinicalMedicine. 2019;13:21–30.
Bajanca-Lavado MP, Cavaco L, Fernandes M, et al. Haemophilus influenzae carriage among healthy children in Portugal, 2015–2019. Microorganisms. 2022;10:1964.
De Lencastre H, Kristinsson KG, Brito-Avô A, et al. Carriage of respiratory tract pathogens and molecular epidemiology of Streptococcus pneumoniae colonization in healthy children attending day care centers in Lisbon, Portugal. Microb Drug Resist. 1999;5:19–29.
Instituto Nacional de Saúde Doutor Ricardo Jorge. Inquérito Serológico Nacional 2015-2016: Doenças Evitáveis por Vacinação. 2017. Available at: http://repositorio.insa.pt/handle/10400.18/5401 . Accessed January 26, 2023.
European Centre for Disease Prevention and Control. Vaccine scheduler. Available at: https://vaccine-schedule.ecdc.europa.eu/ . Accessed January 11, 2023.