[en] [en] BACKGROUND: Non-typeable Haemophilus influenzae has become increasingly important as a causative agent of invasive diseases following vaccination against H. influenzae type b. The emergence of antibiotic resistance underscores the necessity to investigate typeable non-b carriage and non-typeable H. influenzae (NTHi) in children.
METHODS: Nasopharyngeal swab samples were taken over a three-year period (2016-2018) from 336 children (6-30 months of age) attending daycare centers (DCCs) in Belgium, and from 218 children with acute otitis media (AOM). Biotype, serotype, and antibiotic resistance of H. influenzae strains were determined phenotypically. Mutations in the ftsI gene were explored in 129 strains that were resistant or had reduced susceptibility to beta-lactam antibiotics. Results were compared with data obtained during overlapping time periods from 94 children experiencing invasive disease.
RESULTS: Overall, NTHi was most frequently present in both carriage (DCC, AOM) and invasive group. This was followed by serotype "f" (2.2%) and "e" (1.4%) in carriage, and "b" (16.0%), "f" (11.7%), and "a" (4.3%) in invasive strains. Biotype II was most prevalent in all studied groups, followed by biotype III in carriage and I in invasive strains. Strains from both groups showed highest resistance to ampicillin (26.7% in carriage vs. 18.1% in invasive group). A higher frequency of ftsI mutations were found in the AOM group than the DCC group (21.6 vs. 14.9% - p = 0.056). Even more so, the proportion of biotype III strains that carried a ftsI mutation was higher in AOM compared to DCC (50.0 vs. 26.3% - p < 0.01) and invasive group.
CONCLUSION: In both groups, NTHi was most frequently circulating, while specific encapsulated serotypes for carriage and invasive group were found. Biotypes I, II and III were more frequently present in the carriage and invasive group. The carriage group had a higher resistance-frequency to the analyzed antibiotics than the invasive group. Interestingly, a higher degree of ftsI mutations was found in children with AOM compared to DCC and invasive group. This data helps understanding the H. influenzae carriage in Belgian children, as such information is scarce.
Disciplines :
Immunology & infectious disease
Author, co-author :
Ekinci, Esra; Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
Willen, Laura; Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
Rodriguez Ruiz, Juan Pablo; Laboratory of Medical Microbiology, University of Antwerp, Wilrijk, Belgium
Maertens, Kirsten; Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
Van Heirstraeten, Liesbet; Laboratory of Medical Microbiology, University of Antwerp, Wilrijk, Belgium
Serrano, Gabriela; National Reference Centre for Haemophilus influenzae, Laboratoire Hospitalier Universitaire de Bruxelles - Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium
Wautier, Magali; National Reference Centre for Haemophilus influenzae, Laboratoire Hospitalier Universitaire de Bruxelles - Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium
Deplano, Ariane; National Reference Centre for Haemophilus influenzae, Laboratoire Hospitalier Universitaire de Bruxelles - Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium
Goossens, Herman; Laboratory of Medical Microbiology, University of Antwerp, Wilrijk, Belgium
Van Damme, Pierre; Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
Beutels, Philippe; Centre for Health Economics Research and Modelling Infectious Diseases, University of Antwerp, Wilrijk, Belgium
Malhotra-Kumar, Surbhi; Laboratory of Medical Microbiology, University of Antwerp, Wilrijk, Belgium
Martiny, Delphine ; Université de Mons - UMONS > Faculté de Médecine et de Pharmac > Service du Doyen de la Faculté de Médecine et Pharmacie ; National Reference Centre for Haemophilus influenzae, Laboratoire Hospitalier Universitaire de Bruxelles - Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium
Theeten, Heidi; Centre for the Evaluation of Vaccination, University of Antwerp, Wilrijk, Belgium
The study is supported by a research grant from Research Foundation Flanders (FWO Research Grant 1150017N, Antigoon ID 33341) and an investigator-initiated research grant from Pfizer.We would like to thank all members of the expert advisory board (HG, R. Cohen, A. Finn, K. Van Herck, and D. Tuerlinckx) for their contribution to the study protocol and interpretation of the results; Research Link–ECSOR operating as the CRO; the cooperating nurses, physicians, ONE and Kind & Gezin for assistance in the recruitment and sampling; the children and their parents for their participation.
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