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  • Title: [Clinical characteristics of 84 children with invasive Haemophilus influenzae infection from 2014 to 2018].
    Author: Wang GL, Hua CZ, Yang LH, Deng HL, Xu HM, Yu H, Wang SF, Zhang CH.
    Journal: Zhonghua Er Ke Za Zhi; 2019 Aug 02; 57(8):592-596. PubMed ID: 31352743.
    Abstract:
    Objective: To investigate the clinical characteristics of invasive Haemophilus influenzae (HI) infection in children. Methods: The clinical manifestations, laboratory examinations and treatment outcomes of 84 children with HI infection confirmed by bacterial culture in 7 tertiary children's hospitals from 2014 to 2018 were analyzed retrospectively. Results: Among the 84 cases, 50 were males. The age was 1.54 years (ranged from 5 days to 13 years).Twenty cases (24%) had underlying diseases and 48 cases (57%) had not received antibiotics before collecting specimens. Eighty-two cases (98%) had fever and 75 cases (89%) had clear infection foci, among which 31 cases (37%) had meningitis and 27 cases (32%) had pneumonia. Blood culture was positive in 62 cases (74%), cerebrospinal fluid culture was positive in 10 cases (12%), blood culture and cerebrospinal fluid culture were both positive in 11 cases (13%). Antibiotics susceptibility test showed that 27% (22/82) of all HI strains produced β-lactamases and 48% (37/77) strains were resistant to ampicillin. The drug resistance rates to cefuroxime, ampicillin-sulbactam, trimethoprim-sulfamethoxazole and azithromycin were 25% (20/80) , 20% (9/45) , 71% (44/62) and 19%(11/58), respectively. All strains were sensitive to meropenem, levofloxacin and ceftriaxone. After sensitive antibiotic therapy, 83% (70/84) of all patients were cured and improved, the mortality rate and loss of follow-up rate were 13% (11/84) and 4% (3/84) respectively. Conclusions: Meningitis and pneumonia are common presentation of invasive HI infections in children. Mortality in HI meningitis children is high and the third generation of cephalosporins, such as ceftriaxone can be used as the first choice for the treatment of invasive HI infection. 目的： 了解儿童侵袭性流感嗜血杆菌（HI）感染的临床特点。 方法： 回顾性分析7家三级儿童医院2014—2018年经细菌培养证实为侵袭性HI感染的84例患儿的临床表现、实验室检查及治疗转归特点。 结果： 84例患儿中男50例，年龄1.54岁（5日龄~13岁）。20例（24%）患儿有基础疾病，48例（57%）患儿采集标本前未使用抗菌药物。82例（98%）患儿有发热，75例（89%）患儿有明确感染灶，其中脑膜炎、肺炎分别有31例（37%）和27例（32%）。血培养阳性62例（74%）、脑脊液培养阳性10例（12%）、血培养和脑脊液培养均阳性11例（13%）。药敏试验显示，27%（22/82）的菌株产生β内酰胺酶，48%（37/77）的菌株对氨苄西林耐药，对头孢呋辛、氨苄西林-舒巴坦、复方新诺明和阿奇霉素的耐药率分别为25%（20/80）、20%（9/45）、71%（44/62）和19%（11/58）；所有菌株对美罗培南、左氧氟沙星、头孢曲松敏感。患儿经敏感抗菌药物治疗，83%（70/84）的患儿治愈好转，病死率和失访率分别为13%（11/84）和4%（3/84）。 结论： 儿童侵袭性HI感染以脑膜炎和肺炎多见，HI脑膜炎病死率较高，头孢曲松等第三代头孢菌素可作为侵袭性HI感染治疗的首选药物。.
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