Haemophilus diseases in ENT in children before and after the introduction of Haemophilus influenzae type b vaccine

Česká verzia

Authors: G. Forstová ¹; M. Urík ¹; P. Mikolášek ²; D. Pavlovská ³; A. Ševčíková ⁴; I. Šlapák ¹
Authors place of work: Klinika dětské otorinolaryngologie FN a LF MU, Brno ¹; Klinika dětských infekčních nemocí FN a LF MU, Brno ²; Klinika dětské radiologie FN a LF MU, Brno ³; Oddělení klinické mikrobiologie FN, Brno ⁴
Published in the journal: Čes-slov Pediat 2017; 72 (1): 20-24.
Category: Original Papers

Summary

Introduction:
The article presents the results of a study aiming to find out the change in the spectrum of bacterial pathogens causing acute otitis media, otogenic meningitis and paediatric epiglottitis after the introduction of compulsory vaccination against H. influenzae b (Hib) at a national level in the Czech Republic.

Material and methods:
Two patient groups were observed within the study. The control group consisted of children born before 2001 who were not vaccinated by Hib vaccine. The observed group consisted of children born after 2001 who were vaccinated by Hib vaccine. The study was performed during 2002–2012. Three subgroups of children were observed within each group: 1. Suffering from acute otitis media, 2. Suffering from otogenic meningitis, 3. Suffering from epiglottitis. In all cases the samples were cultivated in order to identify Hib as the cause of the infection.

Results:
In the control group, a total of 205 smears from external ear canal were taken for cultivation in children with acute otitis after paracentesis. Hib was identified as a cause in 26.3 %. In otogenic meningitis subgroup only one case was caused by Hib. Eight children suffered from epiglottitis and all cases were caused by Hib. In the observed group, a total of 201 smears from external ear canal were taken in children with acute otitis after paracentesis. Hib was identified in only 4.4 % of cases. In the subgroup of otogenic meningitis Hib was not cultivated in any single case. There were no cases of epiglottitis in the control group.

Conslusion:
The study results show a significant decrease in occurrence of Hib as a cause of acute otitis media, otogenic meningitis and epiglottitis in the group of children vaccinated by Hib vaccine. There were no cases of meningitis or epiglottitis cases caused by Hib in the group of vaccinated children. Vaccination provides a complete protection against serious invasive diseases, in our case meningitis and epiglottitis, and decreases the occurrence of acute otitis media caused by Hib.

Key words:
Haemophilus influenzae b, acute otitis, meningitis, epiglotitis, pediatric age, vaccination

Zdroje

1. Máchalová M, Forstová G. Hrtan a průdušnice. Akutní zánět středouší. In: Šlapák I, a kol. Dětská otorinolaryngologie. Praha: Mladá fronta, 2013: 54–56, 193–200.

2. Votava M. Hemofilové infekce. In: Votava M. Lékařská mikrobiologie speciální. Brno: Neptun, 2003: 1–53.

3. Krbková L. Hemofilové infekce. In: Beneš J, a kol. Infekční lékařství. I. vyd. Praha: Galén, 2009: 225–227.

4. Blechová Z. Hnisavé meningitidy nejmladších věkových skupin. Neurol pro praxi 2006; 3: 131–133.

5. van de Beek D. Adjunctive dexamethasone in bacterial meningitis: a meta-analysis of individual patient data. Lancet Neurol 2010; 3: 245–263.

6. Šašinka M, Šagát T, a spol. Pediatria. Košice: Status s.r.o., 1998: 462–465.

7. Křížová P. Hemofilové vakcíny a jejich použití v České republice. Pediatr praxi 2001; 2: 13–15.

8. Dagan R, Fraser D, Roitman M, et al. Effectivenes of a nationwide infant immunization program agains H. influenzae b. Vaccine 1999; 17: 134–141.

9. Hobstová J. Hnisavé meningitidy v dětském věku. Praha: Galén, 1999.

10. Hobstová J, Petráš M, Kostřicová E, et al. Problematika meningitid vyvolaných H. influenzae b v souvislosti s plošnou vakcinací proti H. influenzae b. Klin mikrobiol inf lék 1998; 2: 70–73.

11. Křížová P, Lebedová V. Sledování selhání vakcíny proti H. influenzae b. Praha: Zprávy CEM (SZÚ) 2003;12 (2): 76–77.

12. Křížová P, Lebedová V, Beneš Č. Vliv rutinní vakcinace v České republice na výskyt invazivních onemocnění způsobených H. influenzae b. Klin mikrobiol inf lék 2004; 3: 118–123.

13. McVernon J, Johnson PDR, Pollard AJ, et al. Imunologic memory in H. influenzae b conjugate vaccine failure. Arch Dis Child 2003; 4: 379–383.

14. Peltola H. H. influenzae b disease and vaccination i Europe:leasons learned. Pediatr Infect Dis 1998; 17: 126–132.

15. Zjevíková A, Rožnovský L, Křížová P, Lebedová V. Hemofilová meningitida u řádně očkovaného dítěte. Klin mikrobiol inf lék 2004; 1: 22–24.

16. Chaudhuri A. EFNS guideline on the management of community-acquired bacterial meningitis: report of an EFNS Task Force on acute bacterial meningitis in older children and adults. Eur J Neurol 2008; 15 (7): 649–659.