Changing epidemiology of invasive Haemophilus influenzae in Ontario, Canada: Evidence for herd effects and strain replacement due to Hib vaccination

被引:118
作者
Adam, H. J. [1 ]
Richardson, S. E. [2 ,3 ,4 ]
Jamieson, F. B. [2 ,3 ]
Rawte, P. [2 ]
Low, D. E. [2 ,3 ,5 ,6 ]
Fisman, D. N. [7 ]
机构
[1] Hlth Sci Ctr, Dept Microbiol, Winnipeg, MB R3A 1R9, Canada
[2] Ontario Agcy Hlth Protect & Promot, Publ Hlth Labs Toronto, Toronto, ON, Canada
[3] Univ Toronto, Fac Med, Dept Lab Med & Pathobiol, Toronto, ON, Canada
[4] Hosp Sick Children, Div Microbiol, Toronto, ON M5G 1X8, Canada
[5] Univ Hlth Network, Toronto, ON, Canada
[6] Mt Sinai Hosp, Dept Microbiol, Toronto, ON M5G 1X5, Canada
[7] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada
关键词
Haemophilus influenzae; Hib vaccination; Strain replacement; CONJUGATE VACCINE; B VACCINE; DISEASE; CARRIAGE; INFECTIONS; CHILDREN; IMPACT; ERA;
D O I
10.1016/j.vaccine.2010.03.075
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The epidemiology of invasive Haemophilus influenzae infections was evaluated in Ontario between 1989 and 2007 to assess the impact of the introduction of the conjugate H. influenzae serotype b (Hib) vaccine in the early 19905 on Hib and non-Hib serotypes in both vaccinated and unvaccinated cohorts as well as the possibility of "strain replacement" with non-vaccine H. influenzae strains. Data were collected by the provincial Public Health Laboratories-Toronto, Ontario Agency for Health Protection and Promotion, which performed almost all serotyping on invasive (blood, CSF, other sterile sites) H. influenzae strains isolated in the province during the study period. Temporal trends for Nib, other typeable strains, and non-typeable H. influenzae were evaluated by Poisson regression, controlling for the specimen submissions. Prior to infant Hib vaccination, the most commonly observed serotype was serotype b (64.9%). Subsequently, 70.3%, 13.6%, and 9.4% of isolates were non-typeable, serotype f, and serotype b, respectively. Infant Hib vaccination resulted in a decrease in Hib incidence in all age groups (pooled IRR 0.432) and marked increases of non-typeable and serotype f H. influenzae in children aged <5 years (IRR 2.4 and 3.0, respectively). Vaccination against Hib has altered the epidemiology of invasive H. influenzae infections in Ontario. Prevention of invasive Hib disease was observed in both vaccinated and unvaccinated age groups. Invasive H. influenzae infection now commonly presents as sepsis due to non-typeable H. influenzae in older individuals. However, strain replacement of Hib with serotype f and non-typeable strains in children under 5 years was documented. (C) 2010 Elsevier Ltd. All rights reserved.
引用
收藏
页码:4073 / 4078
页数:6
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