Haemophilus Influenzae Type B Invasive Disease in a Pediatric Hospital of Argentina

Abstract

BackgroundSinceThe vaccination strategy is a three-dose primary series (at two,Active surveillance is important to opportunely detect variations on these trends.MethodsCross-sectional study, including all hospitalized patients with Hib infection since 2012 to May 2017 at Hospital de Niños “Ricardo Gutiérrez” in Buenos Aires, Argentina.ResultsTwenty previously healthy children were admitted. Male/female ratio 1.8:1. Median age: 12 (range 45 days-114) months; 85% younger than 2 years and 35% younger than 6 months. Nine patients (45%) had complete vaccination schedule, with three or more doses of DTP-Hib-HBV vaccine. Hospitalization Hib infections by year in Table 1.YearHib admissions (n)Total hospital admissions (n)Hospitalization rates (per 100.000 admissions/year)201219,7641,02201329,3042,15(IC 95% 0.26–7.76)201439,0663,31(IC95% 0.68–13.81)201569,4506,35 (IC 95% 2.33–13.81)201689,7808,18 (IC 95% 3.5– 6.11)Clinical presentation: meningitis (14/20), pneumonia (6/20) and arthritis (5/20), osteomyelitis (1/20). All patients with meningitis, 25% of pneumonias and 50% of arthritis had positive blood cultures. Hib was isolated from blood in 17/20 cases, cerebrospinal fluid in 7/14, joint fluid in 3/5 and pleural fluid in 2/6. Median WBC: 12,400/mm3 (1,600–42,900) and median C-reactive protein level 111 mg/L (7–358). Median days of hospitalization was 13 (8–40). Nine patients required intensive care, four of them required mechanical ventilation. None patients died. Immunological studies ruled out immunodeficiency in 10 patients, although four continues under study.Conclusion(i) Burden of invasive Hib infections have increased over the last few years in our setting. (ii) Most of patient had adequate immunization schedule for age; (iii) Surveillance studies should be continued to confirm these preliminary results as well as to evaluate possible causes.Disclosures All authors: No reported disclosures.