Carriage of Haemophilus influenzae among Brazilian children attending day care centers in the era of widespread Hib vaccination

Oropharyngeal Colonization by NontypeableHaemophilus influenzaeAmong Healthy Children Attending Day Care Centers

“…In our current work, the rate of ampicillin resistance due to b-lactamase production was very low (24% in 2005 and 13% in 2004) compared to other worldwide studies that ranged between 35% and 45% of the H. influenzae isolates. 2,6,7,12,19,21 Despite this low prevalence, ampicillin resistance increased significantly in the second year where we observed a twofold increment in the b-lactamaseproducing strains. The isolate characterization was completed with a determination of the PBP3 mutations associated to ampicillin resistance.…”

“…The prevalence of H. influenzae was similar or lower than other colonization studies conducted on worldwide centers. 2,7,10,13,14,19,20 Recently, Carvalho et al 7 reported NTHi colonization in 32% of the children from DCCs in a large Brazilian city with a frequent antibiotic use (> 80%) within the studied population, 7 while studies in the United States showed a carriage rate of 64%. 2,10 Antimicrobial susceptibility was high probably due to the low range of antimicrobial agents given to treat infections in children.…”

“…16 Although NTHi is considered less virulent than Hib, it can be responsible for severe diseases, especially among children with previous comorbidities. 11 Several studies have been performed to establish the H. influenzae carriage rate after vaccine introduction, 2,7,10,[12][13][14][19][20][21] although to our knowledge, no studies have been reported from Spain. Longitudinal studies performed on one or two selected DCCs give information about the dynamics of colonization, but fail to give an overall view of the situation in similar centers of the same geographical area.…”

“…7,14,19,21 However, risk factors such as age, size of the center, and antibiotic consumption on the sampling day were linked to H. influenzae colonization. The age factor (> 36 months) has been associated to higher colonization levels only in the first year of study, probably because the study was unintentionally biased toward this age range as a result of the randomness of the sample.…”

The continuing role ofHaemophilus influenzaetype b carriage surveillance as a mechanism for early detection of invasive disease activity

“…This social and demographic risk, has been associated with increases Hib carriage and for this reason, these centers are often targeted for routine surveillance of Hib carriage and other childhood pathogens. 21,33,38,70,71,73,[80][81][82][83][84][85][86][87] Special efforts to immunize children attending day-care centers need to be continually emphasized as this poses a higher risk to Hib than for children who do not attend day-care.…”