Pathogenesis and Prevention of Recurrent Infection After Haemophilus influenzae Bacteremia

Abstract

Recurrence of disease after Haemophilus influenzae bacteremia is relatively uncommon and may often be preventable. Three previously unreported and 11 reported occurrences in ten patients were evaluated in regard to pathogenesis. Recrudescence can be prevented by adequate culturing prior to therapy, proper treatment based on complete sensitivity testing and pharmacologic principles, and careful evaluation of clinical and microbiologic response. Relapse may be prevented in some instances by administering prophylactic rifampin to patients and close contacts who may be carriers of an infecting strain. Reinfections may be prevented through public health measures and the development of effective vaccines.

Infections of the Upper and Middle Airways

“…A second episode of invasive Hib disease in the index case is uncommon but recognised, [47][48][49][50] and usually occurs occur within six months of the initial episode. 48 It is often difficult to distinguish between re-infection and relapse, which can occur even if the index case receives appropriate prophylaxis to eliminate carriage.…”

“…49 Reinfection tends to occur several weeks to months after the primary infection. 49,50 There are limited data on the risk of second episodes in the post-vaccine era. In the UK, only four cases with two distinct episodes of invasive Hib disease have been identified through enhanced national surveillance during 1992-2012.…”

Recommendations for the prevention of secondary Haemophilus influenzae type b (Hib) disease

“…49 Re-infection tends to occur several weeks to months after the primary infection. 49,50 There are limited data on the risk of second episodes in the post-vaccine era. In the UK, only four cases with two distinct episodes of invasive Hib disease have been identified through enhanced national surveillance since 1992.…”