Prospective epidemiological study of invasiveHaemophilus influenzae disease in adults

Abstract

The incidence and characteristics of invasive Haemophilus influenzae disease were studied in 43 adult patients admitted to the acute care hospitals in El Vallés County (Barcelona, Spain) between January 1987 and June 1992. The annual incidence of Haemophilus influenzae disease was 1.2 per 100,000 inhabitants. Pneumonia occurred in 24 patients, meningitis in five, intraabdominal infections in three, obstetric infections in two, epiglottitis in two and cellulitis in one. In six patients the source of infection was unknown. Ten (23%) of the infections were hospital acquired. Underlying conditions were diagnosed in 30 (70%) patients. Nontypeable Haemophilus influenzae strains predominated in all adult age groups. Sixty-one percent of type b and 34% of nontypeable strains were ampicillin resistant (p = 0.08). Multiple antibiotic resistance was also high among type b (53%) and nontypeable (18%) strains. The mortality rate was significantly higher in patients with pneumonia, bacteremia from an unidentified focus or shock at presentation.

Radiological Findings in Acute Haemophilus influenzae Pulmonary Infection

“…In our study, the underlying diseases in 211 patients were mainly a smoking habit (n543, 20.4%), cardiac disease (n535, 16.6%), pulmonary emphysema (n523, 10.9%), alcoholism (n520, 9.5%) and bronchial asthma (n515, 7.1%). In the present study, the frequencies of underlying diseases were lower than those described in previous reports [1,4,[17][18][19][20]. Furthermore, in the present study, the patients diagnosed with concurrent infectious diseases (n5223, 51.4%) were excluded.…”

“…Underlying disease is found in 69-90% of adults with H. influenzae disease [1,4,[17][18][19][20]. Deulofeu et al [4] have reported that 30 of 43 patients (69.8%) with H. influenzae disease had underlying conditions, including malignancy (n512, 27.9%), alcoholism (n510, 23.3%), COPD (n59, 20.9%) and diabetes mellitus (n58, 18.6%).…”

“…Deulofeu et al [4] have reported that 30 of 43 patients (69.8%) with H. influenzae disease had underlying conditions, including malignancy (n512, 27.9%), alcoholism (n510, 23.3%), COPD (n59, 20.9%) and diabetes mellitus (n58, 18.6%). Kofteridis et al [1] have reported that the underlying diseases in 45 patients with H. influenzae respiratory tract infection consisted mainly of COPD (n528, 62.2%), followed by cardiovascular diseases (n516, 35.6%), alcoholism (n516, 35.6%) and diabetes mellitus (n513, 28.9%).…”

“…The mortality rate in patients with H. influenzae pneumonia has been reported as 10-42% [3][4][5][6]. Moreover, nosocomial outbreaks caused by H. influenzae have been reported [7].…”

Characterisation of non-capsulate Haemophilus influenzae by repetitive extragenic palindromic (REP)-PCR

“…NCHI is now also recognised as an important cause of invasive disease [3,4]. NCHI strains are extremely diverse and there is no universally accepted typing method for epidemiological investigations.…”