Ten years of Hib vaccination in Italy: Prevalence of non-encapsulated Haemophilus influenzae among invasive isolates and the possible impact on antibiotic resistance

Giufrè, Maria; Cardines, Rita; Caporali, Maurizio; Accogli, Marisa; D’Ancona, Fortunato; Cerquetti, Marina

doi:10.1016/j.vaccine.2011.03.059

Cited by 55 publications

(36 citation statements)

References 33 publications

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“…As reported in a previous study of ours, in Italy, the introduction of conjugate vaccines against H. influenzae type b (Hib) has resulted in a drastic reduction of invasive Hib disease. This success has been accompanied by some changes in the epidemiological characteristics of invasive H. influenzae disease, with the predominant serotype changing from Hib to ncHi (3). The same has been observed in other European countries with established Hib immunization programs, where most invasive disease cases are now caused by ncHi (4)(5)(6).…”

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confidence: 71%

“…In H. influenzae, resistance to ␤-lactam antibiotics due to ␤-lactamase production by either the bla TEM or bla ROB gene is the main resistance mechanism observed (3,7,8). Polymorphism in the bla TEM gene promoter sequence has been detected previously, but there is no knowledge regarding the distribution of the different promoter types among H. influenzae isolates from Italy (9).…”

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confidence: 99%

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Identification of Haemophilus influenzae Clones Associated with Invasive Disease a Decade after Introduction of H. influenzae Serotype b Vaccination in Italy

Giufrè

Cardines

Accogli

et al. 2013

Clin Vaccine Immunol

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The introduction of Haemophilus influenzae serotype b (Hib) conjugate vaccines has changed the epidemiology of invasive H. influenzae disease, with a shift in the predominant serotype from Hib to nonencapsulated H. influenzae (ncHi). The objective of this study was to identify the genotypes/clones associated with invasive H. influenzae disease in Italy. Eighty-seven H. influenzae strains isolated in the years 2009 to 2011 within the National Surveillance of Invasive Bacterial Disease program were analyzed. Strains were characterized by serotyping, antimicrobial susceptibility testing, and multilocus sequence typing (MLST). Genetic polymorphisms in the bla TEM gene promoter region as well as the occurrence of both adhesin genes (hmwA and hia) and the IgA1 protease-encoding gene (igaB) were also investigated. Of 87 strains, 67 were ncHi and 20 were encapsulated. Eleven strains were ␤-lactamase positive, harboring the bla TEM gene. Most bla TEM genes (10/11) were associated with a Pdel promoter region exhibiting a 135-bp deletion; the remaining strain possessed the Pa/Pb overlapping promoter. MLST analysis showed that encapsulated isolates were clonal, with each serotype sharing a few related sequence types (STs). Forty-six different STs were identified among the 67 ncHi strains. Despite this heterogeneity, a group of closely related STs (ST103, ST139, and ST145) encompassed almost 25% of all ncHi strains and 45.5% of the ␤-lactamase producers carrying the Pdel promoter. These major ST clones were found to be associated with the hmwA gene but not with the igaB gene. To conclude, although the heterogeneity of the ncHi population was confirmed, diffusion of major successful ST clones was documented.

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confidence: 71%

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confidence: 99%

Identification of Haemophilus influenzae Clones Associated with Invasive Disease a Decade after Introduction of H. influenzae Serotype b Vaccination in Italy

Giufrè

Cardines

Accogli

et al. 2013

Clin Vaccine Immunol

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“…The epidemiological characteristics of H. influenzae disease appear to be changing as the incidence of serotype b infection in children decreases and non-capsulated/non-b serotype infections in adults increase [40,46,48]. However, it should be highlighted that there is still a significant burden of disease in children.…”

Section: Invasive Haem Ophilus Influenzae Diseasementioning

confidence: 99%

Targeted vaccination of teenagers following continued rapid endemic expansion of a single meningococcal group W clone (sequence type 11 clonal complex), United Kingdom 2015

et al. 2015

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Since the epidemiological year 2009/10, the United Kingdom has experienced a year-on-year increase in meningococcal group W (MenW) disease due to rapid expansion of a single endemic hyper-virulent strain belonging to sequence type 11 clonal complex (cc). This strain was identified among cases diagnosed across all regions and was not linked to travel abroad. Consequently, an adolescent MenACWY conjugate vaccination programme for 13-18 year-olds will be introduced in August 2015, with priority given to 17-18 year-olds (school leavers).

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“…In a large 10-year Italian study, investigators demonstrated a marked 50% decrease in β-lactamase -mediated resistance to ampicillin and related β-lactam antibiotics [87]. Similarly, a Spanish study showed that antibiotic resistance in Haemophilus influenzae decreased in Spain from 1997 to 2007, due to a Hib vaccine -related reduction in the use of several antibiotics [88].…”

Section: Value Of Conjugated Vaccine Technologiesmentioning

confidence: 99%

The global response to the threat of antimicrobial resistance and the important role of vaccines

Utt

Wells

2016

PPL

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Ten years of Hib vaccination in Italy: Prevalence of non-encapsulated Haemophilus influenzae among invasive isolates and the possible impact on antibiotic resistance

Cited by 55 publications

References 33 publications

Identification of Haemophilus influenzae Clones Associated with Invasive Disease a Decade after Introduction of H. influenzae Serotype b Vaccination in Italy

Identification of Haemophilus influenzae Clones Associated with Invasive Disease a Decade after Introduction of H. influenzae Serotype b Vaccination in Italy

Targeted vaccination of teenagers following continued rapid endemic expansion of a single meningococcal group W clone (sequence type 11 clonal complex), United Kingdom 2015

The global response to the threat of antimicrobial resistance and the important role of vaccines

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