Haemophilus influenzae Invasive Disease, 2016: DCN - Minnesota Dept. of Health

Haemophilus influenzae Invasive Disease, 2016

One hundred twenty-six invasive Haemophilus influenzae disease cases (2.3 per 100,000 population) were reported in 2016. Cases ranged in age from newborn to 97 years (median 70 years). Allowing for more than one syndrome per case, 52 (41%) cases had pneumonia; 30 (24%) had bacteremia without another focus; 15 (12%) had septic shock; 12 (10%) had meningitis; 4 (3%) had epiglottitis; 2 (2%) had peritonitis; 3 (2%) had abscess; 1 (1%) had a combination of meningitis, pneumonia, and otitis media; and 1 (1%) each had cholangitis, empyema, endometritis, endophthalmitis, pyelonephritis, septic abortion, and septic arthritis. Sixteen (13%) cases died.

Of 118 H. influenzae isolates for which typing was performed at PHL, 15 were type a, 17 type f, 5 type b, 4 type e, and 77 were untypeable. The 5 type b (Hib) disease cases compared to 2 cases in 2015, 1 in 2014, and 4 in 2013. Three were in children <4 years old, 2 were in adults; all survived. Two had meningitis, one had bacteremia without another focus of infection, one had bacteremia with septic shock, and one had a combination of meningitis and pneumonia. One of the three children, who was <3 months old had received 1 dose of vaccine, and the other two (ages 1 and 3 years) had not been vaccinated.

Thirty-five (30%) of the case-isolates were resistant to ampicillin and produced ß-lactamase, but all were susceptible to amoxicillin-clavulanate, which contains a ß-lactamase inhibitor. Two isolates showed intermediate resistance to ampicillin and did not produce ß-lactamase. Ten isolates showed non-susceptibility to 2 or more antibiotics. Of those, 3 showed non-susceptibility to 3 antibiotics.

The 16 deaths occurred in patients ranging in age from newborn to 92 years. Seven cases had pneumonia, 8 had bacteremia without another focus of infection (of these 2 also had septic shock), and 1 had meningitis. Fourteen cases had H. influenzae isolated from blood, 1 from CSF, and 1 from the heart. Co-morbidities were reported in 15 cases. Of the 16 cases that died, 13 case-isolates were untypeable, 1 was serotype a, and 2 isolates were not available for serotyping.

Updated Thursday, 24-Jan-2019 08:37:57 CST