Intern
    Meningokokken und Haemophilus Influenzae

    Data of the NRZMHi for Haemophilus influenzae 2013

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    1. Introduction

     

    The Consulting Laboratory for Haemophilus influenzae (KLHi) has been merged with the National Reference Laboratory for Meningococci in 2013. Both laboratories henceforth will be called National Reference Laboratory for Meningococci and Haemophilus influenzae (NRZMHi). The tasks assigned by the Robert Koch Institute for the surveillance of invasive Haemophilus influenzae disease include serotyping of clinical isolates and the detection of antibiotic resistance against β-Lactams.In 2013, 349 submissions from 344 patients were analysed. In 288 of the submitted cases, H. influenzae was detected from primarily sterile materials (this figure equals the number of invasive diseases); in two submissions from patients with invasive disease, H. haemolyticus was identified. The differentiation of both species may be challenging. At the NRZMHi, it is accomplished in doubtful cases by molecular biologic analysis of the genes ompP2, ompP6 and fucK.The age group most affected by invasive H. influenzae disease was > 40 years (247 cases, 86.1 %). The vast majority of invasive cases was caused by non-typeable H. influenzae (NTHi, 250 cases, 87.1 %), followed by Hif as the most frequent capsular serotype (22 cases; 7.7 %). Hie showed third highest frequency among the serotypes (10 cases; 3.5 %), closely followed by Hib (3 cases, 1 %) and Hia (2 cases, 1 %). In one case, where detection of the bacteria was carried out by molecular methods, the serotype was not determined.The NRZMHi analyzed the frequency of ampicillin resistance of 287 viable invasive isolates using Etests. Fourty-two isolates (14.7 %) were ampicillin resistant (MIC > 1 µg/ml), of which 32 isolates (71.2 %) showed β lactamase production.

     

    2. Serotype distribution of German invasive H. influenzae isolates in 2012

     

    3. Age distribution of patients with invasive H. influenzae disease

    4. Serotype distribution in Federal States

     

    BW

    BY

    BE

    BB

    HB

    HH

    HE

    MV

    NI

    NW

    RP

    SL

    SN

    SA

    SH

    TH

    Hia

    1

    0

    0

    0

    0

    0

    0

    0

    0

    0

    1

    0

    0

    0

    0

    0

    Hib

    1

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    2

    0

    0

    0

    Hie

    3

    1

    1

    0

    0

    0

    0

    0

    1

    2

    2

    0

    0

    0

    0

    0

    Hif

    4

    5

    1

    0

    0

    0

    4

    0

    1

    4

    1

    0

    0

    1

    0

    1

    NTHi

    52

    47

    14

    7

    0

    4

    18

    3

    13

    54

    11

    6

    7

    4

    7

    3

    n.d.

    0

    0

    0

    0

    0

    0

    0

    0

    1

    0

    0

    0

    0

    0

    0

    0

    Total

    61

    53

    16

    7

    0

    4

    22

    3

    16

    60

    15

    6

    9

    5

    7

    4

    BW: Baden-Württemberg, BY: Bavaria, BE: Berlin, BB: Brandenburg, HB: Bremen, HH: Hamburg, HE: Hesse, MV: Mecklenburg-Vorpommern, NI: Lower Saxony, NW: North Rhine-Westfalia, RP: Rhineland-Palatinate, SL: Saarland, SN: Saxony, ST: Saxony-Anhalt, SH: Schleswig-Holstein, TH: Thuringia.

    5. Serotype distribution according to site of isolation

    Hia

    Hib

    Hie

    Hif

    NTHi

    n.d.

    Total

    Blood

    1

    3

    8

    22

    232

    1

    267

    CSF

    1

    0

    1

    0

    15

    0

    17

    other*

    0

    0

    1

    0

    3

    0

    4

    * other – primarily sterile sites: pleural effusion

     

    6. Ampicillin resistance in invasive H. influenzae isolates

    7. Publications of the KLHi

    Original Articles

    - Lâm TT, Elias J, Frosch M, Vogel U, Claus H. New diagnostic PCR for Haemophilus influenzae serotype e based on the cap locus of strain ATCC 8142. Int J Med Microbiol. 2011 Feb;301(2):176-9.

    - Lâm TT, Frosch M, Claus H, Vogel U. Sequence analysis of the serotype-specific synthesis regions II of Haemophilus influenzae serotypes c and d: evidence for common ancestry of capsule synthesis in Pasteurellaceae and Neisseria meningitidis. Research in Microbiology 2011 Jun;162(5):483-7.

    Reviews

    - Lâm TT, Claus H, Elias J, Hellenbrand W, Imöhl M, Prelog M, Sing A, van der Linden M, Vogel U. Infections with Pneumococci, Menigococci, H. influenzae and Diphtheria in Germany: the RKI Reference Network for Invasive Bacterial Infections (IBI) at the 5th Würzburg Workshop on Epidemiology, Prevention and Therapy for Invasive Meningococcal Diseases 2010 (Meeting Report). Gesundheitswesen. 2011. DOI: 10.1055/s-0031-1286269.

    Disclaimer: the above data were generated with federal funds (RKI). Scientific use is prohibited without prior written consent by KLHi or RKI. Commercial use is strictly prohibited. Inclusion of figures or tables in talks or oral presentations is not allowed. 

     

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