Intern
    Meningokokken und Haemophilus Influenzae

    Data of the NRZMHi for Haemophilus influenzae 2014

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    1. Introduction 

    The tasks of the National Reference Laboratory for Meningococci and Haemophilus influenzae (NRZMHi) assigned by the Robert Koch Institute for the surveillance of invasive Haemophilus influenzae disease include serotyping of clinical isolates from blood or cerebrospinal fluid (CSF) and the detection of antibiotic resistance against ß-lactam antibiotics.

    In 2014 all in all 427 submissions were analysed. In 372 submissions, bacterial isolates from blood or CSF were provided to the NRZMHi. Detection of H. influenzae from these materials have to be notified according to the German Infection Protection Act (IfSG). Five of these submissions were from both blood as well as CSF.

    Out of the total number of submissions from blood or CSF, 355 H. influenzae viable isolates from individual patients could be typed. Three strains were H. haemolyticus, H. parainfluenzae, or H. parahaemolyticus. In 9 submissions, H. influenzae could not be grown from the sample.

    Of the 355 cases with invasive H. influenza disease, the age group most affected was > 40 years (289 cases, 80.3 % of all cases). The vast majority of blood or CSF isolates was caused by non-typeable H. influenzae (NTHi, 299 isolates, 84.2 %), followed by Hif as the most frequent capsular serotype (36 cases; 10.1 %). Hib showed third highest frequency among the serotypes (11 cases; 3.1 %), closely followed by Hie (9 cases, 2.5 %). Other capsular types were not found.

    The NRZMHi analyzed the frequency of ampicillin resistance using gradient agar diffusion tests (E-test). Seventy-six isolates (21.4 %) were ampicillin resistant (MIC > 1 µg/ml), of which 54 (71.1 %) showed β‑lactamase production.

    2. Serotype distribution of H. influenzae isolates from blood or CSF in 2014

    3. Age distribution of patients with H. influenzae detected in blood or CSF

     

    4. Serotype distribution in Federal States

     

     

    BW

    BY

    BE

    BB

    HB

    HH

    HE

    MV

    NI

    NW

    RP

    SL

    SN

    SA

    SH

    TH

    abr

    Hib

    2

    0

    0

    0

    0

    0

    1

    0

    3

    5

    0

    0

    0

    0

    0

    0

    0

    Hie

    4

    1

    1

    0

    0

    0

    0

    0

    0

    1

    1

    0

    0

    0

    0

    1

    0

    Hif

    7

    5

    5

    1

    0

    0

    3

    0

    0

    10

    2

    1

    1

    0

    0

    0

    1

    NTHi

    65

    46

    14

    8

    1

    9

    30

    4

    14

    54

    15

    5

    9

    8

    6

    3

    8

    Total

    78

    52

    20

    9

    1

    9

    34

    4

    17

    70

    18

    6

    10

    8

    6

    4

    9

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

    5. Serotype distribution according to site of isolation

    Hib

    Hie

    Hif

    NTHi

    Total

    Blood

    9

    9

    25

    280

    323

    CSF

    2

    0

    10

    15

    27

    both

    0

    0

    1

    4

    5

     

     

    6. Ampicillin resistance in isolates H. influenzae from blood or CSF

    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.