Poor Clinical Outcome for Meningitis Caused byHaemophilus influenzaeSerotype A Strains Containing the IS1016‐bexADeletion | Zendy

Josilene Borges Torres Lima | Zendy; Guilherme S. Ribeiro | Zendy; Soraia Machado Cordeiro | Zendy; Edilane Lins Gouveia | Zendy; Kátia Salgado | Zendy; Brian G. Spratt | Zendy; Daniel Godoy | Zendy; Mitermayer Galvão dos Reis | Zendy; Albert I. Ko | Zendy; Joice Neves Reis | Zendy

Open Access

Poor Clinical Outcome for Meningitis Caused byHaemophilus influenzaeSerotype A Strains Containing the IS1016‐bexADeletion

Author(s) -

Josilene Borges Torres Lima,

Guilherme S. Ribeiro,

Soraia Machado Cordeiro,

Edilane Lins Gouveia,

Kátia Salgado,

Brian G. Spratt,

Daniel Godoy,

Mitermayer Galvão dos Reis,

Albert I. Ko,

Joice Neves Reis

Publication year - 2010

Publication title -

the journal of infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 2.69

H-Index - 252

eISSN - 1537-6613

pISSN - 0022-1899

DOI - 10.1086/656778

Subject(s) - meningitis , serotype , haemophilus influenzae , microbiology and biotechnology , biology , virology , haemophilus , polymerase chain reaction , pasteurellaceae , conjugate vaccine , medicine , gene , bacteria , streptococcus pneumoniae , genetics , antibiotics , pediatrics

Since the introduction of Haemophilus influenzae type b (Hib) conjugate vaccines, meningitis caused by serotypes other than Hib has gained in importance. We conducted active hospital-based surveillance for meningitis over an 11-year period in Salvador, Brazil. H. influenzae isolates were serotyped and analyzed by polymerase chain reaction, pulsed-field gel electrophoresis, and DNA sequencing to identify strains with a specific deletion (IS1016) in the bexA gene (IS1016-bexA). We identified 43 meningitis cases caused by non-type b H. influenzae: 28 (65%) were caused by type a (Hia), 9 (21%) were caused by noncapsulated strains, and 3 (7%) each were caused by types e and f. Hia isolates clustered in 2 clonal groups; clonal group A strains (n = 9) had the IS1016-bexA deletion. Among children <5 years of age, meningitis caused by Hia from clonal group A had higher case-fatality than meningitis caused by clonal group B. Despite small numbers, these results indicate that the presence of the IS1016-bexA deletion is associated with enhanced virulence in non-type b H. influenzae.

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