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We present 2 cases of meningitis caused by the same Haemophilus influenzae type b (Hib) strain in a nursery at a 3-month interval. Causative agents isolated showed good susceptibility to beta-lactams and both patients recovered without any sequelae. Survey culture at each occurrence of meningitis showed 10 asymptomatic nasopharyngeal carriers. Oral rifampin was administrated to all staff and infants, but 2 carriers were found a month later from chemoprophylaxis. Pulsed-field gel electrophoresis analysis showed that the two strains isolated from meningitis patients and 12 from asymptomatic carriers were apparently identical. When systemic Hib infection occurs in a nursery, other infants may be at high risk for secondary disease. It is difficult, however, to eliminate Hib carriage by chemoprophylaxis, indicating that Hib vaccination to prevent systemic Hib infection is necessary in Japan.

Two Cases of Meningitis Caused by the Same Haemophilus influenzae Type B Strain in a Nursery at a 3-month Interval