Meningite por Haemophilus influenzae em Salvador, Bahia: aspectos do período pré e pós vacinal. / Haemophilus influenzae meningitis in Salvador, Bahia: features from before and after vaccine implementation.

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

Introduction of polysaccharide conjugate vaccines against Haemophilus influenzae type b (Hib) was a major public health advances, practically eliminating the Hib meningitis in coutries where it was implemented. The aims of this work were to describe the H. influenzae meningitis in Salvador, Bahia, looking for the impact of vaccination, and to characterize non-type b isolates of H. influenzae, identified during active surveillance. The study population included patients identified through positive cultures for H. influenzae, and clinical data obtained through interview and medical chart review. The serotype of the strains was determined using anti-sera and polymerase chain reaction. Molecular typing was performed through pulsed field gel electrophoresis and multiloccus sequence typing; and to identify a virulence mechanism, we performed a polymerase chain reaction and sequencing of IS1016-bexA deletion region. For the incidence numbers, it was utilized the number of cases of Metropolitan region of Salvador, and census for the population in 2000. Five years after the implementation of vaccine, the incidence of meningitis caused by H. influenzae reduced to 97.6% in the total population, and 97.5% at children <5 years old. In 11 years of surveillance, it was identified 40 cases of meningitis due to nontype b isolates, being 80% after vaccine. In the molecular characterization, it was identified two clones of type a isolates, one of those presenting the IS1016-bexA deletion as a virulence factor associated with high mortality (OR 10.8; CI 0.7-345). Concluding, studies of molecular epidemiology are important to evaluate the efficacy of vaccines, and to monitor the sprouting of isolates from others serotypes (non-type b) to evaluate if it is necessary a vaccines composition intervention.

ASSUNTO(S)

meningite molecular epidemiology haemophilus influenzae epidemiologia molecular vigilância populacional meningitis vacina active surveillance vaccines imunologia haemophilus influenzae

ACESSO AO ARTIGO

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