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Table 1 Summary of published studies of paediatric community-acquired pneumonia (CAP) in which non-typeable Haemophilus influenzae (NTHi) was identified as a significant pathogen

From: A review of the role of Haemophilus influenzae in community-acquired pneumonia

Authors

Country

Study details

Number of cases

Age of children

Year of study

Assay

Diagnostic criteria

Number of positive cultures (%)

H. influenzae isolated (%)

NTHi: proportion of total H. influenzae isolates (%)

Virology

Hib vaccine introduced

Silverman et al [62]

Nigeria

Children with severe, untreated, acute pneumonia

88

4 months to 8 years

1977

Lung aspirate

Growth

70/88 (80%)

10/88 (11%)

All CIE negative ie not Hib

no

no

      

Blood culture

Growth

4/36 (11%)

0/36 (0%)

   
      

Sera

CIE for pneumococci and Hib

9/45 (20%)

0/45 (0%)

   

Shann et al [100]

Papua New Guinea

Children hospitalised with pneumonia

83

<5 years

1978–1988

Blood culture

Growth

51/83 (61%)

19/83 (23%)a

4/19 (21%)

yes

no

      

Lung aspirate

Growth

 

33/83 (40%)a

18/32 (56%)

  

Wall et al [102]

The Gambia

Children and adults with pneumonia

64

51 aged

<16 years

1982–1984

Blood culture

Growth

14/51 children (28%); 2/13 adults (15%)

11/49 (23%) children <5 years; 2/15

0/9 (0%)

no

no

      

Lung aspirate

Growth

29/51 children (57%); 7/13 adults (54%)

(13%) older patientsb

4/13 (31%)

  
      

Sera

CIE for Hib

2/64 (3%)

0/6 (0%)

0/2 (0%)

  

Ghafoor et alc[103]

Pakistan

Children hospitalised with pneumonia

1,331

<5 years

1986–1988

Blood culture

Growth

276/1,331 (21%)

144/1,331 (11%)

34/105 (32%)

yes

no

Yin et al [106]

Singapore

Children with pneumonia

1,158

<15 years (median age 1.37 years)

1988, 1995, 1999

Blood culture

Growth

671/1,158 (58%)

0/8 (0%)

 

yes

no

      

Pleural fluid

Growth

 

0/15 (0%)

   
      

Sputum

Growth

 

101/1,158 (9%)

101/101 (100%)d

  

Rahman et al [12]

Bangladesh

Children hospitalised with pneumonia

1,493

<5 years

1999–2003

Blood culture

Growth

25/1,493 (1.7%)

25/1,493 (1.7%)

6/25 (24%)e

no

no

De Schutter et al [61]

Belgium

Children with acute nonresponsive or recurrent CAP

250

1 month to 15 years (median age 33 months)

2005–2007

BAL

Growth with quantitative culture (≥104 cfu/ml) and PCR

190/250 (76%)

33/127 (26%) in NR13AP; 63/123 (51%) in Rec-CAP

94/96 (98%)f

yes

yes

Howie et al [105]

The Gambia

Children with severe pneumonia

55

2 months to <5 years

2007–2008

Lung aspirates (n=47) and pleural aspirates

Growth

21/56 (38%)g

3/56 (5%)g

3/3 (100%)

yes

yes

       

PCR

28/53 (53%)

12/53 (23%)

3/4 (75%)h

  
  1. BAL, broncho-alveolar lavage; CIE, counter-current Immunoelectrophoresis; PCR, polymerase chain reaction; NR-CAP, non-responding CAP; Rec-CAP, recurrent CAP; Spn, Streptococcus pneumoniae; cfu, colony forming units; Hia, Haemophilus infuenzae type a; Hib, Haemophilus infuenzae type b; Hic, Haemophilus infuenzae type c; Hid, Haemophilus infuenzae type d; Hie, Haemophilus infuenzae type e; Hif, Haemophilus infuenzae type f; n, number
  2. a32/42 (76%) H. influenzae isolates serotyped. Other serotypes included 1 Hia, 6 Hib, 3 Hic, 2 Hid, 1 Hie and 1 Hif. H. influenzae frequently co-cultured with Spn. Spn isolated from 28/83 (34%) children
  3. bH. influenzae isolate serotypes included 2 Hia (from lung) and 7 Hib (Of these, 3 from lung)
  4. cSee also Weinberg et al [104] for more details of this study
  5. dNTHi only recovered from sputum samples which were from older children and only assessed if there were <25 epithelial cells/high power field
  6. eOther serotypes included 15 Hib, 3 Hic and 1 Hid
  7. f2 isolates lost for typing
  8. g56 specimens were cultured. NTHi and Spn co-cultured in 21% (11/53) of cases
  9. h1/4 (25%) isolates was Hib
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Pneumonia

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