Invasive Haemophilus influenzae type b infections in children in paraguay

Background aguay, as in most Latin American countries, data on the epidemiology and clinical characteristics of Haemophilus influenzae type b (Hib) diseases are scarce and incomplete. s ress this issue, we performed a retrospective analysis of 102 patients admitted to the Instituto de Medicina Tropical, a referral hospital in Asunciَn, Paraguay, between January 1991 and September 1995 with diagnosis of invasive Hib infection. This study included patients 15 years of age and underidentified with positive cultures for Hib in blood, cerebrospinal fluid, or other sterile body fluids. s three (81%) patients presented with meningitis as principal focus of infection with median age of 9 months. Forty five (54%) patients with Hib meningitis were <12 months of age and 20 (24% of total cases) were <6 months of age. Overall mortality rate of meningitis was 13%. Of 11 patients who died, 10 (91%) were <12 months of age (p <0.02). Risk for mortality was correlated with presence of coma during admission (p <0.007) and CSF glucose level of <10 mg/dL (p <0.05). Severe sequelae such as bilateral hearing loss, hydrocephalus, and mental retardation were observed in 39% (28/72) of surviving patients, of whom 18 (51%) patients were <12 months of age (p <0.02). Thirty percent of isolated strains of Hib were resistant to ampicillin, 20% were resistant to chloramphenicol, and 10% to both drugs. sions nformation provides evidence concerning the importance of continued support for Hib vaccine supplies in immunization programs in countries with limited resources such as Paraguay.