Invasive Haemophilus influenzae disease in India: a preliminary report of prospective multihospital surveillance. IBIS (Invasive Bacterial Infections Surveillance) Group.

OBJECTIVE: To determine the frequency, clinical characteristics and outcome of acute invasive infections caused by Haemophilus influenzae.
DESIGN: Prospective hospital-based surveillance.
SETTING: Six large academic referral hospitals in India. PARTICIPANTS: Three thousand four hundred forty-one patients from infancy to adulthood with pneumonia, meningitis or suspected bacterial sepsis.
RESULTS: Preliminary data from 24 months of surveillance are presented. There were 58 H. influenzae isolates, of which 96% were serotype b. Nearly all isolates were from infants and children <5 years old, and most of the childhood isolates were from infants <1 year of age. Meningitis cases accounted for 69% of isolates. Overall case fatality was 11%. More than 50% of isolates were resistant to chloramphenicol, and up to 40% were resistant to ampicillin, trimethoprim-sulfamethoxazole or erythromycin. There was no resistance to third-generation cephalosporins.
CONCLUSIONS: These preliminary data from six hospitals suggest a substantial burden of severe, preventable H. influenzae infections in India. The distribution of clinical syndromes and the ages of our Hib patients are fairly similar to data from North America and Europe.