Materiały źródłowe

• #1 About Haemophilus influenzae Disease | H. influenzae | CDC

  https://www.cdc.gov/hi-disease/about/index.html

  Healthcare providers usually diagnose H. influenzae disease with one or more lab tests. The most common testing methods use a sample of blood or spinal fluid. […] Vaccines can prevent Hib disease, but not disease caused by other types of H. influenzae. The best way to prevent Hib disease is to get vaccinated. CDC recommends Hib vaccines for all children younger than 5 years old.

• #2 Haemophilus influenzae Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562176/

  Haemophilus influenzae disease is a name collectively used for any kind of infection caused by the bacteria called Haemophilus influenzae. […] The most familiar and predominant form is H. influenzae type b (Hib), which infects mostly children and immunocompromised individuals. […] The Hib conjugate vaccine is effective for protection against capsular polysaccharide type b and has decreased the rate of Hib infections to a greater extent. […] More definitively, tests like polymerase chain reaction (PCR) and matrix-associated laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) are done to determine capsule types. […] The initial test is Gram staining, which reveals pleomorphic gram-negative coccobacilli. […] Cultures of blood and body fluids confirm the presence of the organism.

• #3 Epidemiology, clinical manifestations, diagnosis, and treatment of Haemophilus influenzae – UpToDate

  https://www.uptodate.com/contents/epidemiology-clinical-manifestations-diagnosis-and-treatment-of-haemophilus-influenzae

  INTRODUCTION […] Haemophilus influenzae are pleomorphic gram-negative rods that commonly colonize and infect the human respiratory tract. The H. influenzae species is divided into typeable (encapsulated) and nontypeable (unencapsulated) strains. […] Among typeable strains, H. influenzae serotype b (Hib) is the most virulent. In areas of the world where Hib vaccination is not widespread, Hib is a leading of cause of meningitis and epiglottitis in children and pneumonia in adults. By contrast, in areas where vaccination is routine, the prevalence of Hib has declined, while the prevalence of nontypeable H. influenzae has increased. Nontypeable strains tend to be less virulent than Hib and most commonly cause otitis media and infections of the respiratory tract such as acute rhinosinusitis, acute bronchitis, acute exacerbations of chronic obstructive pulmonary disease, and pneumonia.

• #4 News & Views — Haemophilus Influenzae Type B (Hib): Fast Facts for Healthcare Providers | Children’s Hospital of Philadelphia

  https://www.chop.edu/vaccine-update-healthcare-professionals/newsletter/hib-fast-facts-healthcare-providers

  Our Vaccine Update feature article Fast Facts series continues this month with a focus on Haemophilus influenzae type b (Hib). […] One of the more common questions our infectious disease colleagues are asked is, Should I be worried about something like meningitis in this unvaccinated child?. […] Prior to availability of the Hib vaccine, about 20,000 cases of invasive Hib disease occurred each year in the U.S. This plummeted by 99% with widespread use of the vaccine. […] Importantly, vaccination rates need to remain above approximately 90% in infants and toddlers the groups that drive transmission to maintain these community benefits, more commonly referred to as herd immunity. […] Hib, therefore, needs to be considered as a cause of any of these syndromes in unvaccinated children.

• #5 Haemophilus lnfluenzae Type B (Hib, Haemophilus b)

  https://www.health.ny.gov/diseases/communicable/haemophilus_influenzae/fact_sheet.htm

  Hib is a bacterial illness that can lead to a potentially deadly brain infection in young children. Hib may cause diseases such as meningitis (inflammation of the coverings of the brain and spinal column), bloodstream infections, pneumonia, arthritis and infections of other parts of the body. […] Hib disease can occur at any age. Before the development of a vaccine, Hib was the leading cause of bacterial meningitis among children less than five years of age. Since the introduction in 1988 and the widespread use of the Hib vaccine, the number of new cases of Hib disease in infants and young children decreased by 99 percent to fewer that one case per 100,000 children younger than five years of age. Now, Hib is seen more commonly in the elderly, unvaccinated or incompletely vaccinated children, and people with a weakened immune system.

• #6

  http://www.bccdc.ca/health-info/diseases-conditions/haemophilus-influenzae-type-b-hib

  Haemophilus influenzae type b (Hib) is a severe bacterial infection which occurs mostly in infants and children under 5. […] Since the introduction of Hib-containing vaccines, rates of Hib disease have dropped dramatically. More detailed rates and trends for Hib in British Columbia are available in the Annual Summary of Reportable Diseases and the Reportable Disease Dashboard. […] Hib infection is caused by a germ (or bacteria) called Haemophilus influenzae type b. It usually infects children under 5 years of age. Before Hib vaccine became available, Hib used to be the most common cause of bacterial meningitis in children aged 2 months to 5 years of age. Hib disease is now rare in BC because of routine childhood vaccination programs. […] The majority of cases in children now occur in unvaccinated children or in children who are too young to have received their Hib vaccine at 2, 4, and 6 months of age. […] Diagnosis is based on cultures taken (most often of spinal fluid, blood, lung fluid, or joint fluid) to determine the infection is caused by Hib bacteria.

• #7 How Haemophilus Influenzae Type B Affects the Body

  https://www.verywellhealth.com/haemophilus-influenzae-type-b-overview-4589876

  Haemophilus influenzae type b (Hib) is a disease that can cause complications, including meningitis, pneumonia, or a bloodstream infection. […] Because Hib can look like many other bacterial infections, healthcare providers often rely on lab tests, in addition to a persons medical history and physical exam, to diagnose the disease and recommend treatment. […] If positive for Haemophilus influenzae, local health officials might also want to run tests to figure out if the infection is due to type b or some other subtype. […] Before diagnosing Hib, healthcare providers will first take a medical history and look for signs or symptoms of invasive Hib disease or any of its complications. […] If healthcare providers suspect Hib after a physical exam, theyll typically confirm the diagnosis by testing body fluidsoften blood or spinal fluidfor the bacteria.

• #8 Best practice guidelines for diagnosis of Haemophilus influenzae and Neisseria meningitidis disease | Meningococcal | CDC

  https://www.cdc.gov/meningococcal/php/guidance/index.html

  Invasive disease caused by Haemophilus influenzae (Hi) or Neisseria meningitidis (Nm) is diagnosed based on clinical presentation. […] Laboratory tests, including culture and nucleic acid amplification (e.g., polymerase chain reaction [PCR]), can aid in diagnosis. […] State public health laboratories considering PCR for Hi and Nm should select assays capable of detecting and differentiating […] All Hi serotypes (serotypes a-f) […] All Nm serogroups common in the United States (serogroups B, C, W, and Y) […] Regardless of PCR capacity, state public health laboratories with Hi and Nm PCR capacity are strongly encouraged to continue performing culture. […] If Hi or Nm is identified via PCR, laboratories should perform one of the following: […] A simultaneous culture […] A reflex culture.

• #9 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Test results on body fluids from various sites of infection that reveal small, gram-negative, pleomorphic coccobacilli with polymorphonuclear cells are strong evidence of infection. […] Detection of the organism in a blood culture or any other body fluid is the most confirmatory method of establishing the diagnosis. Optimal growth requires the use of chocolate agar and BVCCA, which is a selective media of chocolate agar that contains bacitracin, vancomycin, and clindamycin. […] The viability of H influenzae is lost rapidly, so clinical specimens should be inoculated to an appropriate culture media without delay. […] Seventy to 90% of patients with epiglottitis have positive blood culture results. […] Slide agglutination with type-specific antisera is used for serotyping H influenzae.

• #10 Best practice guidelines for diagnosis of Haemophilus influenzae and Neisseria meningitidis disease | Meningococcal | CDC

  https://www.cdc.gov/meningococcal/php/guidance/index.html

  Invasive disease caused by Haemophilus influenzae (Hi) or Neisseria meningitidis (Nm) is diagnosed based on clinical presentation. […] Laboratory tests, including culture and nucleic acid amplification (e.g., polymerase chain reaction [PCR]), can aid in diagnosis. […] State public health laboratories considering PCR for Hi and Nm should select assays capable of detecting and differentiating […] All Hi serotypes (serotypes a-f) […] All Nm serogroups common in the United States (serogroups B, C, W, and Y) […] Regardless of PCR capacity, state public health laboratories with Hi and Nm PCR capacity are strongly encouraged to continue performing culture. […] If Hi or Nm is identified via PCR, laboratories should perform one of the following: […] A simultaneous culture […] A reflex culture.

• #11 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Detection of the PRP polysaccharide capsule via countercurrent immunoelectrophoresis, latex particle agglutination, co-agglutination, and enzyme-linked immunosorbent assay is an important adjunct to culturing in establishing a rapid diagnosis. […] Even if antibiotics were previously administered, the diagnosis can be confirmed based on the detection of the polysaccharide capsule in body fluids, including serum, CSF, urine, and pleural, pericardial, and articular fluid. […] In meningitis, the CSF examination demonstrates pleocytosis (mean, 4000-5000 WBCs/L) with a predominance of neutrophils. […] Decreased CSF glucose levels are encountered in 75% of patients, increased CSF protein levels and detectable capsular antigen in 90%, and a positive CSF Gram stain result in 80%. […] Prior antibiotic treatment significantly decreases the H influenzae type b (Hib) concentration in the CSF and decreases the sensitivity of the Gram stain; however, antibiotics do not substantially affect the total CSF blood cell count, differential, chemistries, and presence of the PRP capsule in pretreated patients.

• #12 Haemophilus influenzae Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562176/

  Haemophilus influenzae disease is a name collectively used for any kind of infection caused by the bacteria called Haemophilus influenzae. […] The most familiar and predominant form is H. influenzae type b (Hib), which infects mostly children and immunocompromised individuals. […] The Hib conjugate vaccine is effective for protection against capsular polysaccharide type b and has decreased the rate of Hib infections to a greater extent. […] More definitively, tests like polymerase chain reaction (PCR) and matrix-associated laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) are done to determine capsule types. […] The initial test is Gram staining, which reveals pleomorphic gram-negative coccobacilli. […] Cultures of blood and body fluids confirm the presence of the organism.

• #13 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Detection of the PRP polysaccharide capsule via countercurrent immunoelectrophoresis, latex particle agglutination, co-agglutination, and enzyme-linked immunosorbent assay is an important adjunct to culturing in establishing a rapid diagnosis. […] Even if antibiotics were previously administered, the diagnosis can be confirmed based on the detection of the polysaccharide capsule in body fluids, including serum, CSF, urine, and pleural, pericardial, and articular fluid. […] In meningitis, the CSF examination demonstrates pleocytosis (mean, 4000-5000 WBCs/L) with a predominance of neutrophils. […] Decreased CSF glucose levels are encountered in 75% of patients, increased CSF protein levels and detectable capsular antigen in 90%, and a positive CSF Gram stain result in 80%. […] Prior antibiotic treatment significantly decreases the H influenzae type b (Hib) concentration in the CSF and decreases the sensitivity of the Gram stain; however, antibiotics do not substantially affect the total CSF blood cell count, differential, chemistries, and presence of the PRP capsule in pretreated patients.

• #14 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Nucleic acid amplification diagnostics offer a rapid and accurate method of diagnosing microbial pathogens. […] For H influenzae infection, PCR is more accurate than conventional methods of serotyping (slide agglutination method). The diagnostic sensitivity for Hib is 72-92%. […] In patients with pneumonia who are unable to provide lower respiratory tract samples, rtPCR of upper respiratory tract samples yields a sensitivity, specificity, PPV, and NPV of 75%, 80%, 45%, 94%, respectively, for H influenzae. […] Multiplex PCR assay enables simultaneous detection of multiple pathogens, reducing analysis time and cost. […] A line probe assay (LPA) that is based on multiplex PCR followed by reverse hybridization using sequence-specific oligonucleotide probes has been developed for the detection of bacterial pathogens that cause meningitis, specifically H influenzae, S pneumoniae, and N meningitidis.

• #15 Detection of Haemophilus influenzae Type b by Real-Time PCR

  https://pmc.ncbi.nlm.nih.gov/articles/PMC497579/

  A real-time PCR assay targeting the capsulation locus of Haemophilus influenzae type b (Hib) was developed. The linear detection range was from 1 to 106 microorganisms per reaction mixture. No H. influenzae other than Hib or any other control bacteria typically found in the upper respiratory tract was detected. […] Assessment of Hib carriage using cultures of nasopharyngeal specimens gives an accurate picture of the epidemiological status of the bacteria. Hib bacteria are identified by biochemical tests, followed by serotyping for capsular antigen, but the latter is troublesome and ambiguous. Genotyping and ribotyping are more accurate. We established a highly sensitive and specific assay based on real-time PCR (TaqMan) to detect Hib. […] The real-time PCR assay detected all 10 of the invasive H. influenzae isolates identified by capsular genotyping as Hib strains, but none of those identified as non-Hib strains. Serotyping also identified all Hib strains, but the Difco antisera identified three reference and three invasive H. influenzae strains as Hib, all identified as non-Hib strains by genotyping. […] The assay can be completed within 1 day, is faster than conventional culturing and identification, and therefore provides a potential reliable diagnostic tool for Hib and is able to assess nasopharyngeal carriage of Hib.

• #16 Best practice guidelines for diagnosis of Haemophilus influenzae and Neisseria meningitidis disease | Meningococcal | CDC

  https://www.cdc.gov/meningococcal/php/guidance/index.html

  Invasive disease caused by Haemophilus influenzae (Hi) or Neisseria meningitidis (Nm) is diagnosed based on clinical presentation. […] Laboratory tests, including culture and nucleic acid amplification (e.g., polymerase chain reaction [PCR]), can aid in diagnosis. […] State public health laboratories considering PCR for Hi and Nm should select assays capable of detecting and differentiating […] All Hi serotypes (serotypes a-f) […] All Nm serogroups common in the United States (serogroups B, C, W, and Y) […] Regardless of PCR capacity, state public health laboratories with Hi and Nm PCR capacity are strongly encouraged to continue performing culture. […] If Hi or Nm is identified via PCR, laboratories should perform one of the following: […] A simultaneous culture […] A reflex culture.

• #17 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Nucleic acid amplification diagnostics offer a rapid and accurate method of diagnosing microbial pathogens. […] For H influenzae infection, PCR is more accurate than conventional methods of serotyping (slide agglutination method). The diagnostic sensitivity for Hib is 72-92%. […] In patients with pneumonia who are unable to provide lower respiratory tract samples, rtPCR of upper respiratory tract samples yields a sensitivity, specificity, PPV, and NPV of 75%, 80%, 45%, 94%, respectively, for H influenzae. […] Multiplex PCR assay enables simultaneous detection of multiple pathogens, reducing analysis time and cost. […] A line probe assay (LPA) that is based on multiplex PCR followed by reverse hybridization using sequence-specific oligonucleotide probes has been developed for the detection of bacterial pathogens that cause meningitis, specifically H influenzae, S pneumoniae, and N meningitidis.

• #18 Haemophilus influenzae: Infectious substances pathogen safety data sheet – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/haemophilus-influenzae-type-b.html

  Hib infection can be identified by monitoring for symptoms. Diagnosis is most often confirmed by gram-stain followed by a bacterial culture. […] For rapid diagnosis, techniques include detection of the PRP polysaccharide by latex agglutination, enzyme-linked immunosorbent assay, or countercurrent immunoelectrophoresis and PCR. […] Hib associated meningitis can be confirmed through PCR analysis of a cerebrospinal fluid (CSF) obtained through lumbar puncture prior to antibiotic administration. […] Pneumonia can be diagnosed through examination of a chest x-ray, then sputum gram-stain and cultures. Invasive procedures such as bronchoscopy and trans-tracheal aspiration may be required to obtain samples. […] RT-PCR of respiratory secretions has a high sensitivity and specificity. […] Multiplex PCR and a line probe assay (LPA) are advanced techniques that can detect Hib.

• #19 Haemophilus influenzae Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562176/

  For rapid diagnosis, methods like immunoelectrophoresis, latex particle agglutination, and enzyme-linked immunosorbent assay are employed for the identification of PRP polysaccharide, in addition to ordering cultures. […] A real-time PCR is usually done for capsule serotyping, and it also precisely differentiates NTHi from other pathogens such as H. haemolyticus, which resembles H.influenzae but is not pathogenic. […] A promising kind is duplex recombinase polymerase amplification (RPA) because it has both sensitivity and specificity of 100% for diagnosing H. influenzae meningitis. […] The approach to treating H. influenzae infections mainly involves antibiotics and conservative measures. […] The initial antibiotic choice is a third-generation cephalosporin while waiting for the culture and sensitivity results.

• #20 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Detection of the PRP polysaccharide capsule via countercurrent immunoelectrophoresis, latex particle agglutination, co-agglutination, and enzyme-linked immunosorbent assay is an important adjunct to culturing in establishing a rapid diagnosis. […] Even if antibiotics were previously administered, the diagnosis can be confirmed based on the detection of the polysaccharide capsule in body fluids, including serum, CSF, urine, and pleural, pericardial, and articular fluid. […] In meningitis, the CSF examination demonstrates pleocytosis (mean, 4000-5000 WBCs/L) with a predominance of neutrophils. […] Decreased CSF glucose levels are encountered in 75% of patients, increased CSF protein levels and detectable capsular antigen in 90%, and a positive CSF Gram stain result in 80%. […] Prior antibiotic treatment significantly decreases the H influenzae type b (Hib) concentration in the CSF and decreases the sensitivity of the Gram stain; however, antibiotics do not substantially affect the total CSF blood cell count, differential, chemistries, and presence of the PRP capsule in pretreated patients.

• #21 Haemophilus Influenzae: Symptoms and Treatment | Doctor

  https://patient.info/doctor/haemophilus-influenzae

  Cases of invasive Hib disease have declined since the introduction of the Hib conjugate vaccine in 1992 and have remained at low levels since the introduction of the 12-month booster in 2006. In 2020, invasive Hib disease continued to be well controlled across all age groups. […] The most common presentation (60% of all cases) of invasive Hib disease is meningitis, frequently accompanied by bacteraemia. Hib meningitis primarily affects children younger than 2 years, with a peak frequency rate occurring in infants aged 6-9 months. […] Gram stain: small, Gram-negative, pleomorphic coccobacilli with polymorphonuclear cells. […] Detection of the polyribosyl ribitol phosphate (PRP) polysaccharide capsule: methods include countercurrent immunoelectrophoresis and enzyme-linked immunosorbent assay; important for providing a rapid diagnosis and is not affected by prior antibiotics.

• #22 Haemophilus influenzae Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562176/

  For rapid diagnosis, methods like immunoelectrophoresis, latex particle agglutination, and enzyme-linked immunosorbent assay are employed for the identification of PRP polysaccharide, in addition to ordering cultures. […] A real-time PCR is usually done for capsule serotyping, and it also precisely differentiates NTHi from other pathogens such as H. haemolyticus, which resembles H.influenzae but is not pathogenic. […] A promising kind is duplex recombinase polymerase amplification (RPA) because it has both sensitivity and specificity of 100% for diagnosing H. influenzae meningitis. […] The approach to treating H. influenzae infections mainly involves antibiotics and conservative measures. […] The initial antibiotic choice is a third-generation cephalosporin while waiting for the culture and sensitivity results.

• #23 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Compared with standard PCR as reference, the overall sensitivity and specificity of LPA for the detection of bacterial pathogens were 76% and 88%, respectively. For Hib, LPA sensitivity and specificity were 88% and 96%. […] A novel technology (VAPChip assay) currently under development combines bacterial species identification and detection of resistance genes associated with beta-lactam resistance encoding carbapenemases, extended-spectrum beta-lactamases, and penicillin-binding protein 2a. […] Because PCR testing requires expensive thermocycler equipment and a skilled operator, it cannot be used as a point-of-care test or in resource-limited settings. Isothermal nucleic acid amplification methods provide a cheaper alternative to PCR, as they do not require thermocycler equipment. […] Proteomic profiling via matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is an alternative to biochemical and molecular methods of species identification.

• #24 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Studies have shown that MALDI-TOF MS accurately differentiates between NTHi and H haemophilus, a respiratory tract commensal. […] MALDI-TOF MS is quicker to perform than PCR and conventional serotyping (slide agglutination) methods and has a lower cost per sample, making it a useful tool for H influenzae surveillance and outbreak investigations. […] Whole-genomesequencing (WGS)based tools identify species by comparing sample genomes against a reference collection of representative genomes.

• #25 Haemophilus influenzae: Infectious substances pathogen safety data sheet – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/haemophilus-influenzae-type-b.html

  Isothermal nucleic acid amplification test (isothermal NAAT), duplex recombinase polymerase amplification (RPA), and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) are other methods that can aid in rapid species identification with high sensitivity and specificity.

• #26 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Test results on body fluids from various sites of infection that reveal small, gram-negative, pleomorphic coccobacilli with polymorphonuclear cells are strong evidence of infection. […] Detection of the organism in a blood culture or any other body fluid is the most confirmatory method of establishing the diagnosis. Optimal growth requires the use of chocolate agar and BVCCA, which is a selective media of chocolate agar that contains bacitracin, vancomycin, and clindamycin. […] The viability of H influenzae is lost rapidly, so clinical specimens should be inoculated to an appropriate culture media without delay. […] Seventy to 90% of patients with epiglottitis have positive blood culture results. […] Slide agglutination with type-specific antisera is used for serotyping H influenzae.

• #27 Detection of Haemophilus influenzae Type b by Real-Time PCR

  https://pmc.ncbi.nlm.nih.gov/articles/PMC497579/

  A real-time PCR assay targeting the capsulation locus of Haemophilus influenzae type b (Hib) was developed. The linear detection range was from 1 to 106 microorganisms per reaction mixture. No H. influenzae other than Hib or any other control bacteria typically found in the upper respiratory tract was detected. […] Assessment of Hib carriage using cultures of nasopharyngeal specimens gives an accurate picture of the epidemiological status of the bacteria. Hib bacteria are identified by biochemical tests, followed by serotyping for capsular antigen, but the latter is troublesome and ambiguous. Genotyping and ribotyping are more accurate. We established a highly sensitive and specific assay based on real-time PCR (TaqMan) to detect Hib. […] The real-time PCR assay detected all 10 of the invasive H. influenzae isolates identified by capsular genotyping as Hib strains, but none of those identified as non-Hib strains. Serotyping also identified all Hib strains, but the Difco antisera identified three reference and three invasive H. influenzae strains as Hib, all identified as non-Hib strains by genotyping. […] The assay can be completed within 1 day, is faster than conventional culturing and identification, and therefore provides a potential reliable diagnostic tool for Hib and is able to assess nasopharyngeal carriage of Hib.

• #28 Best practice guidelines for diagnosis of Haemophilus influenzae and Neisseria meningitidis disease | Meningococcal | CDC

  https://www.cdc.gov/meningococcal/php/guidance/index.html

  Invasive disease caused by Haemophilus influenzae (Hi) or Neisseria meningitidis (Nm) is diagnosed based on clinical presentation. […] Laboratory tests, including culture and nucleic acid amplification (e.g., polymerase chain reaction [PCR]), can aid in diagnosis. […] State public health laboratories considering PCR for Hi and Nm should select assays capable of detecting and differentiating […] All Hi serotypes (serotypes a-f) […] All Nm serogroups common in the United States (serogroups B, C, W, and Y) […] Regardless of PCR capacity, state public health laboratories with Hi and Nm PCR capacity are strongly encouraged to continue performing culture. […] If Hi or Nm is identified via PCR, laboratories should perform one of the following: […] A simultaneous culture […] A reflex culture.

• #29 Detection of Haemophilus influenzae Type b by Real-Time PCR

  https://pmc.ncbi.nlm.nih.gov/articles/PMC497579/

  A real-time PCR assay targeting the capsulation locus of Haemophilus influenzae type b (Hib) was developed. The linear detection range was from 1 to 106 microorganisms per reaction mixture. No H. influenzae other than Hib or any other control bacteria typically found in the upper respiratory tract was detected. […] Assessment of Hib carriage using cultures of nasopharyngeal specimens gives an accurate picture of the epidemiological status of the bacteria. Hib bacteria are identified by biochemical tests, followed by serotyping for capsular antigen, but the latter is troublesome and ambiguous. Genotyping and ribotyping are more accurate. We established a highly sensitive and specific assay based on real-time PCR (TaqMan) to detect Hib. […] The real-time PCR assay detected all 10 of the invasive H. influenzae isolates identified by capsular genotyping as Hib strains, but none of those identified as non-Hib strains. Serotyping also identified all Hib strains, but the Difco antisera identified three reference and three invasive H. influenzae strains as Hib, all identified as non-Hib strains by genotyping. […] The assay can be completed within 1 day, is faster than conventional culturing and identification, and therefore provides a potential reliable diagnostic tool for Hib and is able to assess nasopharyngeal carriage of Hib.

• #30 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Studies have shown that MALDI-TOF MS accurately differentiates between NTHi and H haemophilus, a respiratory tract commensal. […] MALDI-TOF MS is quicker to perform than PCR and conventional serotyping (slide agglutination) methods and has a lower cost per sample, making it a useful tool for H influenzae surveillance and outbreak investigations. […] Whole-genomesequencing (WGS)based tools identify species by comparing sample genomes against a reference collection of representative genomes.

• #31 Best practice guidelines for diagnosis of Haemophilus influenzae and Neisseria meningitidis disease | Meningococcal | CDC

  https://www.cdc.gov/meningococcal/php/guidance/index.html

  If obtaining a culture isn’t possible, at a minimum, laboratories should collect and maintain an adequate clinical sample. This way another laboratory can conduct further testing with a PCR or culture-free sequencing assay that can detect serotype/serogroup. […] Cases are considered confirmed if PCR-positive for Hi or Nm in an appropriate specimen type: […] H. influenzae disease case definition […] Meningococcal disease case definition. […] CDC has validated, specific real-time PCR assays capable of detecting […] Hi species and all 6 serotypes (a-f) […] Nm species and 6 serogroups (A, B, C, W, X, and Y) […] Determining serotype and serogroup is crucial for […] Identifying potential outbreaks […] Determining appropriate public health responses. […] Haemophilus influenzae type b (Hib) is the only Hi serotype that vaccines offer protection against.

• #32 News & Views — Haemophilus Influenzae Type B (Hib): Fast Facts for Healthcare Providers | Children’s Hospital of Philadelphia

  https://www.chop.edu/vaccine-update-healthcare-professionals/newsletter/hib-fast-facts-healthcare-providers

  Depending on the patients syndrome, different tests may be required. If evaluating for meningitis, a lumbar puncture is needed for a gram stain (looking for small gram-negative coccobacilli), white blood cell count, measurements of protein (which will be high) and glucose (which will be low). […] Many multiplex PCR panels for meningitis include testing for Hib; alternatively, the diagnosis can be confirmed through culturing spinal fluid. […] While the evaluation of an unvaccinated child does not need to change for these conditions, clinicians should consider Hib as a cause of these illnesses in unvaccinated children as this will impact the choice of antibiotic for treatment. […] Antibiotics are the primary method of treatment for Hib. […] Clinical guidelines in the vaccine era highlight the need to consider a patients vaccination status when making empiric treatment decisions.

• #33 Haemophilus influenzae Infections – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/bacterial-infections-gram-negative-bacteria/haemophilus-influenzae-infections

  Identifying the bacteria in a sample taken from blood or from infected tissue confirms the diagnosis. […] To diagnose the infection, doctors take a sample of blood, pus, or other body fluids and send it to a laboratory to grow (culture) the bacteria. They also can test for genes of the bacteria. […] If people have symptoms of meningitis, doctors do a spinal tap (lumbar puncture) to obtain a sample of the fluid that surrounds the brain and spinal cord (cerebrospinal fluid). Identifying the bacteria in a sample confirms the diagnosis. […] After the bacteria are identified, they may be tested to see which antibiotics are effective (a process called susceptibility testing).

• #34 News & Views — Haemophilus Influenzae Type B (Hib): Fast Facts for Healthcare Providers | Children’s Hospital of Philadelphia

  https://www.chop.edu/vaccine-update-healthcare-professionals/newsletter/hib-fast-facts-healthcare-providers

  Depending on the patients syndrome, different tests may be required. If evaluating for meningitis, a lumbar puncture is needed for a gram stain (looking for small gram-negative coccobacilli), white blood cell count, measurements of protein (which will be high) and glucose (which will be low). […] Many multiplex PCR panels for meningitis include testing for Hib; alternatively, the diagnosis can be confirmed through culturing spinal fluid. […] While the evaluation of an unvaccinated child does not need to change for these conditions, clinicians should consider Hib as a cause of these illnesses in unvaccinated children as this will impact the choice of antibiotic for treatment. […] Antibiotics are the primary method of treatment for Hib. […] Clinical guidelines in the vaccine era highlight the need to consider a patients vaccination status when making empiric treatment decisions.

• #35 News & Views — Haemophilus Influenzae Type B (Hib): Fast Facts for Healthcare Providers | Children’s Hospital of Philadelphia

  https://www.chop.edu/vaccine-update-healthcare-professionals/newsletter/hib-fast-facts-healthcare-providers

  Depending on the patients syndrome, different tests may be required. If evaluating for meningitis, a lumbar puncture is needed for a gram stain (looking for small gram-negative coccobacilli), white blood cell count, measurements of protein (which will be high) and glucose (which will be low). […] Many multiplex PCR panels for meningitis include testing for Hib; alternatively, the diagnosis can be confirmed through culturing spinal fluid. […] While the evaluation of an unvaccinated child does not need to change for these conditions, clinicians should consider Hib as a cause of these illnesses in unvaccinated children as this will impact the choice of antibiotic for treatment. […] Antibiotics are the primary method of treatment for Hib. […] Clinical guidelines in the vaccine era highlight the need to consider a patients vaccination status when making empiric treatment decisions.

• #36 News & Views — Haemophilus Influenzae Type B (Hib): Fast Facts for Healthcare Providers | Children’s Hospital of Philadelphia

  https://www.chop.edu/vaccine-update-healthcare-professionals/newsletter/hib-fast-facts-healthcare-providers

  Depending on the patients syndrome, different tests may be required. If evaluating for meningitis, a lumbar puncture is needed for a gram stain (looking for small gram-negative coccobacilli), white blood cell count, measurements of protein (which will be high) and glucose (which will be low). […] Many multiplex PCR panels for meningitis include testing for Hib; alternatively, the diagnosis can be confirmed through culturing spinal fluid. […] While the evaluation of an unvaccinated child does not need to change for these conditions, clinicians should consider Hib as a cause of these illnesses in unvaccinated children as this will impact the choice of antibiotic for treatment. […] Antibiotics are the primary method of treatment for Hib. […] Clinical guidelines in the vaccine era highlight the need to consider a patients vaccination status when making empiric treatment decisions.

• #37 Haemophilus influenzae: Infectious substances pathogen safety data sheet – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/haemophilus-influenzae-type-b.html

  Hib infection can be identified by monitoring for symptoms. Diagnosis is most often confirmed by gram-stain followed by a bacterial culture. […] For rapid diagnosis, techniques include detection of the PRP polysaccharide by latex agglutination, enzyme-linked immunosorbent assay, or countercurrent immunoelectrophoresis and PCR. […] Hib associated meningitis can be confirmed through PCR analysis of a cerebrospinal fluid (CSF) obtained through lumbar puncture prior to antibiotic administration. […] Pneumonia can be diagnosed through examination of a chest x-ray, then sputum gram-stain and cultures. Invasive procedures such as bronchoscopy and trans-tracheal aspiration may be required to obtain samples. […] RT-PCR of respiratory secretions has a high sensitivity and specificity. […] Multiplex PCR and a line probe assay (LPA) are advanced techniques that can detect Hib.

• #38 Haemophilus influenzae: Infectious substances pathogen safety data sheet – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/haemophilus-influenzae-type-b.html

  Hib infection can be identified by monitoring for symptoms. Diagnosis is most often confirmed by gram-stain followed by a bacterial culture. […] For rapid diagnosis, techniques include detection of the PRP polysaccharide by latex agglutination, enzyme-linked immunosorbent assay, or countercurrent immunoelectrophoresis and PCR. […] Hib associated meningitis can be confirmed through PCR analysis of a cerebrospinal fluid (CSF) obtained through lumbar puncture prior to antibiotic administration. […] Pneumonia can be diagnosed through examination of a chest x-ray, then sputum gram-stain and cultures. Invasive procedures such as bronchoscopy and trans-tracheal aspiration may be required to obtain samples. […] RT-PCR of respiratory secretions has a high sensitivity and specificity. […] Multiplex PCR and a line probe assay (LPA) are advanced techniques that can detect Hib.

• #39 Haemophilus influenzae: Infectious substances pathogen safety data sheet – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/haemophilus-influenzae-type-b.html

  Hib infection can be identified by monitoring for symptoms. Diagnosis is most often confirmed by gram-stain followed by a bacterial culture. […] For rapid diagnosis, techniques include detection of the PRP polysaccharide by latex agglutination, enzyme-linked immunosorbent assay, or countercurrent immunoelectrophoresis and PCR. […] Hib associated meningitis can be confirmed through PCR analysis of a cerebrospinal fluid (CSF) obtained through lumbar puncture prior to antibiotic administration. […] Pneumonia can be diagnosed through examination of a chest x-ray, then sputum gram-stain and cultures. Invasive procedures such as bronchoscopy and trans-tracheal aspiration may be required to obtain samples. […] RT-PCR of respiratory secretions has a high sensitivity and specificity. […] Multiplex PCR and a line probe assay (LPA) are advanced techniques that can detect Hib.

• #40 Haemophilus influenzae: Infectious substances pathogen safety data sheet – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/haemophilus-influenzae-type-b.html

  Hib infection can be identified by monitoring for symptoms. Diagnosis is most often confirmed by gram-stain followed by a bacterial culture. […] For rapid diagnosis, techniques include detection of the PRP polysaccharide by latex agglutination, enzyme-linked immunosorbent assay, or countercurrent immunoelectrophoresis and PCR. […] Hib associated meningitis can be confirmed through PCR analysis of a cerebrospinal fluid (CSF) obtained through lumbar puncture prior to antibiotic administration. […] Pneumonia can be diagnosed through examination of a chest x-ray, then sputum gram-stain and cultures. Invasive procedures such as bronchoscopy and trans-tracheal aspiration may be required to obtain samples. […] RT-PCR of respiratory secretions has a high sensitivity and specificity. […] Multiplex PCR and a line probe assay (LPA) are advanced techniques that can detect Hib.

• #41 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Test results on body fluids from various sites of infection that reveal small, gram-negative, pleomorphic coccobacilli with polymorphonuclear cells are strong evidence of infection. […] Detection of the organism in a blood culture or any other body fluid is the most confirmatory method of establishing the diagnosis. Optimal growth requires the use of chocolate agar and BVCCA, which is a selective media of chocolate agar that contains bacitracin, vancomycin, and clindamycin. […] The viability of H influenzae is lost rapidly, so clinical specimens should be inoculated to an appropriate culture media without delay. […] Seventy to 90% of patients with epiglottitis have positive blood culture results. […] Slide agglutination with type-specific antisera is used for serotyping H influenzae.

• #42 Best practice guidelines for diagnosis of Haemophilus influenzae and Neisseria meningitidis disease | Meningococcal | CDC

  https://www.cdc.gov/meningococcal/php/guidance/index.html

  Invasive disease caused by Haemophilus influenzae (Hi) or Neisseria meningitidis (Nm) is diagnosed based on clinical presentation. […] Laboratory tests, including culture and nucleic acid amplification (e.g., polymerase chain reaction [PCR]), can aid in diagnosis. […] State public health laboratories considering PCR for Hi and Nm should select assays capable of detecting and differentiating […] All Hi serotypes (serotypes a-f) […] All Nm serogroups common in the United States (serogroups B, C, W, and Y) […] Regardless of PCR capacity, state public health laboratories with Hi and Nm PCR capacity are strongly encouraged to continue performing culture. […] If Hi or Nm is identified via PCR, laboratories should perform one of the following: […] A simultaneous culture […] A reflex culture.

• #43 Haemophilus influenzae Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562176/

  In cases of suspected Hib meningitis, antibiotic choices include ceftriaxone, ceftazidime, cefotaxime, ampicillin-sulbactam, fluoroquinolones, and azithromycin given via parenteral route for one week. […] The recommended management of occult bacteremia is obtaining repeated cultures, chest radiographs, and CSF analysis to find out the focus of infection.

• #44 HIBSG – Overview: Haemophilus influenzae Type B Antibody, IgG, Serum

  https://www.mayocliniclabs.com/test-catalog/Overview/614598

  Assessing a patient’s immunological (IgG) response to Haemophilus influenzae type B (HIB) vaccine […] Assessing immunity against HIB […] Aiding in the evaluation of immunodeficiency when the patient is tested pre- and post-vaccination […] Haemophilus influenzae type B (HIB) is an encapsulated Gram-negative cocco-bacillary bacterium that can cause devastating disease in unvaccinated young children, including meningitis, bacteremia, cellulitis, epiglottitis, pneumonia, and septic arthritis. […] A patient’s immunological response to HIB vaccine can be determined by measuring anti-HIB IgG antibody levels using a standardized enzyme immunoassay (EIA). […] An anti-Haemophilus influenzae type B (HIB) IgG antibody concentration of 0.15 mcg/L is generally accepted as the minimum level for protection at a given time; however, it does not confer long-term protection. […] This assay does not provide diagnostic proof of the presence or absence of immune deficiency. Results must be confirmed by clinical findings and other laboratory tests.

• #45 HIBSG – Overview: Haemophilus influenzae Type B Antibody, IgG, Serum

  https://www.mayocliniclabs.com/test-catalog/overview/614598

  Prior infection with H influenzae is associated with protective immunity against reinfection. One of the great advances in modern medicine has been the development of an effective vaccine against HIB, which is based on use of an unconjugated, purified PRP antigen. A patient’s immunological response to HIB vaccine can be determined by measuring anti-HIB IgG antibody levels using a standardized enzyme immunoassay (EIA). Antibody levels of 1 mcg/mL or more at least 3 weeks after vaccination has been correlated with long-term protective immunity. […] An anti-Haemophilus influenzae type B (HIB) IgG antibody concentration of 0.15 mcg/L is generally accepted as the minimum level for protection at a given time; however, it does not confer long-term protection. A study from Finland suggested that the optimum protective level is 1.0 mcg/L postimmunization. […] This assay does not provide diagnostic proof of the presence or absence of immune deficiency. Results must be confirmed by clinical findings and other laboratory tests.

• #46 Haemophilus influenzae b Antibody, IgG | ARUP Laboratories Test Directory

  https://ltd.aruplab.com/Tests/Pub/0050542

  Haemophilus influenzae b Antibody, IgG […] Evaluate the ability of a patient to produce antibody to a protein conjugated bacterial (H. influenza) vaccine to rule out antibody deficiency. […] „Pre” and 30-day „post” Haemophilus influenzae b vaccination specimens should be submitted together for testing. „Post” specimen should be drawn 30 days after immunization and must be received within 60 days of „pre” specimen. […] Responder status is determined according to the ratio of post-vaccination concentration to pre-vaccination concentration of Haemophilus influenza b antibody, IgG as follows:1. If the post-vaccination concentration is less than 3.0 g/mL, the patient is considered to be a nonresponder.2. If the post-vaccination concentration is greater than or equal to 3.0 g/mL, a patient with a ratio of greater than or equal to 4 is a good responder, a ratio of 2-4 is a weak responder, and a ratio of less than 2 is considered a nonresponder. This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

• #47 Haemophilus Influenzae Type B Antigen – Serum Test, Price, Normal Range | Sprint Diagnostics Hyderabad

  https://www.sprintdiagnostics.in/hyderabad/test/haemophilus-influenzae-type-b-antigen-serum

  Haemophilus influenzae type b (Hib) is a bacterium responsible for severe pneumonia, meningitis and other invasive diseases primarily in children. […] The bacteria can be identified through different laboratory tests, and one such test is the detection of Hib antigen in a patient’s blood serum. […] For the Haemophilus Influenzae Type B Antigen test, a blood sample is drawn, usually from a vein in the arm. In the lab, the sample is processed to separate the serum which is then examined for the presence of the Hib antigen. […] This test detects the presence of Haemophilus influenzae type b (Hib) antigen in the blood serum. The presence of the antigen suggests a current or recent infection with the Hib bacterium. […] This test is often recommended for individuals, especially children, who present symptoms indicative of a Hib infection such as fever, lethargy, vomiting, or signs of meningitis like severe headache, neck stiffness, sensitivity to light, and confusion.

• #48 Haemophilus Influenzae Type B Antigen – Serum Test, Price, Normal Range | Sprint Diagnostics Hyderabad

  https://www.sprintdiagnostics.in/hyderabad/test/haemophilus-influenzae-type-b-antigen-serum

  The test requires a blood sample which is drawn from a vein in the arm. In the lab, the blood is processed to obtain the serum, which is then analyzed for the presence of Hib antigen. […] A positive result means that Hib antigen is present in the serum, indicating an active or recent infection with Haemophilus influenzae type b. A negative result means no Hib antigen was detected, and it’s unlikely that the person has a Hib infection. […] Prompt diagnosis of a Hib infection can prevent severe complications such as meningitis or pneumonia. If you or your child are experiencing symptoms indicative of a Hib infection, it is essential to seek medical attention immediately. This test is a valuable tool that can assist in the early detection and treatment of Hib infections.

• #49 Haemophilus Influenzae Antibody | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/lab-tests-v1/haemophilus-influenzae-antibody

  Haemophilus influenzae type b (Hib) IgG antibody level […] This test measures the amount of anti-Hib IgG immunoglobulin, or antibody, in your blood. […] This test can find out whether your body has responded to the Hib vaccine. It’s usually done if your immune system isn’t working the way it should. […] You may need this test if your healthcare provider isn’t sure whether you have developed immunity against Hib after getting the vaccine. You may also get this test both before and a few weeks after a dose of Hib vaccine to measure changes in the amount of Hib antibodies your body is able to make. […] A positive result means that antibodies were found in your blood. That means that you are or were recently infected with Hib or that your immune system was able to respond well to the Hib vaccine. Your healthcare provider will make a final diagnosis based on a physical exam, your symptoms, and other test results.

• #50 Haemophilus influenzae Antibody

  https://healthlibrary.uwmedicine.org/coronavirus/167,haemophilus_influenzae_antibody

  Haemophilus influenzae type b (Hib) IgG antibody level […] This test measures the amount of anti-Hib IgG immunoglobulin, or antibody, in your blood. […] The Hib vaccine is now routinely given to children to prevent infection. […] This test can find out whether your body has responded to the Hib vaccine. […] You may need this test if your healthcare provider isn’t sure whether you have developed immunity against Hib after getting the vaccine. […] A positive result means that antibodies were found in your blood. That means that you are or were recently infected with Hib or that your immune system was able to respond well to the Hib vaccine. Your healthcare provider will make a final diagnosis based on a physical exam, your symptoms, and other test results.

• #51 Haemophilus Influenzae Type B Antigen – Serum Test, Price, Normal Range | Sprint Diagnostics Hyderabad

  https://www.sprintdiagnostics.in/hyderabad/test/haemophilus-influenzae-type-b-antigen-serum

  The test requires a blood sample which is drawn from a vein in the arm. In the lab, the blood is processed to obtain the serum, which is then analyzed for the presence of Hib antigen. […] A positive result means that Hib antigen is present in the serum, indicating an active or recent infection with Haemophilus influenzae type b. A negative result means no Hib antigen was detected, and it’s unlikely that the person has a Hib infection. […] Prompt diagnosis of a Hib infection can prevent severe complications such as meningitis or pneumonia. If you or your child are experiencing symptoms indicative of a Hib infection, it is essential to seek medical attention immediately. This test is a valuable tool that can assist in the early detection and treatment of Hib infections.

• #52 Haemophilus influenzae Type B Antibody (IgG) | Test Detail | Quest Diagnostics

  https://testdirectory.questdiagnostics.com/test/test-detail/35135/haemophilus-influenzae-type-b-antibody-igg?p=r&cc=MASTER

  Haemophilus influenzae Type B Antibody (IgG) – Haemophilus influenzae is a gram-negative bacteria that is present in approximately three-quarters of children and adults. In infants and young children, haemophilus influenzae, especially type B, may cause bacteremias and meningitis. In children and older individuals haemophilus influenzae may cause respiratory tract infections. […] Enzyme Immunoassay (EIA) […] 1 mL serum […] Minimum Volume 0.2 mL […] Transport Container Transport tube […] Transport Temperature Room temperature […] Specimen Stability Room temperature: 7 days Refrigerated: 14 days Frozen: 30 days […] Reject Criteria Gross hemolysis • Grossly lipemic • Grossly icteric.

• #53 Haemophilus influenzae Type b (Hib) Vaccine – Creative Diagnostics

  https://www.creative-diagnostics.com/haemophilus-influenzae-type-b-hib-vaccine.htm

  Haemophilus influenzae (H. influenzae) is a Gram-negative human-specific pathogen that commonly infects the upper respiratory tract of children through the transfer of nasal secretions. […] The diagnosis of Hib infection typically involves a combination of clinical evaluation, laboratory testing, and imaging studies. The most common laboratory testing methods use a sample of blood or cerebrospinal fluid (CSF). […] Blood samples are taken to identify the presence of H. influenzae bacteria and determine the specific strain. […] This procedure involves collecting a sample of CSF from the spinal canal using a needle. The CSF analysis can help identify the presence of H. influenzae bacteria and confirm meningitis. […] PCR testing is used to detect the genetic material (DNA) of H. influenzae bacteria in various clinical samples, such as blood, CSF, or respiratory secretions. It provides rapid and accurate results.

• #54 Haemophilus influenzae Type B Antibody (IgG) | Test Detail | Quest Diagnostics

  https://testdirectory.questdiagnostics.com/test/test-detail/35135/haemophilus-influenzae-type-b-antibody-igg?p=r&cc=MASTER

  Haemophilus influenzae Type B Antibody (IgG) – Haemophilus influenzae is a gram-negative bacteria that is present in approximately three-quarters of children and adults. In infants and young children, haemophilus influenzae, especially type B, may cause bacteremias and meningitis. In children and older individuals haemophilus influenzae may cause respiratory tract infections. […] Enzyme Immunoassay (EIA) […] 1 mL serum […] Minimum Volume 0.2 mL […] Transport Container Transport tube […] Transport Temperature Room temperature […] Specimen Stability Room temperature: 7 days Refrigerated: 14 days Frozen: 30 days […] Reject Criteria Gross hemolysis • Grossly lipemic • Grossly icteric.

• #55

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/haemflu.aspx

  All patients with suspected Hib infection should have blood collected for bacterial culture (and/or nucleic acid amplification testing (NAAT)) (also known as PCR) as soon as possible before, or as soon as possible after, antibiotics are administered. […] The sensitivity of CSF and blood culture for detection of Hib infection is high unless antibiotic therapy has been started before sampling. […] A confirmed case requires laboratory definitive evidence only. […] Isolation or detection of Haemophilus influenzae type b (Hib) from a normally sterile site where typing has been confirmed at a jurisdictional or regional reference laboratory. […] Rifampicin has been shown to eradicate pharyngeal carriage of Hib in 92 to 97% of contacts, and consequently may decrease the risk of secondary cases. […] Because of the length of time necessary to develop antibodies, vaccination does not play a major role in the immediate management of patients with Hib disease or their contacts.

• #56 Best practice guidelines for diagnosis of Haemophilus influenzae and Neisseria meningitidis disease | Meningococcal | CDC

  https://www.cdc.gov/meningococcal/php/guidance/index.html

  Invasive disease caused by Haemophilus influenzae (Hi) or Neisseria meningitidis (Nm) is diagnosed based on clinical presentation. […] Laboratory tests, including culture and nucleic acid amplification (e.g., polymerase chain reaction [PCR]), can aid in diagnosis. […] State public health laboratories considering PCR for Hi and Nm should select assays capable of detecting and differentiating […] All Hi serotypes (serotypes a-f) […] All Nm serogroups common in the United States (serogroups B, C, W, and Y) […] Regardless of PCR capacity, state public health laboratories with Hi and Nm PCR capacity are strongly encouraged to continue performing culture. […] If Hi or Nm is identified via PCR, laboratories should perform one of the following: […] A simultaneous culture […] A reflex culture.

• #57 Haemophilus Influenzae Antibody | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/lab-tests-v1/haemophilus-influenzae-antibody

  Haemophilus influenzae type b (Hib) IgG antibody level […] This test measures the amount of anti-Hib IgG immunoglobulin, or antibody, in your blood. […] This test can find out whether your body has responded to the Hib vaccine. It’s usually done if your immune system isn’t working the way it should. […] You may need this test if your healthcare provider isn’t sure whether you have developed immunity against Hib after getting the vaccine. You may also get this test both before and a few weeks after a dose of Hib vaccine to measure changes in the amount of Hib antibodies your body is able to make. […] A positive result means that antibodies were found in your blood. That means that you are or were recently infected with Hib or that your immune system was able to respond well to the Hib vaccine. Your healthcare provider will make a final diagnosis based on a physical exam, your symptoms, and other test results.

• #58 Haemophilus Influenzae Type B Antigen – Serum Test, Price, Normal Range | Sprint Diagnostics Hyderabad

  https://www.sprintdiagnostics.in/hyderabad/test/haemophilus-influenzae-type-b-antigen-serum

  The test requires a blood sample which is drawn from a vein in the arm. In the lab, the blood is processed to obtain the serum, which is then analyzed for the presence of Hib antigen. […] A positive result means that Hib antigen is present in the serum, indicating an active or recent infection with Haemophilus influenzae type b. A negative result means no Hib antigen was detected, and it’s unlikely that the person has a Hib infection. […] Prompt diagnosis of a Hib infection can prevent severe complications such as meningitis or pneumonia. If you or your child are experiencing symptoms indicative of a Hib infection, it is essential to seek medical attention immediately. This test is a valuable tool that can assist in the early detection and treatment of Hib infections.

• #59 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Detection of the PRP polysaccharide capsule via countercurrent immunoelectrophoresis, latex particle agglutination, co-agglutination, and enzyme-linked immunosorbent assay is an important adjunct to culturing in establishing a rapid diagnosis. […] Even if antibiotics were previously administered, the diagnosis can be confirmed based on the detection of the polysaccharide capsule in body fluids, including serum, CSF, urine, and pleural, pericardial, and articular fluid. […] In meningitis, the CSF examination demonstrates pleocytosis (mean, 4000-5000 WBCs/L) with a predominance of neutrophils. […] Decreased CSF glucose levels are encountered in 75% of patients, increased CSF protein levels and detectable capsular antigen in 90%, and a positive CSF Gram stain result in 80%. […] Prior antibiotic treatment significantly decreases the H influenzae type b (Hib) concentration in the CSF and decreases the sensitivity of the Gram stain; however, antibiotics do not substantially affect the total CSF blood cell count, differential, chemistries, and presence of the PRP capsule in pretreated patients.

• #60 News & Views — Haemophilus Influenzae Type B (Hib): Fast Facts for Healthcare Providers | Children’s Hospital of Philadelphia

  https://www.chop.edu/vaccine-update-healthcare-professionals/newsletter/hib-fast-facts-healthcare-providers

  Depending on the patients syndrome, different tests may be required. If evaluating for meningitis, a lumbar puncture is needed for a gram stain (looking for small gram-negative coccobacilli), white blood cell count, measurements of protein (which will be high) and glucose (which will be low). […] Many multiplex PCR panels for meningitis include testing for Hib; alternatively, the diagnosis can be confirmed through culturing spinal fluid. […] While the evaluation of an unvaccinated child does not need to change for these conditions, clinicians should consider Hib as a cause of these illnesses in unvaccinated children as this will impact the choice of antibiotic for treatment. […] Antibiotics are the primary method of treatment for Hib. […] Clinical guidelines in the vaccine era highlight the need to consider a patients vaccination status when making empiric treatment decisions.

• #61 News & Views — Haemophilus Influenzae Type B (Hib): Fast Facts for Healthcare Providers | Children’s Hospital of Philadelphia

  https://www.chop.edu/vaccine-update-healthcare-professionals/newsletter/hib-fast-facts-healthcare-providers

  For example, first line treatment for community-acquired pneumonia in children is amoxicillin, but many strains of Hib will not respond to this antibiotic, instead requiring a broader antibiotic like amoxicillin-clavulanic acid. […] In contrast, sepsis, meningitis and epiglottitis are all medical emergencies and universally should be treated emergently in the hospital setting with intravenous antibiotics while waiting for results of initial testing. […] About 3%-6% of children infected with Hib will not survive. […] Survivors can also have lifelong neurologic conditions, including developmental delay, seizure disorders and learning disabilities. […] Hib remains uncommon, with fewer than 50 cases occurring each year in the U.S. However, if vaccination rates decrease, more children will be at risk for this deadly infection. Providers should be prepared to recognize its many presentations and act fast.

• #62 Haemophilus influenzae Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562176/

  In cases of suspected Hib meningitis, antibiotic choices include ceftriaxone, ceftazidime, cefotaxime, ampicillin-sulbactam, fluoroquinolones, and azithromycin given via parenteral route for one week. […] The recommended management of occult bacteremia is obtaining repeated cultures, chest radiographs, and CSF analysis to find out the focus of infection.

• #63 Haemophilus influenzae type b (Hib) invasive disease – Health New Zealand | Te Whatu Ora

  https://www.tewhatuora.govt.nz/for-health-professionals/clinical-guidance/communicable-disease-control-manual/haemophilus-influenzae-type-b-invasive-disease

  Cases treated with amoxycillin/clavulanate or amoxycillin alone should also receive oral rifampicin 20 mg/kg (maximum 600 mg) once daily for 4 days to eradicate carriage of the organism before discharge from hospital. […] Cases under 2 years of age should complete a course of Hib immunisation regardless of any previous Hib immunisation. […] Advise the case’s parents or caregivers of the nature of the infection and its mode of transmission. […] To eradicate the carrier state and protect susceptible children, antimicrobial prophylaxis should be given to the following contacts as soon as possible and ideally within 7 days of the index case developing the disease, irrespective of their own immunisation status. […] Use oral rifampicin 20 mg/kg (maximum 600 mg) daily for 4 days. […] Advise all contacts to seek early medical attention if symptoms develop. All children should have their immunisation status checked and, if it is incomplete, should complete their immunisation with an appropriate vaccine containing Hib.

• #64 Haemophilus Influenzae: Symptoms and Treatment | Doctor

  https://patient.info/doctor/haemophilus-influenzae

  Management includes treating all aspects of the infection, including fever, dehydration and any other specific interventions such as oxygen therapy in respiratory tract infections. Recommendations for antibiotic treatment include: H. influenzae epiglottitis: see the article on Epiglottitis. […] The sequelae following Hib meningitis may include deafness, convulsions and intellectual impairment. The case fatality rate from Hib meningitis is 3-7%. The mortality rate for epiglottitis is 5-10% (due to acute respiratory tract obstruction). […] With invasive Hib disease, there is a small, but significant risk of secondary Hib infection, particularly within six months of the first episode. Close contacts of the index case (mainly in a household, or a pre-school or primary school setting) are also at increased risk of developing invasive Hib disease, especially within the first week of the index case becoming ill.

• #65

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/haemflu.aspx

  All patients with suspected Hib infection should have blood collected for bacterial culture (and/or nucleic acid amplification testing (NAAT)) (also known as PCR) as soon as possible before, or as soon as possible after, antibiotics are administered. […] The sensitivity of CSF and blood culture for detection of Hib infection is high unless antibiotic therapy has been started before sampling. […] A confirmed case requires laboratory definitive evidence only. […] Isolation or detection of Haemophilus influenzae type b (Hib) from a normally sterile site where typing has been confirmed at a jurisdictional or regional reference laboratory. […] Rifampicin has been shown to eradicate pharyngeal carriage of Hib in 92 to 97% of contacts, and consequently may decrease the risk of secondary cases. […] Because of the length of time necessary to develop antibodies, vaccination does not play a major role in the immediate management of patients with Hib disease or their contacts.

• #66

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/haemflu.aspx

  Public health priority: Urgent. […] Laboratory confirmation should be sought for patients suspected to have invasive Haemophilus influenzae type b (Hib) disease (see Clinical presentation and outcome). The patient requires immediate hospitalisation and treatment. If treatment does not include an effective clearance antibiotic, the patient should also be given a course of rifampicin to eliminate nasopharyngeal carriage. Isolate the case using standard and droplet precautions for 48 hours after initiation of clearance antibiotic treatment. […] Defined contacts should receive rifampicin or other clearance antibiotics. Contacts receiving clearance antibiotics may continue to attend school/preschool/childcare. Parents of contacts should be advised to watch for signs and symptoms of Hib disease in contacts and to seek medical attention early should these occur.

• #67 Haemophilus influenzae type b (Hib) infection – invasive only | Australian Government Department of Health and Aged Care

  https://www.health.gov.au/diseases/haemophilus-influenzae-type-b-hib-infection-invasive-only

  Haemophilus influenzae type b (Hib) infection – invasive only […] Hib is a bacterial infection caused by Haemophilus influenzae type b that affects the airways, skin, ears, bones or brain. […] Hib can be prevented with vaccination. […] Treatment includes antibiotics, usually in hospital. […] Hib can be prevented with vaccination. If you’re eligible, you can get Hib vaccines for free under the National Immunisation Program. […] For information about symptoms, diagnosis and treatment, see healthdirect’s Hib page. […] Hib is a nationally notifiable disease. […] We monitor cases through the National Notifiable Diseases Surveillance System.

• #68

  http://www.bccdc.ca/health-info/diseases-conditions/haemophilus-influenzae-type-b-hib

  Haemophilus influenzae type b (Hib) is a severe bacterial infection which occurs mostly in infants and children under 5. […] Since the introduction of Hib-containing vaccines, rates of Hib disease have dropped dramatically. More detailed rates and trends for Hib in British Columbia are available in the Annual Summary of Reportable Diseases and the Reportable Disease Dashboard. […] Hib infection is caused by a germ (or bacteria) called Haemophilus influenzae type b. It usually infects children under 5 years of age. Before Hib vaccine became available, Hib used to be the most common cause of bacterial meningitis in children aged 2 months to 5 years of age. Hib disease is now rare in BC because of routine childhood vaccination programs. […] The majority of cases in children now occur in unvaccinated children or in children who are too young to have received their Hib vaccine at 2, 4, and 6 months of age. […] Diagnosis is based on cultures taken (most often of spinal fluid, blood, lung fluid, or joint fluid) to determine the infection is caused by Hib bacteria.

• #69 HIBSG – Overview: Haemophilus influenzae Type B Antibody, IgG, Serum

  https://www.mayocliniclabs.com/test-catalog/Overview/614598

  Assessing a patient’s immunological (IgG) response to Haemophilus influenzae type B (HIB) vaccine […] Assessing immunity against HIB […] Aiding in the evaluation of immunodeficiency when the patient is tested pre- and post-vaccination […] Haemophilus influenzae type B (HIB) is an encapsulated Gram-negative cocco-bacillary bacterium that can cause devastating disease in unvaccinated young children, including meningitis, bacteremia, cellulitis, epiglottitis, pneumonia, and septic arthritis. […] A patient’s immunological response to HIB vaccine can be determined by measuring anti-HIB IgG antibody levels using a standardized enzyme immunoassay (EIA). […] An anti-Haemophilus influenzae type B (HIB) IgG antibody concentration of 0.15 mcg/L is generally accepted as the minimum level for protection at a given time; however, it does not confer long-term protection. […] This assay does not provide diagnostic proof of the presence or absence of immune deficiency. Results must be confirmed by clinical findings and other laboratory tests.

• #70 Haemophilus influenzae Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562176/

  Haemophilus influenzae disease is a name collectively used for any kind of infection caused by the bacteria called Haemophilus influenzae. […] The most familiar and predominant form is H. influenzae type b (Hib), which infects mostly children and immunocompromised individuals. […] The Hib conjugate vaccine is effective for protection against capsular polysaccharide type b and has decreased the rate of Hib infections to a greater extent. […] More definitively, tests like polymerase chain reaction (PCR) and matrix-associated laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) are done to determine capsule types. […] The initial test is Gram staining, which reveals pleomorphic gram-negative coccobacilli. […] Cultures of blood and body fluids confirm the presence of the organism.

• #71 Haemophilus Influenzae: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/23106-haemophilus-influenzae

  Haemophilus influenzae type b (Hib) affects children younger than 5 years of age and adults over 65 years of age. […] The Hib vaccine can help protect against Haemophilus influenzae type b infections. […] The Hib vaccine is part of the routine childhood immunization schedule. Therefore, H. influenzae diseases primarily affect children who haven’t been vaccinated for Hib type b. […] Haemophilus influenzae treatment depends on the type of infection or disease. Treatment usually includes the use of antibiotics to fight the infection. […] You can protect your child from Haemophilus influenzae type b (Hib) infections with the Hib vaccine. […] The Hib vaccine prevents infections from Haemophilus influenzae type b. But it doesn’t prevent infections caused by other types of H. influenzae. […] The outlook (prognosis) for H. influenzae infections depends on the type and severity of your child’s condition.

• #72 News & Views — Haemophilus Influenzae Type B (Hib): Fast Facts for Healthcare Providers | Children’s Hospital of Philadelphia

  https://www.chop.edu/vaccine-update-healthcare-professionals/newsletter/hib-fast-facts-healthcare-providers

  Our Vaccine Update feature article Fast Facts series continues this month with a focus on Haemophilus influenzae type b (Hib). […] One of the more common questions our infectious disease colleagues are asked is, Should I be worried about something like meningitis in this unvaccinated child?. […] Prior to availability of the Hib vaccine, about 20,000 cases of invasive Hib disease occurred each year in the U.S. This plummeted by 99% with widespread use of the vaccine. […] Importantly, vaccination rates need to remain above approximately 90% in infants and toddlers the groups that drive transmission to maintain these community benefits, more commonly referred to as herd immunity. […] Hib, therefore, needs to be considered as a cause of any of these syndromes in unvaccinated children.

• #73 Best practice guidelines for diagnosis of Haemophilus influenzae and Neisseria meningitidis disease | Meningococcal | CDC

  https://www.cdc.gov/meningococcal/php/guidance/index.html

  Invasive disease caused by Haemophilus influenzae (Hi) or Neisseria meningitidis (Nm) is diagnosed based on clinical presentation. […] Laboratory tests, including culture and nucleic acid amplification (e.g., polymerase chain reaction [PCR]), can aid in diagnosis. […] State public health laboratories considering PCR for Hi and Nm should select assays capable of detecting and differentiating […] All Hi serotypes (serotypes a-f) […] All Nm serogroups common in the United States (serogroups B, C, W, and Y) […] Regardless of PCR capacity, state public health laboratories with Hi and Nm PCR capacity are strongly encouraged to continue performing culture. […] If Hi or Nm is identified via PCR, laboratories should perform one of the following: […] A simultaneous culture […] A reflex culture.

• #74 Detection of Haemophilus influenzae Type b by Real-Time PCR

  https://pmc.ncbi.nlm.nih.gov/articles/PMC497579/

  A real-time PCR assay targeting the capsulation locus of Haemophilus influenzae type b (Hib) was developed. The linear detection range was from 1 to 106 microorganisms per reaction mixture. No H. influenzae other than Hib or any other control bacteria typically found in the upper respiratory tract was detected. […] Assessment of Hib carriage using cultures of nasopharyngeal specimens gives an accurate picture of the epidemiological status of the bacteria. Hib bacteria are identified by biochemical tests, followed by serotyping for capsular antigen, but the latter is troublesome and ambiguous. Genotyping and ribotyping are more accurate. We established a highly sensitive and specific assay based on real-time PCR (TaqMan) to detect Hib. […] The real-time PCR assay detected all 10 of the invasive H. influenzae isolates identified by capsular genotyping as Hib strains, but none of those identified as non-Hib strains. Serotyping also identified all Hib strains, but the Difco antisera identified three reference and three invasive H. influenzae strains as Hib, all identified as non-Hib strains by genotyping. […] The assay can be completed within 1 day, is faster than conventional culturing and identification, and therefore provides a potential reliable diagnostic tool for Hib and is able to assess nasopharyngeal carriage of Hib.

• #75 Haemophilus Influenzae Infections Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/218271-workup

  Detection of the PRP polysaccharide capsule via countercurrent immunoelectrophoresis, latex particle agglutination, co-agglutination, and enzyme-linked immunosorbent assay is an important adjunct to culturing in establishing a rapid diagnosis. […] Even if antibiotics were previously administered, the diagnosis can be confirmed based on the detection of the polysaccharide capsule in body fluids, including serum, CSF, urine, and pleural, pericardial, and articular fluid. […] In meningitis, the CSF examination demonstrates pleocytosis (mean, 4000-5000 WBCs/L) with a predominance of neutrophils. […] Decreased CSF glucose levels are encountered in 75% of patients, increased CSF protein levels and detectable capsular antigen in 90%, and a positive CSF Gram stain result in 80%. […] Prior antibiotic treatment significantly decreases the H influenzae type b (Hib) concentration in the CSF and decreases the sensitivity of the Gram stain; however, antibiotics do not substantially affect the total CSF blood cell count, differential, chemistries, and presence of the PRP capsule in pretreated patients.

• #76 Best practice guidelines for diagnosis of Haemophilus influenzae and Neisseria meningitidis disease | Meningococcal | CDC

  https://www.cdc.gov/meningococcal/php/guidance/index.html

  If obtaining a culture isn’t possible, at a minimum, laboratories should collect and maintain an adequate clinical sample. This way another laboratory can conduct further testing with a PCR or culture-free sequencing assay that can detect serotype/serogroup. […] Cases are considered confirmed if PCR-positive for Hi or Nm in an appropriate specimen type: […] H. influenzae disease case definition […] Meningococcal disease case definition. […] CDC has validated, specific real-time PCR assays capable of detecting […] Hi species and all 6 serotypes (a-f) […] Nm species and 6 serogroups (A, B, C, W, X, and Y) […] Determining serotype and serogroup is crucial for […] Identifying potential outbreaks […] Determining appropriate public health responses. […] Haemophilus influenzae type b (Hib) is the only Hi serotype that vaccines offer protection against.

• #77 HIBSG – Overview: Haemophilus influenzae Type B Antibody, IgG, Serum

  https://www.mayocliniclabs.com/test-catalog/Overview/614598

  Assessing a patient’s immunological (IgG) response to Haemophilus influenzae type B (HIB) vaccine […] Assessing immunity against HIB […] Aiding in the evaluation of immunodeficiency when the patient is tested pre- and post-vaccination […] Haemophilus influenzae type B (HIB) is an encapsulated Gram-negative cocco-bacillary bacterium that can cause devastating disease in unvaccinated young children, including meningitis, bacteremia, cellulitis, epiglottitis, pneumonia, and septic arthritis. […] A patient’s immunological response to HIB vaccine can be determined by measuring anti-HIB IgG antibody levels using a standardized enzyme immunoassay (EIA). […] An anti-Haemophilus influenzae type B (HIB) IgG antibody concentration of 0.15 mcg/L is generally accepted as the minimum level for protection at a given time; however, it does not confer long-term protection. […] This assay does not provide diagnostic proof of the presence or absence of immune deficiency. Results must be confirmed by clinical findings and other laboratory tests.

• #78 News & Views — Haemophilus Influenzae Type B (Hib): Fast Facts for Healthcare Providers | Children’s Hospital of Philadelphia

  https://www.chop.edu/vaccine-update-healthcare-professionals/newsletter/hib-fast-facts-healthcare-providers

  For example, first line treatment for community-acquired pneumonia in children is amoxicillin, but many strains of Hib will not respond to this antibiotic, instead requiring a broader antibiotic like amoxicillin-clavulanic acid. […] In contrast, sepsis, meningitis and epiglottitis are all medical emergencies and universally should be treated emergently in the hospital setting with intravenous antibiotics while waiting for results of initial testing. […] About 3%-6% of children infected with Hib will not survive. […] Survivors can also have lifelong neurologic conditions, including developmental delay, seizure disorders and learning disabilities. […] Hib remains uncommon, with fewer than 50 cases occurring each year in the U.S. However, if vaccination rates decrease, more children will be at risk for this deadly infection. Providers should be prepared to recognize its many presentations and act fast.

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