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Hemophilus influenzae Type b-Reply

Am J Dis Child. 1984;138(5):508. doi:10.1001/archpedi.1984.02140430084028.
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In Reply.—Dr Philip correctly points out a discrepancy between my editorial1 and the two articles in that issue of the AJDC on which it was based.2,3 In part, this was deliberate, although I should have elaborated my theme. There are two elements to Dr Philip's point: (1) Not all H influenzae infections in early infancy are caused by type b bacteria. (2) Resistance to ampicillin is less frequent among nontype b and nontypeable organisms.

Wallace et al4 pointed out in a recent review that 16 women and 36 neonates experienced infection with H influenzae; 17% of the isolates from neonates (blood or CSF) were type b, and all others were nontypeable. Three of the neonates had ampicillin-resistant organisms. Wallace et al4 discussed the "low rate" of ampicillin resistance among all of their isolates, but three (27%) of 11 infants had lactamase-producing organisms isolated from blood.


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