Research Article
Volume 6 Issue 5
Mzilem Sabrine*
October 27, 2025
Abstract
Background: Haemophilus influenzae (Hi) remains a significant pathogen, causing invasive and non-invasive infections worldwide. Before Hib conjugate vaccines, serotype b (Hib) was the leading cause of meningitis, pneumonia, and septicemia in children under five, with high morbidity and mortality, particularly in Africa. In North Africa, Hib vaccination programs introduced in the early 2000s drastically reduced invasive Hib disease. However, this success has been followed by two key shifts: the rise of non-typeable H. influenzae (NTHi) as the predominant cause of invasive disease and increasing antimicrobial resistance (AMR), particularly to β-lactam antibiotics.
Materials and Methods: This review synthesizes two decades of data from Tunisia, Morocco, Algeria, Egypt, and Libya on vaccine impact, serotype dynamics, and evolving resistance. Published studies, surveillance reports, and immunization data were analyzed, including the prevalence of different serotypes and resistance patterns to antibiotics. Molecular techniques for detecting β-lactamase production and penicillin-binding protein (PBP) mutations were also reviewed.
Results: Hib incidence dropped significantly post-vaccination, with declines of 75-93% in Morocco and near elimination in Tunisia. However, NTHi and serotype a emerged as leading invasive strains. AMR to ampicillin rose from ~27% to >40%, linked to β-lactamase production and PBP3 mutations. Despite this, third-generation cephalosporins remain effective, though some regions show reduced susceptibility.
Conclusion: Hib vaccines have been successful, but the rise of NTHi and AMR presents new challenges. Sustained vaccine coverage, molecular surveillance, and novel vaccines targeting NTHi are critical.
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