phenylephrine-hydrochloride and Haemophilus-Infections

Antimicrobials have been commonly used to control bacterial diseases in farm animals. The efficacy of these drugs deterred the development of other control measures, such as vaccines, which are currently getting more attention due to the increased concern about antimicrobial resistance. Glässer's disease is caused by Glaesserella (Haemophilus) parasuis and affects pork production around the world. Balance between colonization and immunity seems to be essential in disease control. Reduction in antimicrobial use in veterinary medicine requires the implementation of preventive measures, based on alternative tools such as vaccination and other strategies to guarantee a beneficial microbial colonization of the animals. The present review summarizes and discusses the current knowledge on diagnosis and control of Glässer's disease, including prospects on alternatives to antimicrobials.

Topics: Animals; Anti-Bacterial Agents; Disease Management; Haemophilus Infections; Haemophilus parasuis; Microbiota; Nose; Swine; Swine Diseases; Vaccination

Glaesserella parasuis (G. parasuis) is commonly located in the upper respiratory tract of pigs as an opportunistic pathogen. It can cause Glässer's disease, which leads to serious economic losses in the swine industry. The occurrence of the disease is often linked with the adhesion and colonization of the pathogen. The PilA pilus subunit is important for adhesion to the host, twitching motility, and biofilm formation in many bacteria. However, no research has focused on the function of PilA in

Topics: Animals; Antigens, Bacterial; Fimbriae, Bacterial; Haemophilus Infections; Haemophilus parasuis; Mice; Nose; Swine; Swine Diseases; Vaccines, Subunit

Glaesserella (formerly Haemophilus) parasuis causes Glässer's disease, which results in high economic loss in the swine industry. To understand the polymicrobial interactions of G. parasuis and the nasal microbiota, the statistical association patterns of nasal colonizing bacteria with virulent and non-virulent strains of G. parasuis were studied accounting for the farm management practices as potential risk factors for the occurrence of Glässer's disease. The nasal microbiota from 51 weaned-piglets from four farms with Glässer's disease and three farms with no respiratory diseases was previously characterized and included in this study. The presence of virulent and/or non-virulent G. parasuis strains in the nasal cavities was determined in order to establish the potential association with other members of the nasal microbiota. Multivariate logistic and linear regression models were performed among the various members of nasal microbiota and G. parasuis. The multi-site production system and disease presence in the farm were both significantly associated with the presence of G. parasuis virulent strains in the nose of the piglets. Differential bacterial associations were observed with virulent or non-virulent G. parasuis. Chitinophagaceae, Corynebacteriaceae and Corynebacterium were positively associated with the virulent G. parasuis strains, while Enterobacteriaceae, Peptostreptococcaceae, Clostridium XI, and Escherichia/Shigella were negatively associated with virulent G. parasuis. On the other hand, Flavobacteriaceae, Planobacterium, and Phascolarctobacterium were positively associated with the non-virulent G. parasuis strains, while Rikenellaceae, Enterococcaceae, Odoribacter, and Corynebacterium were negatively associated with non-virulent G. parasuis. In conclusion, the nasal microbiota communities showed variations in the association with the G. parasuis strains type.

Topics: Animals; Haemophilus Infections; Haemophilus parasuis; Microbiota; Nose; Swine; Swine Diseases; Virulence; Weaning

Topics: Abattoirs; Animals; Anti-Bacterial Agents; Carrier State; China; Farms; Haemophilus Infections; Haemophilus parasuis; Microbial Sensitivity Tests; Nose; Polymerase Chain Reaction; Prevalence; Serogroup; Swine; Swine Diseases; Weaning

Acute rhinosinusitis (ARS) is among the most common infectious diseases. Neutrophils play a major role in innate host defenses against pathogenic microorganisms such as fungi and bacteria. Recently, in neutrophils, ligation of the triggering receptor expressed on myeloid cells (TREM)-1 was found to activate the full spectrum of neutrophil effector mechanisms, including the release of inflammatory mediators, degranulation, phagocytosis, and oxidative burst in synergy with Toll-like receptors (TLRs). In this study, we investigated the effect of TREM-1 on the functions of neutrophils in relation to TLR4 in a nasal and nasopharyngeal inflammation mouse model via nontypeable Haemophilus influenzae (NTHi) intranasal inoculation.. Bacterial counts of NTHi from nasal washes were significantly lower in WT mice than in TLR4-mutant mice after inoculation. The numbers of inflammatory cells in nasal washes were significantly higher in WT mice at 6 h, 12 h, and 24 h after inoculation than in TLR4-deficient mice. The expression of TREM-1 protein on neutrophils and the mRNA levels were greater in WT mice than in TLR4-mutant mice. The concentrations of soluble TREM-1 in WT nasal washes were also significantly higher than in those of TLR4-deficient mice.. TREM-1 may play an important role together with TLR4 in the nasopharyngeal clearance of NTHi by neutrophils. Further studies will need to clarify the innate immune responses of neutrophils via TLR4 to prevent NTHi infection.

Topics: Animals; Biomarkers; Haemophilus Infections; Haemophilus influenzae; Immunity, Innate; Mice; Mice, Inbred C3H; Nasopharynx; Neutrophils; Nose; Rhinitis; Sinusitis; Toll-Like Receptor 4; Triggering Receptor Expressed on Myeloid Cells-1

Nontypeable Haemophilus influenzae (NTHi) is a commensal in the human nasopharynx and the cause of pneumonia, meningitis, sinusitis, acute exacerbations of chronic obstructive pulmonary disease and acute otitis media (AOM). AOM is the most common ailment for which antibiotics are prescribed in the United States. With the emergence of new strains of antibiotic-resistant bacteria, finding an effective and broad coverage vaccine to protect against AOM-causing pathogens has become a priority. Mouse models are a cost-effective and efficient way to help determine vaccine efficacy. Here, we describe an NTHi AOM model in C57BL/6J mice, which also utilizes a mouse-adapted H1N1 influenza virus to mimic human coinfection.. We tested our coinfection model using a protein vaccine formulation containing protein D, a well-studied NTHi vaccine candidate that can be found in the 10-valent Streptococcus pneumoniae conjugate vaccine. We verified the usefulness of our mouse model by comparing bacterial loads in the nose and ear between protein D-vaccinated and control mice.. While there was no measurable difference in nasal bacterial loads, we did detect significant differences in the bacterial loads of ear washes and ear bullae between vaccinated and control mice.. The results from this study suggest that our NTHi AOM coinfection model is useful for assessing protein vaccines.

Topics: Administration, Intranasal; Animals; Antibodies, Bacterial; Bacterial Proteins; Carrier Proteins; Coinfection; Disease Models, Animal; Female; Haemophilus Infections; Haemophilus influenzae; Haemophilus Vaccines; Humans; Immunoglobulin D; Influenza A Virus, H1N1 Subtype; Lipoproteins; Male; Mice; Mice, Inbred C57BL; Nose; Otitis Media; Vaccines, Conjugate

Haemophili are representative microbiota of the upper respiratory tract. The aim of this study was to assess the effects of perioperative antimicrobial prophylaxis and/or postoperative treatment on Haemophilus parainfluenzae prevalence, and antimicrobial sensitivity in short-term hospitalized patients with lung cancer who underwent surgery.. Samples were collected from 30 short-term hospitalized patients with lung cancer and from 65 healthy people. The nasal and throat specimens were taken twice from each patient: before (EI, Examination I), on the fourth/fifth day (EII, Examination II) after surgery, and once from healthy people. The isolates identification and antimicrobial susceptibility were detected by routine diagnostic methods. H. parainfluenzae was found in throat specimens of 42/65 (64.6 %) healthy people, while in 19/30 (63.3 %) lung cancer patients in EI (p = 0.6203) and in 13/30 (43.3 %) ones in EII (p = 0.0106). Neither the disease itself nor short-term hospitalization with perioperative prophylaxis alone affected H. parainfluenzae prevalence in EII, while perioperative prophylaxis with postoperative treatment significantly decreased its colonization in EII. The differences in the number of patients colonized by Candida spp. in EI and in EII were observed (p = 0.0082).Totally, 23/58 (39.7 %) of H. parainfluenzae isolates were resistant mainly to beta-lactams; among 11 ampicillin-resistant isolates only 3 were beta-lactamase positive.. The antimicrobial perioperative prophylaxis together with postoperative treatment may disturb the composition of the airways microbiota represented by H. parainfluenzae, in addition to selecting the resistant strains of bacteria and promoting yeasts colonization in lung cancer patients undergoing surgery.

Topics: Adult; Aged; Anti-Bacterial Agents; Antibiotic Prophylaxis; Cefazolin; Cefuroxime; Drug Resistance, Bacterial; Female; Haemophilus Infections; Haemophilus parainfluenzae; Humans; Lung Neoplasms; Male; Microbial Sensitivity Tests; Middle Aged; Nose; Perioperative Care; Pharynx; Prevalence; Respiratory System; Treatment Outcome

Haemophilus parasuis is a colonizer of the upper respiratory tract and the causative agent of Glässer's disease in swine. This study focused on the nasal carriage of H. parasuis after treatment with marbofloxacin. Three marbofloxacin treatments (three doses of 2mg/kg body weight [bw] every 24h, two doses of 4 mg/kg bw every 48 h and 8 mg/kg bw in one single shot) were used and all of them reduce significantly (p<0.05) the nasal carriage of H. parasuis as compared to control animals. Moreover, H. parasuis was not detected in the nasal cavities of piglets after administering the highest dose. The effect of a dose of 8 mg marbofloxacin/kg bw in one shot was further studied in a farm with clinical cases of Glässer's disease using a longitudinal study. Statistically significant reduction of nasal carriage of H. parasuis was detected during the first week after treatment in comparison with the control group. However, a clear relationship between the minimum inhibitory concentration (MIC) of the different strains, their putative virulence or the treatment group (antibiotic or control) from which they were isolated was not detected. Finally, the effect induced by the antibiotic treatment on the bacterial strains seemed to be transitory, since diverse H. parasuis strains (with high and low marbofloxacin MICs) were observed 7 days after finishing the treatment.

Topics: Animals; Anti-Bacterial Agents; Fluoroquinolones; Haemophilus Infections; Haemophilus parasuis; Longitudinal Studies; Microbial Sensitivity Tests; Nose; Random Allocation; Swine; Swine Diseases

The colonization dynamics of Moraxella catarrhalis were studied in a population comprising 1079 healthy children living in Rotterdam, The Netherlands (the Generation R Focus cohort). A total of 2751 nasal swabs were obtained during four clinic visits timed to take place at 1.5, 6, 14 and 24 months of age, yielding a total of 709 M. catarrhalis and 621 Haemophilus influenzae isolates. Between January 2004 and December 2006, approximate but regular 6-monthly cycles of colonization were observed, with peak colonization incidences occurring in the autumn/winter for M. catarrhalis, and winter/spring for H. influenzae. Co-colonization was significantly more likely than single-species colonization with either M. catarrhalis or H. influenzae, with genotypic analysis revealing no clonality for co-colonizing or single colonizers of either bacterial species. This finding is especially relevant considering the recent discovery of the importance of H. influenzae-M. catarrhalis quorum sensing in biofilm formation and host clearance. Bacterial genotype heterogeneity was maintained over the 3-year period of the study, even within this relatively localized geographical region, and there was no association of genotypes with either season or year of isolation. Furthermore, chronological and genotypic diversity in three immunologically important M. catarrhalis virulence genes (uspA1, uspA2 and hag/mid) was also observed. This study indicates that genotypic variation is a key factor contributing to the success of M. catarrhalis colonization of healthy children in the first years of life. Furthermore, variation in immunologically relevant virulence genes within colonizing populations, and even within genotypically identical M. catarrhalis isolates, may be a result of immune evasion by this pathogen. Finally, the factors facilitating M. catarrhalis and H. influenzae co-colonization need to be further investigated.

Topics: Bacterial Typing Techniques; Carrier State; Child, Preschool; Genetic Variation; Genotype; Haemophilus Infections; Haemophilus influenzae; Human Experimentation; Humans; Infant; Moraxella catarrhalis; Moraxellaceae Infections; Multilocus Sequence Typing; Netherlands; Nose; Virulence; Virulence Factors

To determine nasopharyngeal colonization rates of two vaccine preventable bacterial pathogens Hemophilus influenzae type b (Hib), and Streptococcus pneumoniae (Pneumococcus), antibiotic susceptibility of isolates, factors associated with their colonization, and immunization history in a cohort of HIV infected children.. The authors conducted a cross-sectional nasopharyngeal swab survey of 151 children affected with HIV presenting for routine outpatient care in West Bengal, India.. 151 HIV affected children were enrolled. The median age was 6, 148/151 children were HIV positive, 65% had moderate to severe malnutrition, 53% were moderately to severely immunosuppressed, 17% were on antiretroviral therapy (ART), 90% were on cotrimoxazole prophylaxis (TMP/SMX). None had received the pneumococcal or Hib conjugate vaccines. Hib prevalence was 13% and pneumococcal prevalence was 28%. Children with normal or moderate immune suppression had high rates of colonization compared to those with severe immunosuppression (71% Hib, 61% pneumococcus). Hib and pneumococcal isolates had high rates of resistance to tested antibiotics including TMP/SMX and third generation cephalosporins. Neither ART nor TMP/SMX prevented colonization. Children colonized with multidrug resistant isolates had high rates of exposure to TMP/SMX.. HIV infection, late access to ART, high rates of colonization to resistant organisms and lack of access to vaccines makes this population vulnerable to invasive disease from Hib and pneumococcus.

Topics: AIDS-Related Opportunistic Infections; Child; Child, Preschool; Cross-Sectional Studies; Female; Haemophilus Infections; Haemophilus influenzae type b; HIV Infections; Humans; India; Infant; Infant, Newborn; Male; Nose; Pneumococcal Infections; Streptococcus pneumoniae

Most common bacterial species causing peritonitis in the course of peritoneal dialysis (PDP) are coagulase-negative staphylococci, Staphylococcus aureus and streptococci. Haemophilus influenzae is rarely associated with PDP. Hereby we present the first known case of APD-associated peritonitis caused by non-type able H. influenzae (NTHi) presenting the beta-lactamase negative, ampicillin-resistant (BLNAR) phenotype. An 18 year old boy who had been treated with the APD for 12 months due to SLE was admitted in good general condition with diagnosis of PDP. Standard diagnostic and therapeutical procedures were initiated. Dialysis fluid was turbid with cytosis of 435 WBC/ml. From dialysis fluid pure culture of Gram-negative coccobacillus was isolated. The isolate was identified as a BLNAR phenotype. The same bacterium was isolated from nasal swab. Blood cultures were negative. After evaluation of antimicrobial susceptibility the treatment was changed for the oral ciprofloxacin. The treatment was successful. Control tests 2 days later revealed cytosis of 15 WBC/mm3 and control cultures of peritoneal fluid were negative. After two weeks of treatment the patient was discharged in a good condition. Haemophilus influenzae is a bacterium frequently colonizing the nasopharyngeal cavity. A PCR-based method allowed to classify isolates as NTHi. Infection was probably of the respiratory origin as the isolates (from peritoneal fluid and nasal swab) were undistinguishable. There are only few reports describing this species as an ethiologic agent of peritonitis. This case prove that Haemophilus species should be taken into account as a possible aethiologic agent of PDP, especially in patients on immunosupression with carrier state of H. influenzae in the upper respiratory tract. This kind of microorganism requires specific conditions during its growing in vitro. Identification of its sensitivity to antibiotics is essential in order to detect strains of BLNAR phenotype, as it is a crucial part of an effective antibiotic therapy.

Topics: Adolescent; Ampicillin Resistance; Ascitic Fluid; Ciprofloxacin; Haemophilus Infections; Haemophilus influenzae; Humans; Male; Nose; Peritoneal Dialysis; Peritonitis; Phenotype

Complications of primary nasoplasty, at the time of definitive primary cheiloplasty, are underreported in the literature. This study endeavors to examine the occurrences of these complications at our cleft-craniofacial center, in an effort to identify causative factors and management strategies. A case series of patients with postoperative nasal complications after primary cleft lip nasal surgery is presented.. A retrospective chart review of primary cleft lip nasal repairs was conducted at our cleft-craniofacial center between January 2003 and December 2007. Consecutive cases of 3 staff surgeons were evaluated. Specific data points included number and type of complications, subsequent required interventions, and relevant history, with particular attention paid to the details of the primary nasoplasty.. Eighty-six primary cleft lip nasoplasties were completed between the years 2003 and 2007. Six complications (6.9%) related to the primary cleft lip nasoplasty were identified. Four patients (4.6%) experienced nasal tip infections; all 4 required surgical drainage. Twenty-four patients (27.9%) undergoing primary cleft lip and nose repair had postoperative nostril conformers placed, and 2 (8.3%) of them experienced complications deemed conformer related.. Postoperative nasal complications of primary cheiloplasty occur and are likely underreported. In this series, complications resulted from infection, often occurring late, and secondary to the use of nostril conformers. Surgeon awareness and caregiver education, to identify the early signs of postoperative nasal complications, are critical to the successful treatment of these occurrences. Although this study did not intend on examining antibiotic use, the significance of nasal tip infections might support the regular use of antibiotics in this population, and the use of postoperative nostril conformers must be followed closely.

Topics: Abscess; Cleft Lip; Drainage; Female; Follow-Up Studies; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Male; Nasal Cartilages; Nose; Nose Diseases; Plastic Surgery Procedures; Postoperative Complications; Retrospective Studies; Staphylococcal Infections; Surgical Fixation Devices; Surgical Wound Infection; Suture Techniques

A PCR test for identification of Haemophilus parasuis was optimized using the 16S rDNA sequences of the 15 serotype reference strains of H. parasuis. The test was evaluated on a collection of 218 Danish field isolates as well as on 81 representatives of 27 other species, including genetically affiliated species within Pasteurellaceae. In addition, DNA preparations from 56 H. parasuis isolates from North America were included. To obtain a test that was specific for H. parasuis, a multiplex PCR using 3 different primers was developed. The PCR test produced an amplicon of approximately 1090 bp only with representatives of H. parasuis. The test was further evaluated on 55 clinical samples from 16 Danish pigs suspected for being infected with H. parasuis, showing polyserositis or septicemia at autopsy as well as on 492 nasal swabs. The test was compared with the performance of a PCR test earlier published by Oliveira et al. [Oliveira, S., Galina, L., Pijoan, C., 2001. Development of a PCR test to diagnose Haemophilus parasuis infections. J. Vet. Diagn. Invest. 13, 495-501]. The sensitivity of the present PCR test was found to be slightly lower when applied on clinical samples from diseased pigs and 10-fold lower when tested on pure cultures of H. parasuis (5CFU and 0.5CFU/PCR reaction, respectively). Addition of 1.4 x 10(5) Escherichia coli to each PCR tube did not alter the sensitivity of the tests. No difference in sensitivity of the tests was observed when tested on purified DNA. On the other hand, the present PCR test was found to be 100% species specific for H. parasuis, in contrast to the PCR test of Oliveira et al., which also tested positive for strains belonging to A. indolicus, A. porcinus, and A. minor, species commonly occurring in the upper respiratory tract. However, when the PCR test of Oliveira et al. is used on samples from systemic locations the chances for false positive results are apparently low. The present PCR test represents a rapid and reliable method for genetically based identification of H. parasuis. The high species specificity of the test makes it suitable for detection of H. parasuis in clinical samples, regardless of the presence of affiliated species and contaminating flora. As the two PCR tests differ in sensitivity and specificity, the use of both PCR tests for different purposes is a possibility.

Topics: Animals; Colony Count, Microbial; DNA Primers; DNA, Bacterial; DNA, Ribosomal; Haemophilus Infections; Haemophilus parasuis; Nose; Polymerase Chain Reaction; Reproducibility of Results; RNA, Ribosomal, 16S; Sensitivity and Specificity; Sequence Analysis, DNA; Serotyping; Species Specificity; Swine; Swine Diseases

Haemophilus parasuis is the aetiological agent of Glässer's disease in swine. In addition, this bacterium causes other clinical outcomes and can also be isolated from the upper respiratory tract of healthy pigs. Isolates of H. parasuis differ in phenotypic features (e.g. protein profiles, colony morphology or capsule production) and pathogenic capacity. Differences among strains have also been demonstrated at the genetic level. Several typing methods have been used to classify H. parasuis field strains, but they had resolution or implementation problems. To overcome these limitations, a multilocus sequence typing (MLST) system, using partial sequences of the house-keeping genes mdh, 6pgd, atpD, g3pd, frdB, infB and rpoB, was developed. Eleven reference strains and 120 field strains were included in this study. The number of alleles per locus ranged from 14 to 41, 6pgd being the locus with the highest diversity. The high genetic heterogeneity of this bacterium was confirmed with MLST, since the strains were divided into 109 sequence types, and only 13 small clonal complexes were detected by the Burst algorithm. Further analysis by unweighted-pair group method with arithmetic mean (UPGMA) identified six clusters. When the clinical background of the isolates was examined, one cluster was statistically associated with nasal isolation (putative non-virulent), while another cluster showed a significant association with isolation from clinical lesions (putative virulent). The remaining clusters did not show a statistical association with the clinical background of the isolates. Finally, although recombination among H. parasuis strains was detected, two divergent branches were found when a neighbour-joining tree was constructed with the concatenated sequences. Interestingly, one branch included almost all isolates of the putative virulent UPGMA cluster.

Topics: Alleles; Animals; Bacterial Proteins; Bacterial Typing Techniques; Cluster Analysis; DNA, Bacterial; Genetic Heterogeneity; Genotype; Haemophilus Infections; Haemophilus parasuis; Molecular Epidemiology; Molecular Sequence Data; Nose; Sequence Analysis, DNA; Statistics as Topic; Swine; Swine Diseases

Resistance of Haemophilus influenzae from clinical isolates can be predicted on the basis of results of antimicrobial susceptibility of nasopharyngeal isolates. The carriage rate and the antimicrobial susceptibility of H. influenzae isolated in healthy children attending day-care centres in Moscow, Smolensk and Yartsevo was studied. The susceptibility of ampicillin, amoxycillin/clavulanate, cefaclor, erythromycin, roxithromycin, clarithromycin and trimethoprim-sulphamethoxazole were determined by the E-test. The mean carriage rate of H. influenzae was 44%. Resistance of H. influenzae to ampicillin was 2.3%, to amoxycillin/clavulanate 0.7%, to cefaclor 0.7%, to clarithromycin 18.7% and to trimethoprim-sulphamethoxazole 21%. These included strains that showed intermediate-resistance. The antimicrobial resistance profiles varied in different centres. The clinical use of trimethoprim-sulphamethoxazole should be restricted because of the high resistance of H. influenzae to antifolate compounds.

Topics: Anti-Bacterial Agents; Child; Child Day Care Centers; Child, Preschool; Drug Resistance, Multiple, Bacterial; Haemophilus Infections; Haemophilus influenzae; Humans; Microbial Sensitivity Tests; Nose; Pharynx; Trimethoprim Resistance

We performed a prospective observational cohort study of the epidemiology and etiology of nosocomial pneumonia in 358 medical ICU patients in two university-affiliated hospitals. Protected bronchoscopic techniques (protected specimen brush and bronchoalveolar lavage) were used for diagnosis to minimize misclassification. Risk factors for ventilator-associated pneumonia were identified using multiple logistic regression analysis. Twenty-eight cases of pneumonia occurred in 358 patients for a cumulative incidence of 7.8% and incidence rates of 12.5 cases per 1, 000 patient days and 20.5 cases per 1,000 ventilator days. Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Hemophilus species made up 65% of isolates from the lower respiratory tract, whereas only 12.5% of isolates were enteric gram-negative bacilli. Daily surveillance cultures of the nares, oropharynx, trachea, and stomach demonstrated that tracheal colonization preceded ventilator-associated pneumonia in 93.5%, whereas gastric colonization preceded tracheal colonization for only four of 31 (13%) eventual pathogens. By multiple logistic regression, independent risk factors for ventilator- associated pneumonia were admission serum albumin <= 2.2 g/dl (odds ratio [OR] 5.9; 95% confidence interval [CI] 2.0-17.6; p = 0.0013), maximum positive end-expiratory pressure >= 7.5 cm H2O (OR, 4.6; 95% CI, 1.4 to 15.1; p = 0.012), absence of antibiotic therapy (OR, 6.7; 95% CI, 1.8 to 25.3; p = 0.0054), colonization of the upper respiratory tract by respiratory gram-negative bacilli (OR, 3.4; 95% CI, 1.1 to 10.1; p = 0.028), pack-years of smoking (OR, 2.3 for 50 pack-years; 95% CI, 1. 2 to 4.2; p = 0.012), and duration of mechanical ventilation (OR, 3. 4 for 14 d; 95% CI, 1.5 to 7.8; p = 0.0044). Several of these risk factors for ventilator-associated pneumonia appear amenable to intervention.

Topics: Anti-Bacterial Agents; Bronchoalveolar Lavage; Bronchoscopes; Bronchoscopy; Cohort Studies; Confidence Intervals; Critical Care; Cross Infection; Enterobacteriaceae; Enterobacteriaceae Infections; Haemophilus Infections; Humans; Incidence; Logistic Models; Nose; Odds Ratio; Oropharynx; Pneumonia, Bacterial; Pneumonia, Pneumococcal; Pneumonia, Staphylococcal; Positive-Pressure Respiration; Prospective Studies; Pseudomonas aeruginosa; Pseudomonas Infections; Risk Factors; Serum Albumin; Smoking; Stomach; Tennessee; Time Factors; Trachea; Ventilators, Mechanical

Haemophilus influenzae type b, a causative agent of bacterial sepsis and meningitis in young children, contains a single superoxide dismutase (SOD), a cytoplasmic MnSOD. To study the role of this enzyme, a chromosomal sodA::lacZ mutant (M-2) was constructed. M-2 had an increased sensitivity towards oxygen and the redox-active agent paraquat. A 3.4-fold increase in sodA-lacZ expression was found in M-2 grown with oxygen supply rates between 3 and 36 mmol of O2/liter/h. In similar experiments with the wild type, assaying SodA activity, a 3.1-fold increase was found. Both the wild type and M-2 grew best at the lowest oxygen supply rate tested, consistent with the notion that H. influenzae prefers a more anaerobic environment. In the infant rat model of infection, the ability of M-2 to colonize the nasopharynx was found to be impaired, but its ability to cause invasive disease was unaffected. This suggests that after invasion, the growth disadvantage imposed by a SodA- phenotype is not limiting.

Topics: Animals; Bacteremia; Haemophilus Infections; Haemophilus influenzae; Mutation; Nose; Oxidative Stress; Pharynx; Rats; Superoxide Dismutase; Virulence

Two sampling techniques, nasal swabbing and oropharyngeal swabbing, for detection of the upper respiratory tract carriage of Streptococcus pneumoniae and Haemophilus influenzae were studied prospectively with 296 healthy Filipino infants at various ages: 6 to 8, 10 to 12, 14 to 17, 18 to 22, 32 to 39, and 46 to 65 weeks. In all age groups S. pneumoniae was isolated significantly more often (P < 0.0001) from the nasal site than from the oropharyngeal site. H. influenzae was found equally often at both sites.

Topics: Carrier State; Child, Preschool; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Male; Nose; Oropharynx; Philippines; Pneumococcal Infections; Respiratory Tract Infections; Specimen Handling; Suburban Population

The value of pernasal swabs and direct adenoid swabs in chronic adenoid and adenotonsillar disease was assessed in 175 patients. Prior to adenoidectomy (53 patients) or adenotonsillectomy (122 patients), pernasal and direct adenoid swabs were taken. Adenoid currettings and tonsil tissue were cultured. Haemophilus influenzae was the bacterium most frequently isolated from adenoid currettings and from the centre (core) of the resected tonsil. There was a close relationship between the bacteriology of the pernasal swab and the adenoid tissue and tonsil core in 72 and 71% of patients, respectively. There was an identical profile of pathogens in 52 and 49%, respectively. We suggest that in children with adenoiditis or adenotonsillitis and hypertrophy of the adenoid, a pernasal swab should be used in preference to a throat swab in selecting appropriate antimicrobial therapy. Penicillin and ampicillin are not appropriate blind therapy in chronic adenoid and adenotonsillar infections because of the prevalence of beta-lactamase-producing aerobes (40%) in adenoid and tonsil core in these conditions.

Topics: Adenoidectomy; Adenoids; Adolescent; Ampicillin; Bacteriological Techniques; beta-Lactamases; Child; Child, Preschool; Chronic Disease; Contraindications; Culture Techniques; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Hypertrophy; Male; Nose; Palatine Tonsil; Penicillins; Pharynx; Pneumococcal Infections; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Tonsillectomy; Tonsillitis

The value of pernasal retropharyngeal swabs in chronic adenoid and tonsillar disease was assessed in a prospective study involving 52 patients. Prior to adenoidectomy (34 patients) or adenotonsillectomy (17 patients), pernasal and tonsillar swabs were taken and the culture compared to the bacteriology profile obtained in the adenoid and tonsil tissue following surgery. The pernasal swab correctly identified 76% of pathogens isolated in the adenoid tissue. In addition, pernasal swabs forecast the presence of pathogens in 64% of core tonsil specimens, compared to an accuracy of 38% when superficial tonsil swabs were compared to the microbes in the deep tonsil. H. influenzae was the predominant organism isolated in all cultures. Our results clearly demonstrate that pernasal swabs give a representative picture of the adenoid bacterial content. Pernasal swabs are also superior to superficial tonsil swabs in indicating the deep tonsillar organisms.

Topics: Adenoidectomy; Adenoids; Bacteria; Bacterial Infections; Bacteriological Techniques; Child; Child, Preschool; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Lymphatic Diseases; Male; Nose; Palatine Tonsil; Prospective Studies; Staphylococcal Infections; Tonsillectomy

The relationship between serotypes and biotypes of 505 carriage strains of Haemophilus influenzae isolated from the upper respiratory tracts of well children, children with pneumonia, and healthy adults was studied. All except serotype c were significantly associated with one or two specific biotypes (P less than 0.001). No encapsulated organisms belonging to biotypes V, VI, or VII were encountered. No significant difference in the interaction of biotypes and serotypes isolated from well and sick children was present. Both encapsulated and nonserotypable biotype I H. influenzae strains were commonly carried in the upper respiratory tracts of healthy Melanesian children. The distribution of nonserotypable H. influenzae strains occurred throughout all biotypes, and the frequency of nonencapsulated biotype III and IV strains differed significantly from serotypable organisms with the same biotype (P less than 0.001).

Topics: Adult; Child, Preschool; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Infant, Newborn; Nasopharynx; Nose; Papua New Guinea; Pneumonia; Serotyping

A total of 464 Haemophilus influenzae strains, most of them fresh clinical isolates, have been classified by chemotyping --a combination of auxotyping and biotyping. Seven auxotests and four other biochemical tests allowed recognition of 56 types. These were to a degree site-specific. H. influenzae of capsular type b proved almost without exception to belong to one chemotype, and 24 of 33 strains assigned to this chemotype were capsulated. When surgical-ward isolates of H. influenzae were typed, the results suggested that some cross-infection had occurred.

Topics: Amino Acids; Culture Media; Ear; Eye; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Hypoxanthine; Hypoxanthines; Nose; Paranasal Sinuses; Pharynx; Sputum; Thymidine; Vagina

Nasal swabs from 62 villagers of Kalauna, Goodenough Island were cultured. Streptococcus pneumoniae was isolated from 16 of 25 adults (64%) and 36 of 37 children (97%). Significant regional clustering of prevalent pneumococcal serotypes were seen among families in core hamlets. Five of 20 adults (20%) and 30 of 37 children (81%) grew Haemophilus influenzae all of which were biotypable. A variety of faecal Gram negative bacilli comprising enterobacteria, Alcaligenes species and an aeromonad were isolated from 30 of 62 (48%) swabs.

Topics: Alcaligenes; Bacterial Infections; Carrier State; Enterobacteriaceae Infections; Haemophilus Infections; Haemophilus influenzae; Humans; Nose; Papua New Guinea; Pneumococcal Infections

Septicemic disease occurred in 49 of 126 pigs several days after being transported 80 km. All affected pigs died. The main changes in acutely affected pigs were skin discoloration, pulmonary edema, arthritis, meningitis, and renal glomerular thrombosis. In peracute cases, gross findings were minimal. Haemophilus parasuis was isolated from multiple organ sites in most affected pigs. Haemophilus parasuis was isolated from nasal swab specimens from 17 of 20 clinically normal pigs on the farm of origin. Fatal acute septicemia was reproduced in 2 pigs by intravenous or intratracheal exposure to an isolant of H parasuis obtained from 1 of of the 49 fatally affected pigs. Aerosol exposure of 5 pigs resulted in mild pneumonia in 4 pigs and severe pneumonia, pleurisy, pericarditis, and terminal septicemia in 1 pig.

Topics: Animals; Brain; Haemophilus; Haemophilus Infections; Kidney; Lung; Nose; Swine; Swine Diseases; Synovial Fluid

Topics: Animals; Cattle; Cattle Diseases; Female; Haemophilus; Haemophilus Infections; Male; Nose; Pasteurella; Stress, Physiological; Trachea

Topics: Aged; Ampicillin; England; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Male; Nose; Pharynx; Sputum; Tetracycline

Topics: Animals; Haemophilus; Haemophilus Infections; Lung; Nose; Pneumonia; Swine; Swine Diseases; Trachea