scholarly journals The Adenoids but Not the Palatine Tonsils Serve as a Reservoir for Bacteria Associated with Secretory Otitis Media in Small Children

mSystems ◽  
2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Helena Fagö-Olsen ◽  
Laura Marie Dines ◽  
Christian Hjort Sørensen ◽  
Anders Jensen
Keyword(s):  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Moraxella Catarrhalis ◽  
Secretory Otitis Media ◽  
Small Children ◽  
Palatine Tonsils ◽  
Content Type ◽  
Significant Difference ◽  
Tract Infections

ABSTRACT Acute otitis media (AOM), secretory otitis media (SOM), and acute pharyngotonsillitis are the most frequent reasons for visits to general practitioners, pediatricians, and otolaryngologists. Microbial colonization of the epithelial lining of Waldeyer’s lymphatic tissues, consisting of the palatine tonsils, lingual tonsils, adenoids, and Eustachian tube tonsil, is a well-known clinical challenge during infancy due to frequent episodes of upper respiratory tract infections. However, no previous studies have investigated the combined role of the palatine tonsils and the adenoids as a reservoir for pathogens associated with SOM in small children. We analyzed the combined crypt microbiome of the palatine tonsils and adenoids from 14 small children with hyperplasia of the tonsils or adenoids and 14 small children with SOM using 16S rRNA gene pyrosequencing. Our study demonstrated a significant difference between the microbiome of the adenoids and that of the palatine tonsils in the two groups but not between the two anatomical locations within the two groups. In particular, the potential pathogens Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were almost exclusively found in the adenoids of both patient groups, indicating that the adenoids and not the palatine tonsils are the main reservoir for potential pathogens leading to AOM and SOM. IMPORTANCE Our findings that the microbiome differs between crypts of the adenoids and crypts of the palatine tonsils, including the relative abundances of potential pathogens such as Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis, may be the stepping stone for further investigation of individual microbiomes in a longitudinal design that includes recording of the fluctuating health status of the child. Such studies may have the potential to lead to new preventive measurements such as implantation of protective nonpathogens at the nasopharynx as an alternative to adenoidectomy.

scholarly journals The Relationship between Colonization by Moraxella catarrhalis and Tonsillar Hypertrophy

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Mirela C. M. Prates ◽  
Edwin Tamashiro ◽  
José L. Proenca-Modena ◽  
Miriã F. Criado ◽  
Tamara H. Saturno ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Moraxella Catarrhalis ◽  
Pathogenic Bacteria ◽  
Simultaneous Detection ◽  
Tonsillar Hypertrophy ◽  
Palatine Tonsils ◽  
Adenotonsillar Hypertrophy

We sought to investigate the prevalence of potentially pathogenic bacteria in secretions and tonsillar tissues of children with chronic adenotonsillitis hypertrophy compared to controls. Prospective case-control study comparing patients between 2 and 12 years old who underwent adenotonsillectomy due to chronic adenotonsillar hypertrophy to children without disease. We compared detection of Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Pseudomonas aeruginosa, and Moraxella catarrhalis by real-time PCR in palatine tonsils, adenoids, and nasopharyngeal washes obtained from 37 children with and 14 without adenotonsillar hypertrophy. We found high frequency (>50%) of Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Pseudomonas aeruginosa in both groups of patients. Although different sampling sites can be infected with more than one bacterium and some bacteria can be detected in different tissues in the same patient, adenoids, palatine tonsils, and nasopharyngeal washes were not uniformly infected by the same bacteria. Adenoids and palatine tonsils of patients with severe adenotonsillar hypertrophy had higher rates of bacterial coinfection. There was good correlation of detection of Moraxella catarrhalis in different sampling sites in patients with more severe tonsillar hypertrophy, suggesting that Moraxella catarrhalis may be associated with the development of more severe hypertrophy, that inflammatory conditions favor colonization by this agent. Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Moraxella catarrhalis are frequently detected in palatine tonsils, adenoids, and nasopharyngeal washes in children. Simultaneous detection of Moraxella catarrhalis in adenoids, palatine tonsils, and nasopharyngeal washes was correlated with more severe tonsillar hypertrophy.

scholarly journals 1582. Delafloxacin Activity Against Drug-Resistant Streptococcus pneumoniae, Haemophilus influenzae, Haemophilus parainfluenzae, and Moraxella catarrhalis from US Medical Centers (2014–2018)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S577-S578
Author(s):  
Dee Shortridge ◽  
Jennifer M Streit ◽  
Michael D Huband ◽  
Robert K Flamm
Keyword(s):  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Moraxella Catarrhalis ◽  
Active Agent ◽  
The United States ◽  
Multidrug Resistant ◽  
In Vitro Susceptibility ◽  
Amoxicillin Clavulanate ◽  
Tract Infections

Abstract Background Delafloxacin (DLX) is an anionic fluoroquinolone (FQ) antimicrobial that was approved in 2017 by the United States (US) Food and Drug Administration for the treatment of acute bacterial skin and skin structure infections. DLX recently successfully completed a clinical trial for the treatment of community-acquired bacterial pneumonia (CABP). In the present study, in vitro susceptibility (S) results for DLX and comparator agents were determined for CABP pathogens including Streptococcus pneumoniae (SPN), Haemophilus influenzae (HI), H. parainfluenzae (HP) and Moraxella catarrhalis (MC) clinical isolates from US hospitals participating in the SENTRY Program during 2014–2018. Methods A total of 1,975 SPN, 1,128 HI, 684 MC, and 43 HP isolates were collected from community-acquired respiratory tract infections (CARTI) during 2014–2018 from US hospitals. Sites included only 1 isolate/patient/infection episode. Isolate identifications were confirmed at JMI Laboratories. Susceptibility testing was performed according to CLSI broth microdilution methodology, and CLSI (2019) breakpoints were applied where applicable. Other antimicrobials tested included levofloxacin (LEV) and moxifloxacin (MOX; not tested in 2015). Multidrug-resistant (MDR) SPN isolates were categorized as being nonsusceptible (NS) to amoxicillin-clavulanate, erythromycin, and tetracycline; other SPN phenotypes were LEV-NS or penicillin (PEN)-NS. β-Lactamase (BL) presence was determined for HI, HP, and MC. Results The activities of the 3 FQs are shown in the table. The most active agent against SPN was DLX, with the lowest MIC50/90 values of 0.015/0.03 mg/L. DLX activities were similar when tested against the MDR or PEN-NS for SPN phenotypes. LEV-NS isolates had DLX MIC50/90 results of 0.12/0.25 mg/L. DLX was the most active FQ against HI, HP, and MC. BL presence did not affect FQ MIC values for HI or MC; only 2 HP isolates were BL-positive. Conclusion DLX demonstrated potent in vitro antibacterial activity against SPN, HI, HP, and MC. DLX was active against MDR SPN that were NS to the agents commonly used as treatments for CABP. DLX had excellent activity against LEV-NS SPN. These data support the continued study of DLX as a potential treatment for CABP. Disclosures All authors: No reported disclosures.

scholarly journals Natural Development of Antibodies against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis Protein Antigens during the First 13 Years of Life

2016 ◽  
Vol 23 (11) ◽  
pp. 878-883 ◽  
Author(s):  
Igor C. Borges ◽  
Dafne C. Andrade ◽  
Maria Regina A. Cardoso ◽  
Jorma Toppari ◽  
Mari Vähä-Mäkilä ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Antibody Production ◽  
Moraxella Catarrhalis ◽  
Respiratory Infections ◽  
Protein Antigens ◽  
Serum Samples ◽  
Content Type ◽  
Natural Development ◽  
Antibody Levels

ABSTRACTConserved protein antigens have been investigated as vaccine candidates against respiratory pathogens. We evaluated the natural development of antibodies againstStreptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalisproteins during childhood. Serum samples were collected from 50 healthy children from their first months to age 13 years (median sampling interval, 6 months). We also analyzed serum samples from 24 adults. Serum IgG antibodies against eight pneumococcal proteins (Ply, CbpA, PspA 1 and 2, PcpA, PhtD, StkP-C, and PcsB-N), threeH. influenzaeproteins, and fiveM. catarrhalisproteins were measured using a multiplexed bead-based immunoassay. Antibody levels were analyzed using multilevel mixed-effects regression and Spearman's correlation. Antibody levels against pneumococcal proteins peaked at 3 to 5 years of age and then reached a plateau. Antibody levels againstH. influenzaeproteins peaked during the second year and then stabilized. Antibody levels againstM. catarrhalisproteins peaked during the first year and then slowly decreased. Peak antibody levels during childhood were higher than those of adults. Correlations among pneumococcal antibody levels were highest among anti-CbpA, anti-PcpA, and anti-PhtD antibodies (r= 0.71 to 0.75;P< 0.001). The children presented 854 symptomatic respiratory infections on 586 occasions. Symptomatic respiratory infections did not improve prediction of antibody levels in the regression model. The maturation of immune responses against the investigated pneumococcal proteins shares similarities, especially among CbpA, PcpA, and PhtD. Antibody production againstH. influenzaeandM. catarrhalisproteins starts early in life and reaches peak levels earlier than antibody production against the pneumococcal proteins. Basal antibody levels are not related to the occurrence of symptomatic respiratory infections.

Etiological Trends and Antibiotic Susceptibility of Bacterial Strains Causing Respiratory Tract Infections

2020 ◽  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Respiratory Tract ◽  
Haemophilus Influenzae ◽  
Moraxella Catarrhalis ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Bacterial Isolates ◽  
Lower Respiratory Tract Infections ◽  
Streptococcus Pneumonia ◽  
Tract Infections

Background: Lower respiratory tract infections (LTRIs) are emerging as the most common infectious diseases of humans. Antibiotic resistance has increased in all the major pathogens therefore, this project engrossed on defining the current drift of bacterial etiologies of respiratory tract infections among the patients and their antimicrobial susceptibility pattern. Methods: This cross-sectional study with non-probability consecutive sampling was conducted in the microbiology laboratory of Ziauddin Hospital. Bacterial isolates (163) were recuperated from respiratory sputum specimens obtained from patients with lower respiratory tract infections. The pathogens collected for study were Streptococcus pneumonia, Haemophilus influenzae, and Moraxella catarrhalis. Frequencies and percentages were computed for categorical variables like microorganism, gender, age, duration of lower respiratory tract infections, etc. Mean and standard deviation were calculated for quantitative variables like age and infection duration. Furthermore, duration of disease was stratified by post stratification Chi Square with p value ≤ 0.05 was considered significant. Results: Most commonly isolated pathogen is Moraxella catarrhalis 72.39% followed by Haemophilus influenza 14.72% and Streptococcus pneumonia 12.88%. For Streptococcus pneumoniae 47% sensitivity showed to Ampicillin, 52% Penicillin, 61.9% Erythromycin and 57% to Ceftriaxone. For Haemophilus influenzae 100%, sensitivity showed to Ceftriaxone, 100% Amoxicillin and 62.5% Co-trimoxazole. Similarly, for Moraxella catarrhalis 54% sensitivity was showed to Erythromycin, 100% Ceftriaxone and 27% with Levofloxacin. Conclusion: Moraxella catarrhalis, Haemophilus influenzae and Streptococcus pneumoniae were the most common bacterial isolates recovered from LTRIs. We found M. catarrhalis resistant rate was elevated for Levofloxacin, Streptococcus pneumonia for Co-trimoxazole and Haemophilus influenzae to all β-lactams. Keywords: Respiratory Tract Infection; Haemophilus influenzae; Moraxella catarrhalis; Streptococcus pneumonia.

scholarly journals Epigenetic Regulation Alters Biofilm Architecture and Composition in Multiple Clinical Isolates of Nontypeable Haemophilus influenzae

mBio ◽  
2018 ◽  
Vol 9 (5) ◽  
Author(s):  
Kenneth L. Brockman ◽  
Patrick N. Azzari ◽  
M. Taylor Branstool ◽  
John M. Atack ◽  
Benjamin L. Schulz ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Biofilm Formation ◽  
Human Pathogens ◽  
Content Type ◽  
Alkaline Conditions ◽  
Tract Infections ◽  
Biofilm Structure

ABSTRACT Biofilms play a critical role in the colonization, persistence, and pathogenesis of many human pathogens. Multiple mucosa-associated pathogens have evolved a mechanism of rapid adaptation, termed the phasevarion, which facilitates a coordinated regulation of numerous genes throughout the bacterial genome. This epigenetic regulation occurs via phase variation of a DNA methyltransferase, Mod. The phasevarion of nontypeable Haemophilus influenzae (NTHI) significantly affects the severity of experimental otitis media and regulates several disease-related processes. However, the role of the NTHI phasevarion in biofilm formation is unclear. The present study shows that the phasevarions of multiple NTHI clinical isolates regulate in vitro biofilm formation under disease-specific microenvironmental conditions. The impact of phasevarion regulation was greatest under alkaline conditions that mimic those known to occur in the middle ear during disease. Under alkaline conditions, NTHI strains that express the ModA2 methyltransferase formed biofilms with significantly greater biomass and less distinct architecture than those formed by a ModA2-deficient population. The biofilms formed by NTHI strains that express ModA2 also contained less extracellular DNA (eDNA) and significantly less extracellular HU, a DNABII DNA-binding protein critical for biofilm structural stability. Stable biofilm structure is critical for bacterial pathogenesis and persistence in multiple experimental models of disease. These results identify a role for the phasevarion in regulation of biofilm formation, a process integral to the chronic nature of many infections. Understanding the role of the phasevarion in biofilm formation is critical to the development of prevention and treatment strategies for these chronic diseases. IMPORTANCE Upper respiratory tract infections are the number one reason for a child to visit the emergency department, and otitis media (middle ear infection) ranks third overall. Biofilms contribute significantly to the chronic nature of bacterial respiratory tract infections, including otitis media, and make these diseases particularly difficult to treat. Several mucosa-associated human pathogens utilize a mechanism of rapid adaptation termed the phasevarion, or phase variable regulon, to resist environmental and host immune pressures. In this study, we assessed the role of the phasevarion in regulation of biofilm formation by nontypeable Haemophilus influenzae (NTHI), which causes numerous respiratory tract diseases. We found that the NTHI phasevarion regulates biofilm structure and critical biofilm matrix components under disease-specific conditions. The findings of this work could be significant in the design of improved strategies against NTHI infections, as well as diseases due to other pathogens that utilize a phasevarion.

Mucosal Immunity and Bacteriology of the Eustachian Tube

1998 ◽  
Vol 77 (9) ◽  
pp. 748-761
Author(s):  
Christian Hjort Sørensen ◽  
Kirsten Brygge
Keyword(s):  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Mucosal Immunity ◽  
Moraxella Catarrhalis ◽  
Eustachian Tube Dysfunction ◽  
Tube Dysfunction

The pathogenesis of otitis media is a multifaceted process that is not completely understood. Eustachian tube dysfunction plays a central but uncertain role, as do viral and bacterial microorganisms. Of the latter, the three most important are Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. This article reviews the various mechanisms of infection and the immune system's response to them.

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