Moraxella (Branhamella) catarrhalis is an aerobic gram-negative, oxidase positive diplococcus, and was once considered a nonpathogenic commensal of the upper respiratory tract. However it has been regarded as a potential pathogen since the mid-1980s (6). In many countries, M. catarrhalis has become the third most common cause of bacterial lower respiratory tract infection after Haemophilus influenzae and Streptococcus pneumoniae (3). In general, M. catarrhalis is also recognized as a major cause of community-acquired respiratory infections (18,26), otitis media, and sinusitis (4), and a cause of nosocomial respiratory infections (1,5,8,15,19,20). While nosocomial outbreaks of M. catarrhalis were suspected in previous studies, confirmation was hampered by the lack of an established typing system. In fact, several epidemiological typing methods have been used to characterize strains of M. catarrhalis such as phenotypic characterization, electrophoretic mobility of esterases, outer membrane proteins, whole-cell proteins, plasmid profiles, isoelectric focusing of β-lactamase A and B). Of the three patterns, two patterns (A and B) were found in both inpatients and outpatients. More interestingly, two subtypes of pattern B (B1 and B4) were simultaneously found in both inpatients and outpatients. Our results indicated that PFGE with SmaI chromosomal digestion is a suitable technique to establish the inter-strain genetic relatedness of M. catarrhalis, and suggested that the outbreak of M. catarrhalis occasionally included miscellaneous PFGE patterns. The results also showed that PFGE patterns of M. catarrhalis isolates were similar between hospitaland community-acquired respiratory infections. Analysis of the subtypes suggested that there might be some association between hospital-and community-acquired respiratory infections caused by M. catarrhalis.
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