Bacteremic Haemophilus influenzae Genitourinary Tract Infections in Adults

Albritton, William L.

doi:10.1001/archinte.1978.03630370035018

Cited by 43 publications

(7 citation statements)

References 27 publications

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“…Several recent reviews of H. influenzae infections in adults have indicated that GU tract infections are uncommon (19,26), and a recent review of H. influenzae infections in children indicated that perinatal infections are uncommon as well (8). Additional reports of H. influenzae GU tract infections have appeared since the publication of these reviews, including our own report of bacteremic infections in adults (2,15,27,38) and reports of perinatal infections as well (4,7,16,28,36). Recent studies have also shown that H. influenzae can be regularly recovered from the female genital tract (17,24).…”

Section: Discussionmentioning

confidence: 89%

Haemophilus influenzae: comparison of respiratory tract isolates with genitourinary tract isolates

Albritton¹,

Brunton²,

Meier³

et al. 1982

J Clin Microbiol

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Haemophilus influenzae isolates recovered from the genitourinary (GU) tract were shown to have a significantly different biotype distribution compared with respiratory tract isolates. Biotype IV strains were recovered more commonly from the GU tract, and most strains were non-serotypable. Antibiotic-susceptible strains isolated from the GU tract more frequently harbored plasmids of <10 megadaltons than did antibiotic-susceptible respiratory tract strains. One 2.8megadalton plasmid resident in a GU tract isolate and one 1.8-megadalton plasmid resident in a respiratory tract isolate were shown to be related to the small ampicillin resistance plasmids previously described in H. influenzae, Haemophilus parainfluenzae, Haemophilus ducreyi, and Neisseria gonorrhoeae. This supports the suggestion that these ampicillin resistance plasmids originated by transposition or recombination of the ampicillin transposon (TnA) with cryptic endogenous Haemophilus plasmids. Genitourinary (GU) tract colonization withHaemophilus influenzae appears to be infrequent, and serious infections from this source are uncommon (17,24,33). Previous studies have suggested bacteriological differences between H. influenzae GU tract infections and their associated neonatal infections and the more frequently reported respiratory infections in infants and adults due to this organism (3,8). In general, the organisms isolated from the GU tract are non-encapsulated, and the biotype distribution appears to be different.Since 1976, we have isolated H. influenzae from the GU tract of 82 patients; these isolates include strains from two surveys of GU tract colonization due to this organism in asymptomatic pregnant females and symptomatic males and females in an ambulatory population. This study reports the results of biotyping and plasmid analysis of these GU tract isolates compared with a similar analysis of respiratory tract isolates. MATERIALS AND METHODSBacterial strains and plasmids. GU tract isolates of H. influenzae from 82 patients were analyzed and compared with 122 consecutively isolated respiratory strains. Sixty-four of the GU tract strains were recovt Present address: Sexually Transmitted Diseases Research Laboratory, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333. ered by routine isolation in the Clinical Microbiology Laboratory of the Health Sciences Centre, Winnipeg,Manitoba, Canada. Five isolates were recovered during a 12-month prospective study of genital tract colonization in 1,724 asymptomatic pregnant women. Twelve isolates were recovered during a 2-month prospective study of 722 symptomatic patients presenting to the Primary Health Care Clinic of the Health Sciences Centre, a clinic responsible for the treatment of sexually transmitted diseases. A single strain was recovered from a genital ulcer lesion in an ongoing prospective study in Nairobi, Kenya. Clinical and demographic data were obtained from a review of hospital charts. The bacterial plasmids used in this study are described in Table 1.Culture m...

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Section: Discussionmentioning

confidence: 89%

Haemophilus influenzae: comparison of respiratory tract isolates with genitourinary tract isolates

Albritton¹,

Brunton²,

Meier³

et al. 1982

J Clin Microbiol

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“…Neonatal infections and infection during pregnancy due to H. influenza have been described regularly since 1975 (3,4,10,16,20,37,47,53,58,68,72,74). Authors reporting the largest series (16, 58, 72) point to an increasing frequency, H. influenza accounting for 1.4% of positive blood cultures in mothers and neonates in Houston, Tex., in 1975 and up to 5.7% in 1981 (72).…”

Section: Discussionmentioning

confidence: 99%

“…The first neonatal, perinatal, and genital infections due to Haemophilus strains were described in the early 1900s (22,40,66), but the number of cases, while remaining low, has increased only in the last 15 years (3,10,16,20,37,58,72). A specific tropism of some Haemophilus influenza strains to the genital tract has been suggested from biotyping and serotyping studies (2,58,72); this is not unanimously admitted (41).…”

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confidence: 99%

Typing of urogenital, maternal, and neonatal isolates of Haemophilus influenzae and Haemophilus parainfluenzae in correlation with clinical source of isolation and evidence for a genital specificity of H. influenzae biotype IV

et al. 1989

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Over a period of 6 years, 114 strains of Haemophilus influenza and Haemophilus parainfluenzae were isolated from genital, mother-infant, or neonatal infections. Their serotypes, biotypes, antibiotic resistance phenotypes, and outer membrane protein (OMP) electrophoretic patterns were characterized and correlated with the various clinical outcomes. Genital H. influenza and H. parainfluenzae appeared to behave mostly as opportunistic pathogens; for instance, 62% of the cases of endometritis or pelvic inflammatory disease were related to the presence of an intrauterine device. However, as seen clearly in one case, the strains may be sexually transmitted. The analysis of OMP patterns proved to be a very convenient method to seek evidence for the sexual origin of the infection. H. influenzae was more often involved in complicated genital infections than was H. parainfluenzae. Nontypeable and biotype II H. injluenzae strains were the more frequent isolates, except in pelvic inflammatory diseases, in which biotype I prevailed, and in mother-infant infections, in which one-fourth of the cases were due to biotype IV. Characterization of H. influenzae isolates did not support a general concept of specific genital strains. However, strains of biotype IV clearly stood out with two characteristics: (i) a peritrichous fimbriation and (ii) a very peculiar homogeneous OMP pattern comprising an OMP of molecular weight '18,000 unique to this biotype. These characteristics were also found in H. influenza biotype IV strains isolated from genital infections in the United States and used as controls. H. influenza biotype IV strains may thus correspond to a group somewhat adapted to the genital tract. * Corresponding author. mostly from neonatal or mother-infant infections in the United States and France (58, 72). However, clinical outcome has been shown to be more severe in Houston, Tex. (72), than in Tours, France (58). To account for this difference, we have compared our own H. influenza biotype IV isolates to nine strains originating in the United States and kindly provided by R. J. Wallace. MATERIALS AND METHODS Patients. Haemophilus spp. were isolated from 1 October 1979 through 31 March 1987 in patients from the Centre Hospitalier Régional et Universitaire Bretonneau in Tours, France. Patients belonged to two groups: women consulting for genital or urinary tract infections and newborn infants suspected to be at risk of infection on the basis of clinical signs in the mother (fever, genital or urinary tract infections, premature rupture of membranes, or premature onset of labor) or overt clinical signs in the child (fever, respiratory distress syndrome, shock, jaundice, or leukopenia). In these cases, bacterial investigations included two placental smears corresponding to both sides of the placenta, an aspiration of the gastric fluid, and swabs of ears, mouth, anus, and nose. In addition, urine analysis, blood cultures, and lumbar punctures were carried out in three circumstances: when the neonate had clinical or biological signs ...

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“…H. influenzae was most frequent in patients below 5 years of age; bacteremic H. influenzae type b disease is also most frequent during the first five years of life; except during the first weeks after birth when the infant is protected by maternal antibodies. However, cases of bqcteremia due to non-typable H. influenzae strains have been reported (Albritton 1978), and haemophilus ophthalmia has been associated with several systemic infection (Khuri-Bulos & McIntosh 1975). This again indicates the importance of bacterial cultivation from inflammed conjunctiva in this age group.…”

Section: Discussionmentioning

confidence: 99%

A microbiological study of conjunctivitis with emphasis on Chlamydia trachomatis, in Northern Norway

Olafsen

Størvold

Melby

1986

Acta Ophthalmologica

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To determine the microbiological agents in conjunctivitis in children and young adults, physicians outside hospitals were asked to obtain samples from the conjunctiva in patients presenting with conjunctivitis. Specimens from 194 patients and 177 healthy controls were cultivated for Chlamydia trachomatis. In 12 cases Chlamydia trachomatis was isolated (i.e. 4 neonates, 1 three-year-old child and 7 adults, aged 17 to 39 years), but in none of the controls. Of the specimens from patients 168 and all of the healthy controls were cultivated for both bacteria (including Chlamydia trachomatis) and viruses. The main micro-organisms, regarded as infectious, were Haemophilus influenzae (20), Streptococcus pneumoniae (18), Staphylococcus aureus (14) and Chlamydia trachomatis (9). Haemophilus influenzae (non-typable strains) were isolated more frequently in the age group below 5 years of age than in the age group 5-50 years. Herpes simplex virus (type II) was isolated in one neonate. Chlamydia trachomatis is among the most important infectious agents in conjunctivitis treated outside hospitals. As chlamydial infections need special attention regarding treatment and follow-up, physicians should be encouraged to obtain specimens for microbiological examination, including chlamydia, from the population at risk.

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Bacteremic Haemophilus influenzae Genitourinary Tract Infections in Adults

Cited by 43 publications

References 27 publications

Haemophilus influenzae: comparison of respiratory tract isolates with genitourinary tract isolates

Haemophilus influenzae: comparison of respiratory tract isolates with genitourinary tract isolates

Typing of urogenital, maternal, and neonatal isolates of Haemophilus influenzae and Haemophilus parainfluenzae in correlation with clinical source of isolation and evidence for a genital specificity of H. influenzae biotype IV

A microbiological study of conjunctivitis with emphasis on Chlamydia trachomatis, in Northern Norway

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