Possible Relationship of PFGE Patterns of Moraxella catarrhalis between Hospital‐ and Community‐Acquired Respiratory Infections in a Community Hospital

Abstract

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.

Contemporary Prevalence of BRO β-Lactamases in Moraxella catarrhalis : Report from the SENTRY Antimicrobial Surveillance Program (North America, 1997 to 2004)

“…Also, automated ribotyping failed to demonstrate its usefulness as an epidemiologic test for M. catarrhalis. PFGE was very effective in discriminating between isolates, as has been observed in an earlier study (12). Clonal spread among community-acquired isolates producing BRO-1 and BRO-2 was evident, even from this small sample of North American M. catarrhalis strains.…”

Antimicrobial Susceptibility and Genetic Characteristics of Streptococcus pneumoniae Isolates Indicating Possible Nosocomial Transmission Routes in a Community Hospital in Japan

“…Our previous national survey had already demonstrated that the Taiwan19F clone was spreading widely in Japan (30), which suggested that the causative pathogen spreading between NPI patients and outpatients might have originated from the same parent strain. A previous study indicated that there was some association between hospital-and community-acquired respiratory infections caused by Moraxella catarrhalis (20). In this study, we detected pattern A in the serotype 19F group in both NPI patients and outpatients, as well as pattern d in the serotype 23F group, indicating that some association existed between NPI patients and outpatients even in pneumococcal infection.…”

“…Previous studies conducted to determine the antimicrobial susceptibilities of isolates from NPI found that a high percentage of pneumococcal pathogens had multidrug resistance, including resistance to new quinolones (4,5,28,39). Masaki et al reported a possible relationship between the pulsed-field gel electrophoresis (PFGE) patterns of Moraxella catarrhalis isolates from hospital-and community-acquired respiratory infections in a community hospital (20). Yet there still is not sufficient evidence to determine whether a similar pattern exists for S. pneumoniae.…”

Molecular Epidemiological Study of Moraxella catarrhalis Isolated from Nosocomial Respiratory Infection Patients in a Community Hospital in Japan

“…13 (19,25,27). Some studies reported that infants and children were colonized by M. catarrhalis at a higher rate than only 1-5% healthy adults did (21), but isolates from older patients were more likely to be pathogenically significant (32) (15,19).…”

“…M. catarrhalis also plays an important role in nosocomial respiratory infection (NRI) (4,14,19,20) (17,19,25,26,31,33) (2,18,29), thus it has a great sensitivity due to its ability to detect neutral genetic variations (8,22). MLST has been successfully widely used for analysis of many common pathogens such as Neisseria meningitidis, S. pneumoniae, Staphylococcus aureus, Streptococcus pyogenes, and Campylobacter jejuni (6,7,9,10) …”