The bacteriology of recurrent otitis media and the effect of sulfisoxazole chemoprophylaxis

Liston, Thomas E.; Foshee, William S.; McCleskey, F K

doi:10.1097/00006454-198401000-00006

Cited by 21 publications

(6 citation statements)

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“…Although invasive disease, such as bacteremia, is uncommon with nontypabl e H. infl uenza e, local infection is frequent. Nont ypable H. infiu enzae is the second leading cause of acute otitis media and sinusitis and the lead ing ca use of recurrent or chronic otitis media in children (5)(6)(7)(8).…”

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confidence: 99%

Activation of the Neutrophil Bactericidal Activity for Nontypable Haemophilus influenzae by Tumor Necrosis Factor and Lymphotoxin

et al. 1995

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Previous studies have suggested that, in vivo, activated T lymphocytes and neutrophils are important in immunity to nontypable Haemophilus influenzae. We now extend this work by showing that neutrophils pretreated with products of activated T lymphocytes or activated macrophages show significantly enhanced killing of nontypable H. influenrae. Lymphotoxin, a product of activated T lymphocytes, significantly enhanced the neutrophil-mediated killing of nontypable H. infi uenzae, and tumor necrosis factor, produced by activated T lymphocytes as well as macrophages stimulated by activated T lymphocytes, also significantly increased the bactericidal activity of neutrophils. These cytokine-induced effects were seen with short pretreatment times of neutrophils and were maximal by 30 min. The killing of H . infiuenzae by neutrophils required the presence of heat-labile opsonins. In the absence of these opsonins, both tumor necrosis Nontypable Haemoph ilus infiuenzae is a co mmo n resp iratory pa thogen. It is carried in the nasopharynx of 70-80% of health y childr en (1). Coloniza tio n rates incr ease dur ing respirato ry illn ess (2) . In particul ar, colonizat ion of the nasoph arynx w ith nontypable H. infi uenzae may exceed 95% at the time of otitis media (3) , when the organism may compose 50% of the total bacterial flora (4). Although invasive disease, such as bacteremia, is uncommon with nontypabl e H. infl uenza e, local infection is frequent. Nont ypable H. infiu enzae is the second leading cause of acute otitis media and sinusitis and the lead ing ca use of recurrent or chronic otitis media in children (5-8).Th e protective role of antibody against nont ypable H. infiuenzae respi ratory infections in both humans and rat mod els is now qu estion abl e. High levels of antibo dy to this org an ism are presen t in se rum, saliva, and sputum of patients with chronic bronchitis (9, 10) , and in on e study the level of anti body in

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confidence: 99%

Activation of the Neutrophil Bactericidal Activity for Nontypable Haemophilus influenzae by Tumor Necrosis Factor and Lymphotoxin

et al. 1995

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“…In contrast, serum antibody titers remained relatively stable after the initial antibody response. DISCUSSION NT H. influenzae is the most frequent cause of recurrent OME (9,11). Protection against infection with NT H. influenzae, as determined by a bactericidal antibody assay, appears to be strain specific, which was the primary reason for using homologous strains of NT H. influenzae to measure antibody response in the present study (1,8).…”

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confidence: 73%

“…NT Haemophilus influenzae is responsible for a major share of recurrent episodes of OME (9,11). Recent studies have suggested that NT H. influenzae consists of many different strains that may be characterized by their outer membrane proteins (13)(14)(15)(16).…”

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Otitis media in children: Local immune response to nontypeable Haemophilus influenzae

1990

International Journal of Pediatric Otorhinolaryngology

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Twenty children experienced 30 episodes of otitis media with effusion due to nontypeable (NT) Haemophilus influenzae in the first 2 years of life. The local and systemic immune responses to homologous strains of NT H. influenzae were determined by an immunodot assay. Strain-specific immunoglobulin G (IgG) antibody predominated in the middle ear fluid (MEF). It was detected in 91% of the children, compared with IgM in 48% (P < 0.005), IgA in 52% (P < 0.005), and secretory IgA in 18% (P < 0.005). The titer (log2) of NT H. influenzae-specific IgG antibody (mean standard error, 8.2 + 0.1) exceeded the titers of IgM (3.4 0.1), IgA (3.7 0.1), and secretory IgA (1.2 + 0.3). NT H. influenzae-specific antibody was detected exclusively in MEFs of individuals who possessed homologous serum antibody. Although antibody titers in MEF declined over time, serum antibody titers remained stable. These data suggest that immunity to NT H. influenzae in the middle ear, in part, reflects systemic immunity. Whereas local antibody disappears after resolution of the infection, systemic antibody persists.Otitis media with effusion (OME) is among the most common illnesses that affect young children. Approximately 60 to 70% of children experience OME during the first 3 years of life, and at least 40% of them experience more than one episode (26). The incidence of OME is highest in the first 2 years of life and then declines (10). Presumably, immunity plays a role in the reduction of the frequency of OME.Three bacterial species-Streptococcus pneumoniae, nontypeable (NT) Haemophilus influenzae, and Branhamella catarrhalis-account for the majority of identifiable bacterial causes of acute OME (2,3,(18)(19)(20). NT Haemophilus influenzae is responsible for a major share of recurrent episodes of OME (9,11). Recent studies have suggested that NT H. influenzae consists of many different strains that may be characterized by their outer membrane proteins (13-16). Immunity to NT H. influenzae appears to be strain specific and directed to the outer membrane proteins (1,5,6,8,15,17). Susceptibility and resistance to the development of NT H. influenzae OME have been associated with the presence and absence of serum bactericidal antibody (1,8,21). Less is known about the role of local immunity in NT H. influenzae OME.The present study was designed to examine the local development of immunoglobulin G (IgG), IgM, IgA, and secretory IgA (sIgA) antibodies to homologous strains of NT H. influenzae in the middle ear during active infection. The study also analyzed humoral response to NT H. influenzae over a prolonged period of convalescence. MATERIALS AND METHODSGeneral design. A total of 220 children were enrolled in a prospective study of otitis media. At enrollment, 39% were s6 months old, 32% were 7 to 12 months old, and 29% were >12 months old. At the time of entry into the study, 32% had experienced no OME, 51% had had one to five episodes of OME, and 17% had had more than five episodes of OME. During 3 years of monitoring the children, 320 tympanocen-*...

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“…leading cause of acute otitis media and sinusitis and the leading cause of recurrent or chronic otitis media in children (1,3,12,20). Serum antibody against nontypeable H. influenzae is absent in the early phase of an ear infection and develops during convalescence (6).…”

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Release of leukotriene B4 from human neutrophils after interaction with nontypeable Haemophilus influenzae

et al. 1991

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Opsonization of nontypeable Haemophilus influenzae with antibody is critical for the interaction between the organism and human polymorphonuclear leukocytes (PMNs). Nontypeable H. influenzae opsonized in fresh antibody-positive serum induced the release of 42.5 ± 17.9 ng of leukotriene B4 per ml from PMNs after 20 min of incubation at 37°C. On the other hand, opsonization of the organisms in fresh antibody-negative serum stimulated the release of significantly smaller amounts of leukotriene B4 by the PMNs. Simultaneous determinations of phagocytosis demonstrated similar patterns of response. A small amount (26.7 ± 7.6%) of unopsonized nontypeable H. influenzae was phagocytosed by PMNs during 20 min of incubation at 37°C. In contrast, 89.3 ± 2.0% of nontypeable H. influenzae opsonized in fresh antibody-positive serum was phagocytosed during the same incubation period (P < 0.001). Removal of complement through heat inactivation at 56°C for 30 min did not significantly affect phagocytosis. These data suggest that the humoral immune response to nontypeable H. influenzae plays an important role in the inflammatory process and may contribute to the production of middle ear effusions in otitis media.

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The bacteriology of recurrent otitis media and the effect of sulfisoxazole chemoprophylaxis

Cited by 21 publications

References 0 publications

Activation of the Neutrophil Bactericidal Activity for Nontypable Haemophilus influenzae by Tumor Necrosis Factor and Lymphotoxin

Activation of the Neutrophil Bactericidal Activity for Nontypable Haemophilus influenzae by Tumor Necrosis Factor and Lymphotoxin

Otitis media in children: Local immune response to nontypeable Haemophilus influenzae

Release of leukotriene B4 from human neutrophils after interaction with nontypeable Haemophilus influenzae

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