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Query: UNIPROT:O75191 (H. influenzae)
 4,961 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Haemophilus influenzae is an aerobic pleomorphic gram-negative coccobacillus that requires both X and V factors for growth. It grows poorly, if at all, on ordinary blood agar unless streaked with Staph. aureus. It grows well on chocolate agar. Because this medium is often not used in culturing specimens from adults and because the organism may be overgrown by other bacteria, the frequency of H. influenzae infections has undoubtedly been seriously underestimated. This is aggravated by the failure of many physicians to obtain blood cultures in suspected bacterial infections and the failure of many laboratories to subculture them routinely onto chocolate agar. H. influenzae, along with Streptococcus pneumoniae, is a major factor in acute sinusitis. It is probably the most frequent etiologic agent of acute epiglottitis. It is probably a common, but commonly unrecognized, cause of bacterial pneumonia, where it has a distinctive appearance on Gram stain. It is unusual in adult meningitis, but should particularly be considered in alcoholics; in those with recent or remote head trauma, especially with cerebrospinal fluid rhinorrhea; in patients with splenectomies and those with primary or secondary hypogammaglobulinemia. It may rarely cause a wide variety of other infections in adults, including purulent pericarditis, endocarditis, septic arthritis, obstetrical and gynecologic infections, urinary and biliary tract infections, and cellulitis. Antimicrobial susceptibility testing is somewhat capricious in part from the marked effect of inoculum size in some circumstances. In vitro and in vivo results support the use of ampicillin, unless the organism produces beta-lactamase. Alternatives in minor infections include tetracycline, erythromycin, and sulfamethoxazole-trimethoprim. For serious infections chloramphenicol is the best choice if the organism is ampicillin-resistant or the patient is penicillin-allergic.
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PMID:Haemophilus influenzae infections in adults: report of nine cases and a review of the literature. 31 Sep 43

17 infants and children with pyogenic meningitis (14 Haemophilus influenzae, 2 Diplococcus pneumoniae, 1 Neisseria meningitidis) were treated with thiamphenicol, 100 mg/kg body weight/day in 4 doses i.v., as single drug. In the H. influenzae group 10 patients were cured, 4 had relapses of meningitis, 3 with documented subdural effusions. This group is compared with 14 children matched for age, initial leucocyte and CSF cell count treated with ampicillin: all of these were cured, 1 had a subdural effusion. Thiamphenicol concentrations were determined in the serum and CSF 2 h after administration. The mean serum levels were between 10-12 mcg/ml, the mean CSF levels varied from 5.4 mcg/ml at the beginning to 1-1.9 mcg/ml at the end of meningitis. The MIC of H. influenzae was 0.6-12 mcg/ml. A significant, acute, and dose related bone marrow toxicity of thiamphenicol could be documented, but was always rapidly fully reversible. We conclude that thiamphenicol cannot replace chloramphenicol in the treatment of pyogenic meningitis as single systemic antibiotic. Special indications for thiamphenicol in this disease are discussed.
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PMID:Thiamphenicol in treatment of Haemophilus influenzae meningitis. 31 71

To determine the risk of severe Haemophilus influenzae illness among household contacts of patients with H. influenzae meningitis, we studied prospective data obtained in 19 states from January 1, 1977, to June 30, 1978. H. influenzae meningitis was reported in 1403 patients, and 1147 (82 per cent) of the exposed families were investigated for the occurrence of H. influenzae disease within 30 days after its onset in the index patient. During this interval, nine of 1687 household contacts (0.5 per cent) under the age of six years had systemic disease confirmed to be caused by H. influenzae Type b. The risk in children less than one year of age was 6 per cent, and the risk in those less than four years of age was 2.1 per cent. None of 2624 contacts above the age of five was affected. In the 30 days after onset of meningitis, the risk of this infection alone, aside from other types of serious H. influenzae disease, is 585 times greater in household contacts than the age-adjusted risk in the general population. The risk of H. influenzae disease in household contacts under six years of age is similar to the risk of secondary meningococcal disease in all household contacts--indicating a need for effective antimicrobial prophylaxis.
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PMID:Haemophilus influenzae meningitis. A national study of secondary spread in household contacts. 31 3

22 consecutive cases of pleural empyema due to H. influenzae in children are reported. An increment of its incidence during the 1975-76 period is observed. All cases were in children under 3 years of age, with a mean of 15.5 months. The presenting syndrome at admission was varied. In 50% of cases, pleuropulmonary infection was ignored. Nearly one half of cases of pleural empyema due to H. influenzae had simultaneous purulent meningitis caused by the same microorganism. This type of empyemas, though having a prolonged evolution, apparently appear to have a good prognosis, compared with that produced by S. aureus. There are some differences, being the most outstanding: low frequency of pyoneumothorax and the lack of radiological evidences of abscesses and or pneumotoceles, in any phase of the clinical course. Stress is placed on the value of the bacteriological study of blood and CSF in children under 3 years of age with pleural empyema. A high rate of positive blood cultures was found. (75%). Pieuropulmonary complications, as a frequent event during severe infections (septicemic disease) due to H. influenzae is considered. A clinical characterization of children in whom a pleural empyema could occur is proposed. A discussion is made about diagnostic, therapeutic and prognostic implications of these complications.
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PMID:[Pleural empyemas in children due to Hemophilus influenzae]. 31

Children not initially admitted to the hospital accounted for 42 of 94 episodes of bacteremia due to Haemophilus influenzae. Antibiotics were prescribed for 22 of the 42 children who were initially sent home; at second visit, 17 were improved, including all 13 with pneumonia. No antibiotics were prescribed for 20 children; at second visit, 15 had persistent fever or new focal infection and five had resolution of symptoms. New diagnoses of focal infection were made at second visit in three of the 22 treated and in 11 of the 20 untreated children, including three who had a new diagnosis of meningitis (one treated with antibiotics initially; two not treated). Cultures of blood positive for H. influenzae were obtained at second visit in ten children who were not treated initially; no child who was treated initially had a second positive culture. These findings indicate that although young children with bacteremia due to H. influenzae may be mildly ill at first visit, many are at risk for development of serious focal infection, including meningitis.
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PMID:Unsuspected bacteremia due to Haemophilus influenzae: outcome in children not initially admitted to hospital. 31 72

The current prevalence of ampicillin-resistant Haemophilus influenzae b meningitis requires accurate knowledge of susceptibility to alternative antibiotics. One variable affecting susceptibility is inoculum size. We studied the susceptibility of 200 clinical isolates of H. influenzae b to ampicillin, carbenicillin, and cefamandole at inocula of 10(5) and 10(7) CFU by two techniques. Fifty ampicillin-susceptible and fifty ampicillin-resistant strains were tested for susceptibility to ampicillin by broth dilution while 100 of each were tested by agar dilution. An inoculum effect was found, being greatest with the ampicillin-resistant strains. The range of minimal inhibitory concentrations for the resistant strains was 25 to 800 microgram of ampicillin per ml at an inoculum of 10(5) and 2,000 to less than 6,000 microgram of ampicillin at 10(7); 1.0 to 150 microgram of carbenicillin per ml at 10(5) and 6.2 to 2,000 microgram of carbenicillin per ml at 10(7); 0.4 to 2.0 microgram of cefamandole at 10(5) and 1.0 to 125 microgram/ml at 10(7). Because of this inoculum effect, we would not recommend the use of carbenicillin or cefamandole for therapy of ampicillin-resistant H. influenzae meningitis.
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PMID:Effect of inoculum size on the susceptibility of Haemophilus influenzae b to beta-lactam antibiotics. 31 8

An epidemiologic survey of meningitis caused by Haemophilus influenzae type b in children aged zero to four years during an 11-year period (January 1965-December 1975) was conducted in the Baltimore, Maryland, metropolitan area to examine recent trends in the incidence of this disease. Cases of H. influenzae meningitis were identified at all 19 hospitals in the city and county of Baltimore and all 41 hospitals in the surrounding area. The population at risk (age, zero to four years) was estimated using yearly birth rates provided by the state of Maryland and U.S. Census information for 1960 and 1970. Yearly age-adjusted incidence was calculated; in contrast to previous studies, there was no significant increase in the annual incidence (range, 12-27; mean, 19.3/100,000 population at risk). Previous reports of recent increases in the incidence of meningitis caused by H. influenzae type b may be due to differences in study techniques.
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PMID:Absence of increasing incidence of meningitis caused by Haemophilus influenza type b. 31 92

Protein A-rich staphylococci coated with Haemophilus influenzae type b antiserum agglutinate specifically with homologous bacterial cells or with cell-free supernatant fluids of cultures of the organism. Antibody-coated staphylococci were used to detect soluble antigens in body fluids of patients infected with H. influenzae type b. Cerebrospinal fluid from 36 cases of meningitis caused by this orgainsm showed positive coagglutination tests in 86% of patients prior to initiation of therapy. Antigens could be detected in 46% of sterile cerebrospinal fluid specimens obtained from the same cases 1 to 10 days after therapy. Soluble antigens were also detectable in sera (58%) and urine specimens (67%) of patients with H. influenzae type b septicemia, when such specimens were tested within 10 days of onset of illness. No antigen could be detected in body fluids beyond 10 days. The coagglutination test was positive in 57% of all body fluids examined; contercurrent immunoelectrophoresis (CCIE) was positive in only 27%. All specimens positive by CCIE were also positive by coagglutination. No false-positive reactions were noted by either test in body fluids from controls. The coagglutination test is simple, specific, and more sensitive than the CCIE method and could be a valuable tool for detecting antigens in body fluids of patients with various infections.
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PMID:Detection of Haemophilus influenzae type b antigens in body fluids, using specific antibody-coated staphylococci. 31 13

The pathogenesis of bacterial meningitis was studied in infant rats. Intranasal intoculation of greater than 10(3) Haemophilus influenzae type b resulted in an incidence of bacteremia that was directly related to the size of hte challenge inoculum. The temporal and quantitative relationship of bacteremia to meningitis indicated that bacteria spread to the meninges by the hematogenous route and that the magnitude of bacteremia was a primary determinant in the development of meningitis. In a sparate series of experiments, infant rats that were fed Escherichia coli strain C94 (O7:K1:H-) became colonized and developed bacteremia and meningitis, but invasive disease was rare when rats were fed E. Coli strain Easter (O75:K100:H5). A comparison of intranasal vs. oral challenge indicated that the nasopharynx was the most effective route for inducing H. influenzae bacteremia, whereas the gastrointestinal route was the more effective challenge route for the E. coli K1 serotype.
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PMID:The infant rat as a model of bacterial meningitis. 33 Jul 77

Quantitative blood cultures were sought in 383 children, from whom routine blood cultures were obtained because of fever, by direct plating of 10 and 100 microliter blood onto solidified media. There were 14 positive cultures from 12 patients. These were 7 Hemophilus influenzae type b, 5 Streptococcus penumoniae, and 2 Staphylococcus aureus. The direct-plating technique permitted more rapid identification of positive cultures, and detected three episodes not identified by routine broth culture. Bacterial counts ranged from 20 to greater than 10(4) bacteria/ml blood. In the three cases of H. influenzae type b meningitis, bacteremia exceeded 10(3)/ml. Among nine patients in whom bacteremia was unassociated with meningitis, (bacteremia without evident localized disease 5, pneumonia 2, epiglottitis 1, peritonitis 1), bacteremia was less than 10(3)/ml. This technique may aid detection of bacteremia and help identify those children at highest risk for developing septic complications, such as meningitis.
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PMID:Detection and quantitation of bacteremia in childhood. 33 75


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