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Topaz N, Tsang R, Deghmane AE, Claus H, Lâm TT, Litt D, Bajanca-Lavado MP, Pérez-Vázquez M, Vestrheim D, Giufrè M, Van Der Ende A, Gaillot O, Kuch A, McElligott M, Taha MK, Wang X. Phylogenetic Structure and Comparative Genomics of Multi-National Invasive Haemophilus influenzae Serotype a Isolates. Front Microbiol 2022; 13:856884. [PMID: 35401483 PMCID: PMC8988223 DOI: 10.3389/fmicb.2022.856884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Recent reports have indicated a rise of invasive disease caused by Haemophilus influenzae serotype a (Hia) in North America and some European countries. The whole-genome sequences for a total of 410 invasive Hia isolates were obtained from 12 countries spanning the years of 1998 to 2019 and underwent phylogenetic and comparative genomic analysis in order to characterize the major strains causing disease and the genetic variation present among factors contributing to virulence and antimicrobial resistance. Among 410 isolate sequences received, 408 passed our quality control and underwent genomic analysis. Phylogenetic analysis revealed that the Hia isolates formed four genetically distinct clades: clade 1 (n = 336), clade 2 (n = 13), clade 3 (n = 3) and clade 4 (n = 56). A low diversity subclade 1.1 was found in clade 1 and contained almost exclusively North American isolates. The predominant sequence types in the Hia collection were ST-56 (n = 125), ST-23 (n = 98) and ST-576 (n = 51), which belonged to clade 1, and ST-62 (n = 54), which belonged to clade 4. Clades 1 and 4 contained predominantly North American isolates, and clades 2 and 3 predominantly contained European isolates. Evidence of the presence of capsule duplication was detected in clade 1 and 2 isolates. Seven of the virulence genes involved in endotoxin biosynthesis were absent from all Hia isolates. In general, the presence of known factors contributing to β-lactam antibiotic resistance was low among Hia isolates. Further tests for virulence and antibiotic susceptibility would be required to determine the impact of these variations among the isolates.
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Affiliation(s)
- Nadav Topaz
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Raymond Tsang
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Ala-Eddine Deghmane
- Centre National de Référence des Méningocoques, Institut Pasteur, Paris, France
| | - Heike Claus
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Thiên-Trí Lâm
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - David Litt
- Respiratory and Vaccine Preventable Bacterial Reference Unit, Public Health England, London, United Kingdom
| | - Maria Paula Bajanca-Lavado
- Haemophilus Influenzae Reference Laboratory, Department of Infectious Disease, National Institute of Health, Lisbon, Portugal
| | - María Pérez-Vázquez
- Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones Relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Didrik Vestrheim
- Norwegian Institute of Public Health, Division of Infection Control and Environmental Health, Oslo, Norway
| | - Maria Giufrè
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Arie Van Der Ende
- Department of Medical Microbiology and Infection Prevention and the Netherlands Reference Laboratory for Bacterial Meningitis, University of Amsterdam, Amsterdam, Netherlands
| | - Olivier Gaillot
- Service de Bactériologie-Hygiène, CHU Lille, Lille, France
- CNRS, INSERM, U1019-UMR 8204, Center for Infection and Immunity, CHU Lille, Lille, France
| | - Alicja Kuch
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | - Martha McElligott
- Irish Meningitis and Sepsis Reference Laboratory, Children’s Health Ireland at Temple Street, Dublin, Ireland
| | - Muhamed-Kheir Taha
- Centre National de Référence des Méningocoques, Institut Pasteur, Paris, France
| | - Xin Wang
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Collins LF, Havers FP, Tunali A, Thomas S, Clennon JA, Wiley Z, Tobin-D’Angelo M, Parrott T, Read TD, Satola SW, Petit RA, Farley MM. Invasive Nontypeable Haemophilus influenzae Infection Among Adults With HIV in Metropolitan Atlanta, Georgia, 2008-2018. JAMA 2019; 322:2399-2410. [PMID: 31860046 PMCID: PMC6990662 DOI: 10.1001/jama.2019.18800] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
IMPORTANCE Invasive nontypeable Haemophilus influenzae (NTHi) infection among adults is typically associated with bacteremic pneumonia. Nontypeable H influenzae is genetically diverse and clusters of infection are uncommon. OBJECTIVE To evaluate an increase in invasive NTHi infection from 2017-2018 among HIV-infected men who have sex with men in metropolitan Atlanta, Georgia. DESIGN, SETTING, AND PARTICIPANTS A population-based surveillance study with a cohort substudy and descriptive epidemiological analysis identified adults aged 18 years or older with invasive NTHi infection (isolation of NTHi from a normally sterile site) between January 1, 2008, and December 31, 2018 (final date of follow-up). EXPOSURES Time period, HIV status, and genetic relatedness (ie, cluster status) of available NTHi isolates. MAIN OUTCOMES AND MEASURES The primary outcome was incidence of invasive NTHi infection (from 2008-2016 and 2017-2018) among persons with HIV and compared with NTHi infection from 2008-2018 among those without HIV. The secondary outcomes were assessed among those aged 18 to 55 years with invasive NTHi infection and included epidemiological, clinical, and geographic comparisons by cluster status. RESULTS Among 553 adults with invasive NTHi infection (median age, 66 years [Q1-Q3, 48-78 years]; 52% male; and 38% black), 60 cases occurred among persons with HIV. Incidence of invasive NTHi infection from 2017-2018 among persons with HIV (41.7 cases per 100 000) was significantly greater than from 2008-2016 among those with HIV (9.6 per 100 000; P < .001) and from 2008-2018 among those without HIV (1.1 per 100 000; P < .001). Among adults aged 18 to 55 years with invasive NTHi infections from 2017-2018 (n = 179), persons with HIV (n = 31) were significantly more likely than those from 2008-2018 without HIV (n = 124) to be male (94% vs 49%, respectively; P < .001), black (100% vs 53%; P < .001), and have septic arthritis (35% vs 1%; P < .001). Persons with HIV who had invasive NTHi infection from 2017-2018 (n = 31) were more likely than persons with HIV who had invasive NTHi infection from 2008-2016 (n = 24) to have septic arthritis (35% vs 4%, respectively; P = .01). Pulsed-field gel electrophoresis of 174 of 179 NTHi isolates from 18- to 55-year-olds identified 2 genetically distinct clonal groups: cluster 1 (C1; n = 24) and cluster 2 (C2; n = 23). Whole-genome sequencing confirmed 2 clonal lineages of NTHi infection and revealed all C1 isolates (but none of the C2 isolates) carried IS1016 (an insertion sequence associated with H influenzae capsule genes). Persons with HIV were significantly more likely to have C1 or C2 invasive NTHi infection from 2017-2018 (28/31 [90%]) compared with from 2008-2016 among persons with HIV (10/24 [42%]; P < .001) and compared with from 2008-2018 among those without HIV (9/119 [8%]; P < .001). Among persons with C1 or C2 invasive NTHi infection who had HIV (n = 38) (median age, 34.5 years; 100% male; 100% black; 82% men who have sex with men), 32 (84%) lived in 2 urban counties and an area of significant spatial aggregation was identified compared with those without C1 or C2 invasive NTHi infection. CONCLUSIONS AND RELEVANCE Among persons with HIV in Atlanta, the incidence of invasive nontypeable H influenzae infection increased significantly from 2017-2018 compared with 2008-2016. Two unique but genetically related clonal strains were identified and were associated with septic arthritis among black men who have sex with men and who lived in geographic proximity.
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Affiliation(s)
- Lauren F. Collins
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Georgia Emerging Infections Program, Atlanta
| | - Fiona P. Havers
- Division of Bacterial Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
- Atlanta VA Medical Center, Decatur, Georgia
| | - Amy Tunali
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Georgia Emerging Infections Program, Atlanta
| | - Stephanie Thomas
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Georgia Emerging Infections Program, Atlanta
| | - Julie A. Clennon
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Zanthia Wiley
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Melissa Tobin-D’Angelo
- Georgia Emerging Infections Program, Atlanta
- Georgia Department of Public Health, Atlanta
| | - Tonia Parrott
- Georgia Emerging Infections Program, Atlanta
- Georgia Department of Public Health, Atlanta
| | - Timothy D. Read
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Georgia Emerging Infections Program, Atlanta
| | - Sarah W. Satola
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Georgia Emerging Infections Program, Atlanta
| | - Robert A. Petit
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Georgia Emerging Infections Program, Atlanta
| | - Monica M. Farley
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Georgia Emerging Infections Program, Atlanta
- Atlanta VA Medical Center, Decatur, Georgia
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Analysis of Invasive Nontypeable Haemophilus influenzae Isolates Reveals Selection for the Expression State of Particular Phase-Variable Lipooligosaccharide Biosynthetic Genes. Infect Immun 2019; 87:IAI.00093-19. [PMID: 30833337 PMCID: PMC6479036 DOI: 10.1128/iai.00093-19] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 02/26/2019] [Indexed: 12/16/2022] Open
Abstract
Nontypeable Haemophilus influenzae (NTHi) is a major human pathogen, responsible for several acute and chronic infections of the respiratory tract. The incidence of invasive infections caused by NTHi is increasing worldwide. NTHi is able to colonize the nasopharynx asymptomatically, and the exact change(s) responsible for transition from benign carriage to overt disease is not understood. We have previously reported that phase variation (the rapid and reversible ON-OFF switching of gene expression) of particular lipooligosaccharide (LOS) glycosyltransferases occurs during transition from colonizing the nasopharynx to invading the middle ear. Variation in the structure of the LOS is dependent on the ON/OFF expression status of each of the glycosyltransferases responsible for LOS biosynthesis. In this study, we surveyed a collection of invasive NTHi isolates for ON/OFF expression status of seven phase-variable LOS glycosyltransferases. We report that the expression state of the LOS biosynthetic genes oafA ON and lic2A OFF shows a correlation with invasive NTHi isolates. We hypothesize that these gene expression changes contribute to the invasive potential of NTHi. OafA expression, which is responsible for the addition of an O-acetyl group onto the LOS, has been shown to impart a phenotype of increased serum resistance and may serve as a marker for invasive NTHi.
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Iuchi H, Ohori J, Kyutoku T, Ito K, Kurono Y. Role of phosphorylcholine in Streptococcus pneumoniae and nontypeable Haemophilus influenzae adherence to epithelial cells. Auris Nasus Larynx 2018; 46:513-519. [PMID: 30503566 DOI: 10.1016/j.anl.2018.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 09/26/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Phosphorylcholine (PC) is a structural component of Streptococcus pneumoniae (Spn) and nontypeable Haemophilus influenzae (NTHi), and is known to be associated with adherence through the platelet activating factor receptor (PAF-R). Furthermore, high PC expression is considered to be involved in Spn and NTHi virulence. In this study, we examined the influence of PC expression on the adherence of Spn and NTHi to epithelial cells in order to clarify the potential effectiveness of a vaccine targeting PC. METHODS Twenty-seven strains of Spn and twenty-two strains of NTHi were used, cultured overnight, and PC expression was evaluated by fluorescence activated cell sorting; the strains were divided into two groups: PC low expression (PC-low) and PC high expression (PC-high) groups. Bacterial adherence was then examined using Detroit 562 cells and BALB/c mice. Bacterial invasion was then examined in Detroit 562 cells. RESULTS The adherence of Spn and NTHi and invasion of NTHi in the PC-high group was significantly reduced by pretreatment with a monoclonal anti-PC antibody (TEPC-15), PAF-R antagonist (ABT-491), and PC-keyhole limpet hemocyanin (PC-KLH). However, such findings were not observed in the PC-low group. CONCLUSION The present study suggests that PC is involved in the mucosal adhesion of Spn and NTHi, and the mucosal invasion of NTHi with PC-high strains, but not PC-low strains. These results suggest that a PC-targeting mucosal vaccine only affects PC-high Spn and NTHi strains and does not disturb commensal bacterial flora in the upper respiratory tract, which comprises nonpathogenic PC-low bacteria.
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Affiliation(s)
- Hiroyuki Iuchi
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
| | - Junichiro Ohori
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takayuki Kyutoku
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kotoko Ito
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuichi Kurono
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Howard-Anderson J, Satola SW, Collins MH. Breech at the Border: An Atypical Case of Invasive Haemophilus influenzae in a Patient on a Novel Immunotherapeutic. Open Forum Infect Dis 2018; 5:ofy146. [PMID: 30581886 PMCID: PMC6299461 DOI: 10.1093/ofid/ofy146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/25/2018] [Indexed: 12/16/2022] Open
Abstract
Haemophilus influenzae rarely causes pyogenic infections in the female genital tract, and even less commonly does this lead to systemic infections. Novel monoclonal antibody therapies targeting interleukin-17 may impair mucosal immunity, but increased risk for H. influenzae infections has not been documented. Here, we describe a case of H. influenzae bacteremia associated with pyosalpinx and hypothesize that immunomodulatory treatment for psoriasis predisposed our patient to this infection.
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Affiliation(s)
- Jessica Howard-Anderson
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Sarah W Satola
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.,Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Matthew H Collins
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
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6
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Clinical and Bacteriologic Analysis of Nontypeable Haemophilus influenzae Strains Isolated from Children with Invasive Diseases in Japan from 2008 to 2015. J Clin Microbiol 2018; 56:JCM.00141-18. [PMID: 29720429 DOI: 10.1128/jcm.00141-18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/24/2018] [Indexed: 12/30/2022] Open
Abstract
Haemophilus influenzae type b (Hib) conjugate vaccines have led to dramatic reductions in Hib disease among young children worldwide. Nontypeable H. influenzae (NTHi) is now the major cause of invasive H. influenzae infections. We investigated the clinical characteristics of invasive NTHi diseases among children in Japan, to clarify the pathogenicity of isolated NTHi strains. The mortality rate was 10.7%, with deaths occurring mainly among children with underlying comorbidities. Biotypes II and III were the most common, and most strains (64.3%) had multiple amino acid substitutions at the Asp-350, Ser-357, Ser-385, and/or Met-377 sites of penicillin-binding protein 3. Two strains were β-lactamase positive and ampicillin-clavulanate resistant. Biofilm indices varied widely, and IS1016 was detected in 10.7% of the strains tested. Moreover, there was wide variation in the characteristics of invasive NTHi strains. NTHi strains, showing great genetic diversity, are responsible for most invasive H. influenzae infections in children in the postvaccine era. Continuous monitoring of NTHi strains responsible for invasive diseases in children is important to detect changes in the epidemiology of invasive H. influenzae infections in the postvaccine era.
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7
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Osman KL, Jefferies JM, Woelk CH, Cleary DW, Clarke SC. The adhesins of non-typeable Haemophilus influenzae. Expert Rev Anti Infect Ther 2018; 16:187-196. [PMID: 29415569 DOI: 10.1080/14787210.2018.1438263] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Nontypeable Haemophilus influenzae (NTHi) is an opportunistic pathogen of the respiratory tract and the greatest contributor to invasive Haemophilus disease. Additionally, in children, NTHi is responsible for the majority of otitis media (OM) which can lead to chronic infection and hearing loss. In adults, NTHi infection in the lungs is responsible for the onset of acute exacerbations in chronic obstructive pulmonary disease (COPD). Unfortunately, there is currently no vaccine available to protect against NTHi infections. Areas covered: NTHi uses an arsenal of adhesins to colonise the respiratory epithelium. The adhesins also have secondary roles that aid in the virulence of NTHi, including mechanisms that avoid immune clearance, adjust pore size to avoid antimicrobial destruction, form micro-colonies and invoke phase variation for protein mediation. Bacterial adhesins can also be ideal antigens for subunit vaccine design due to surface exposure and immunogenic capabilities. Expert commentary: The host-pathogen interactions of the NTHi adhesins are not fully investigated. The relationship between adhesins and the extracellular matrix (ECM) play a part in the success of NTHi colonisation and virulence by immune evasion, migration and biofilm development. Further research into these immunogenic proteins would further our understanding and enable a basis for better combatting NTHi disease.
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Affiliation(s)
- Karen L Osman
- a Faulty of Medicine , University of Southampton , Southampton , UK
| | | | - Christopher H Woelk
- a Faulty of Medicine , University of Southampton , Southampton , UK.,b Merck Exploratory Science Center , Merck Research Laboratories , Cambridge , MA , USA
| | - David W Cleary
- a Faulty of Medicine , University of Southampton , Southampton , UK.,c Faculty of Medicine and Institute for Life Sciences , University of Southampton , Southampton SO17 1BJ , UK.,d NIHR Southampton Biomedical Research Centre , University Hospital Southampton Foundation NHS Trust , Southampton SO16 6YD , UK
| | - Stuart C Clarke
- a Faulty of Medicine , University of Southampton , Southampton , UK.,c Faculty of Medicine and Institute for Life Sciences , University of Southampton , Southampton SO17 1BJ , UK.,d NIHR Southampton Biomedical Research Centre , University Hospital Southampton Foundation NHS Trust , Southampton SO16 6YD , UK.,e Global Health Research Institute , University of Southampton , Southampton SO17 1BJ , UK
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Characterisation of invasive clinical Haemophilus influenzae isolates in Queensland, Australia using whole-genome sequencing. Epidemiol Infect 2017; 145:1727-1736. [PMID: 28260537 DOI: 10.1017/s0950268817000450] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Haemophilus influenzae is an important aetiological organism of both adult and child respiratory disease. The number of non-typeable (NTHi) invasive H. influenzae isolates referred to the Queensland (QLD) Public Health Microbiology laboratory has increased notably year-by-year. In this study we used whole-genome sequencing to molecularly characterise 100 referred invasive H. influenzae, including 74 NTHi isolates over a 15-year period, observing the carriage of capsular and putative virulence genes, including the major adhesins, antimicrobial resistance genes and population diversity. Encapsulated isolates were largely clonal, however NTHi isolates displayed high genetic variability by MLST and single nucleotide polymorphism typing with no dominant clone observed. The only mechanism for β-lactam resistance identified in the QLD isolates was β-lactamase production. No single set of virulence determinants was conclusively associated with invasive QLD NTHi isolates.
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Otsuka T, Hasegawa H, Yamada T, Kaneko U, Saitoh A. Haemophilus influenzae peritonitis in a girl on automated peritoneal dialysis: Case report and review of the literature. IDCases 2017; 9:47-49. [PMID: 28660129 PMCID: PMC5480228 DOI: 10.1016/j.idcr.2017.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 06/11/2017] [Accepted: 06/11/2017] [Indexed: 11/16/2022] Open
Abstract
H. influenzae peritonitis in a girl on automated peritoneal dialysis is reported. The isolate was multilocus sequence type 3, which is a “common” type. Female-associated factors are important in such patients.
Haemophilus influenzae is a rare cause of peritonitis in patients on peritoneal dialysis (PD). We report a case of peritonitis due to non-typeable H. influenzae in a 5-year-old girl on automated PD. The patient was successfully treated with intraperitoneal cefepime and cefazolin. The isolate was multilocus sequence type 3 and contained the hmw and hia genes but was IS1016-negative. Seven of the eight reported cases were female, indicating that sex-associated factors may be important in H. influenzae peritonitis in patients on PD. Determination of the pathogenesis of PD-associated H. influenzae peritonitis requires gene analysis and a swab sample from the vaginal introitus.
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10
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Ishiwada N, Hishiki H, Nagasawa K, Naito S, Sato Y, Chang B, Sasaki Y, Kimura K, Ohnishi M, Shibayama K. The incidence of pediatric invasive Haemophilus influenzae and pneumococcal disease in Chiba prefecture, Japan before and after the introduction of conjugate vaccines. Vaccine 2014; 32:5425-31. [PMID: 25131741 DOI: 10.1016/j.vaccine.2014.07.100] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 07/18/2014] [Accepted: 07/30/2014] [Indexed: 10/24/2022]
Abstract
The Haemophilus influenzae type b (Hib) vaccine and the heptavalent pneumococcal conjugate vaccine (PCV7) were introduced in Japan in 2008 and 2010, respectively. In 2011, immunization with these two vaccines was encouraged throughout Japan through a governmental program. Children treated in Chiba prefecture for culture-proven invasive H. influenzae disease (IHiD) and invasive Streptococcus pneumoniae disease (IPD) were identified in a prefectural surveillance study from 2008 to 2013. The incidence rate ratio (IRR) and its confidence interval (CI) were calculated to compare the 3 years before and after governmental financial support for vaccination. The average number of IHiD and IPD cases among children <5 years of age in 2011-2013 decreased 84% (IRR: 0.16, 95% CI: 0.09-0.26, p<0.0001) and 51% (IRR: 0.49, 95% CI: 0.37-0.63, p<0.0001) compared with those occurring in 2008-2010. The most common non-PCV7 serotype encountered in 2011 and 2013 was 19A. After governmental subsidization of Hib and PCV7 vaccination, IHiD and IPD decreased in Chiba prefecture, Japan. Continuous surveillance is necessary to determine the effectiveness of these two vaccines and for detection of emerging invasive serotypes.
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Affiliation(s)
- Naruhiko Ishiwada
- Division of Control and Treatment of Infectious Diseases, Chiba University Hospital, Chiba, Japan.
| | - Haruka Hishiki
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Koo Nagasawa
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Sachiko Naito
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yasunori Sato
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Bin Chang
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuko Sasaki
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kouji Kimura
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
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11
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Abe K, Hoshino T, Imuta N, Nishi J, Ishiwada N. [Bacterial meningitis caused by beta-lactamase-negative, ampicillin-resistant nontypeable Haemophilus influenzae in a 1-year-old girl: a case report]. KANSENSHOGAKU ZASSHI. THE JOURNAL OF THE JAPANESE ASSOCIATION FOR INFECTIOUS DISEASES 2014; 88:291-6. [PMID: 24974453 DOI: 10.11150/kansenshogakuzasshi.88.291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We present herein the case report of bacterial meningitis caused by nontypeable Haemophilus influenzae (NTHi) in a 1-year-7-month-old girl with no medically significant history. NTHi from cerebrospinal fluid (CSF) was the beta-lactamase non-producing ampicillin resistant strain (BLNAR). Some beta-lactams were administrated, but fever was prolonged. Finally, rifampicin seemed to be effective. In NTHi, compared with H. influenzae type b (Hib), the prevalence of BLNAR is high. Hence, complicated cases may increase in the near future if the use of the Hib vaccine becomes widespread, and meningitis caused by NTHi increases. It may be necessary to consider combination therapy or use of non-beta-lactams that have a different antimicrobial mechanism from beta-lactams. PCR analysis revealed the possibility that the CSF isolate lacked the P5 protein gene. Though deficiency of P5 fimbriae is known to reduce the affinity of NTHi for the human respiratory epithelium, determining whether P5 deficient NTHi induced meningitis will require further study.
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12
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Strouts FR, Power P, Croucher NJ, Corton N, van Tonder A, Quail MA, Langford PR, Hudson MJ, Parkhill J, Kroll JS, Bentley SD. Lineage-specific virulence determinants of Haemophilus influenzae biogroup aegyptius. Emerg Infect Dis 2012; 18:449-57. [PMID: 22377449 PMCID: PMC3309571 DOI: 10.3201/eid1803.110728] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Novel adhesions, including trimeric autotransporters, might contribute to virulence. An emergent clone of Haemophilus influenzae biogroup aegyptius (Hae) is responsible for outbreaks of Brazilian purpuric fever (BPF). First recorded in Brazil in 1984, the so-called BPF clone of Hae caused a fulminant disease that started with conjunctivitis but developed into septicemic shock; mortality rates were as high as 70%. To identify virulence determinants, we conducted a pan-genomic analysis. Sequencing of the genomes of the BPF clone strain F3031 and a noninvasive conjunctivitis strain, F3047, and comparison of these sequences with 5 other complete H. influenzae genomes showed that >77% of the F3031 genome is shared among all H. influenzae strains. Delineation of the Hae accessory genome enabled characterization of 163 predicted protein-coding genes; identified differences in established autotransporter adhesins; and revealed a suite of novel adhesins unique to Hae, including novel trimeric autotransporter adhesins and 4 new fimbrial operons. These novel adhesins might play a critical role in host–pathogen interactions.
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Affiliation(s)
- Fiona R Strouts
- Imperial College London, Medicine, St Mary’s Hospital campus, Norfolk Place, London W2 1PG, UK
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Rubach MP, Bender JM, Mottice S, Hanson K, Weng HYC, Korgenski K, Daly JA, Pavia AT. Increasing incidence of invasive Haemophilus influenzae disease in adults, Utah, USA. Emerg Infect Dis 2012; 17:1645-50. [PMID: 21888789 PMCID: PMC3322072 DOI: 10.3201/eid1709.101991] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
TOC Summary: The infection disproportionately affected patients >65 years of age. Since the introduction of the Haemophilus influenzae type b vaccine, the incidence of invasive H. influenzae type b disease among children has fallen dramatically, but the effect on invasive H. influenzae disease among adults may be more complex. In this population-based study we examined the epidemiology and outcomes of invasive disease caused by typeable and nontypeable H. influenzae among Utah adults during 1998–2008. The overall incidence increased over the study period from 0.14/100,000 person-years in 1998 to 1.61/100,000 person-years in 2008. The average incidence in persons >65 years old was 2.74/100,000 person-years, accounting for 51% of cases and 67% of deaths. The incidence was highest for nontypeable H. influenzae (0.23/100,000 person-years), followed by H. influenzae type f (0.14/100,000 person-years). The case-fatality rate was 22%. The incidence of invasive H. influenzae in Utah adults appears to be increasing. Invasive H. influenzae infection disproportionately affected the elderly and was associated with a high mortality rate.
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14
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Martí-Lliteras P, López-Gómez A, Mauro S, Hood DW, Viadas C, Calatayud L, Morey P, Servin A, Liñares J, Oliver A, Bengoechea JA, Garmendia J. Nontypable Haemophilus influenzae displays a prevalent surface structure molecular pattern in clinical isolates. PLoS One 2011; 6:e21133. [PMID: 21698169 PMCID: PMC3116884 DOI: 10.1371/journal.pone.0021133] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 05/20/2011] [Indexed: 11/22/2022] Open
Abstract
Non-typable Haemophilus influenzae (NTHi) is a Gram negative pathogen that causes acute respiratory infections and is associated with the progression of chronic respiratory diseases. Previous studies have established the existence of a remarkable genetic variability among NTHi strains. In this study we show that, in spite of a high level of genetic heterogeneity, NTHi clinical isolates display a prevalent molecular feature, which could confer fitness during infectious processes. A total of 111 non-isogenic NTHi strains from an identical number of patients, isolated in two distinct geographical locations in the same period of time, were used to analyse nine genes encoding bacterial surface molecules, and revealed the existence of one highly prevalent molecular pattern (lgtF+, lic2A+, lic1D+, lic3A+, lic3B+, siaA−, lic2C+, ompP5+, oapA+) displayed by 94.6% of isolates. Such a genetic profile was associated with a higher bacterial resistance to serum mediated killing and enhanced adherence to human respiratory epithelial cells.
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Affiliation(s)
- Pau Martí-Lliteras
- Programa de Infección e Inmunidad, Fundación Caubet-CIMERA, Bunyola, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias-CIBERES, Vitoria, Spain
| | - Antonio López-Gómez
- Programa de Infección e Inmunidad, Fundación Caubet-CIMERA, Bunyola, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias-CIBERES, Vitoria, Spain
| | - Silvia Mauro
- Programa de Infección e Inmunidad, Fundación Caubet-CIMERA, Bunyola, Spain
| | - Derek W. Hood
- Molecular Infectious Diseases Group, Department of Paediatrics, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Headington, Oxford, United Kingdom
| | - Cristina Viadas
- Programa de Infección e Inmunidad, Fundación Caubet-CIMERA, Bunyola, Spain
| | - Laura Calatayud
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias-CIBERES, Vitoria, Spain
- Servicio de Microbiología, Hospital Universitario Bellvitge, Barcelona, Spain
- Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, Spain
- Universidad de Barcelona, Barcelona, Spain
| | - Pau Morey
- Programa de Infección e Inmunidad, Fundación Caubet-CIMERA, Bunyola, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias-CIBERES, Vitoria, Spain
| | - Alain Servin
- INSERM, UMR 756, Signalisation and Physiopathology of Epithelial cells, Paris, France
| | - Josefina Liñares
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias-CIBERES, Vitoria, Spain
- Servicio de Microbiología, Hospital Universitario Bellvitge, Barcelona, Spain
- Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, Spain
- Universidad de Barcelona, Barcelona, Spain
| | - Antonio Oliver
- Servicio de Microbiología, Hospital Universitario Son Espases, Palma Mallorca, Spain
| | - José Antonio Bengoechea
- Programa de Infección e Inmunidad, Fundación Caubet-CIMERA, Bunyola, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias-CIBERES, Vitoria, Spain
- Consejo Superior de Investigaciones Científicas-CSIC, Madrid, Spain
| | - Junkal Garmendia
- Programa de Infección e Inmunidad, Fundación Caubet-CIMERA, Bunyola, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias-CIBERES, Vitoria, Spain
- Instituto de Agrobiotecnología, CSIC-Universidad Pública de Navarra-Gobierno de Navarra, Mutilva, Spain
- * E-mail:
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Davie JJ, Earl J, de Vries SPW, Ahmed A, Hu FZ, Bootsma HJ, Stol K, Hermans PWM, Wadowsky RM, Ehrlich GD, Hays JP, Campagnari AA. Comparative analysis and supragenome modeling of twelve Moraxella catarrhalis clinical isolates. BMC Genomics 2011; 12:70. [PMID: 21269504 PMCID: PMC3045334 DOI: 10.1186/1471-2164-12-70] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 01/26/2011] [Indexed: 12/18/2022] Open
Abstract
Background M. catarrhalis is a gram-negative, gamma-proteobacterium and an opportunistic human pathogen associated with otitis media (OM) and exacerbations of chronic obstructive pulmonary disease (COPD). With direct and indirect costs for treating these conditions annually exceeding $33 billion in the United States alone, and nearly ubiquitous resistance to beta-lactam antibiotics among M. catarrhalis clinical isolates, a greater understanding of this pathogen's genome and its variability among isolates is needed. Results The genomic sequences of ten geographically and phenotypically diverse clinical isolates of M. catarrhalis were determined and analyzed together with two publicly available genomes. These twelve genomes were subjected to detailed comparative and predictive analyses aimed at characterizing the supragenome and understanding the metabolic and pathogenic potential of this species. A total of 2383 gene clusters were identified, of which 1755 are core with the remaining 628 clusters unevenly distributed among the twelve isolates. These findings are consistent with the distributed genome hypothesis (DGH), which posits that the species genome possesses a far greater number of genes than any single isolate. Multiple and pair-wise whole genome alignments highlight limited chromosomal re-arrangement. Conclusions M. catarrhalis gene content and chromosomal organization data, although supportive of the DGH, show modest overall genic diversity. These findings are in stark contrast with the reported heterogeneity of the species as a whole, as wells as to other bacterial pathogens mediating OM and COPD, providing important insight into M. catarrhalis pathogenesis that will aid in the development of novel therapeutic regimens.
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Affiliation(s)
- Jeremiah J Davie
- Department of Microbiology and Immunology, University at Buffalo, Buffalo, New York, USA
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SUNAKAWA K, TAKEUCHI Y, IWATA S. Nontypeable Haemophilus influenzae (NTHi) Epidemiology. ACTA ACUST UNITED AC 2011; 85:227-37. [DOI: 10.11150/kansenshogakuzasshi.85.227] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | | | - Satoshi IWATA
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine
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Rogers DJ, Sie KCY, Manning SC. Epiglottitis due to nontypeable Haemophilus influenzae in a vaccinated child. Int J Pediatr Otorhinolaryngol 2010; 74:218-20. [PMID: 20018387 DOI: 10.1016/j.ijporl.2009.11.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 11/23/2009] [Accepted: 11/24/2009] [Indexed: 10/20/2022]
Abstract
Once a prevalent disease, acute epiglottitis in children has become a rare entity. The introduction of the Haemophilus influenzae type b vaccine has had a dramatic impact on the number of invasive infections caused by this organism. However, physicians must be aware that epiglottitis may result from vaccine failures or from infection with other pathogenic organisms. Vaccinated children with epiglottitis present in a similar fashion to those who are not vaccinated. We present a rare case of acute epiglottitis in a fully vaccinated child due to nontypeable H. influenzae and discuss the clinical presentation and management.
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Affiliation(s)
- Derek J Rogers
- Madigan Army Medical Center, Otolaryngology-Head and Neck Surgery, Fitzsimmons Dr, Tacoma, WA 98431, United States.
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