Microbiology, epidemiology and treatment of Haemophilus influenzae
- Sylvia Yeh, MD
Sylvia Yeh, MD
- Associate Clinical Professor
- David Geffen School of Medicine at UCLA
- Harbor-UCLA Medical Center, Pediatric Infectious Diseases
Haemophilus influenzae colonizes the human respiratory tract and is transmitted from person to person via airborne droplets and direct contact with respiratory secretions .
H. influenzae has encapsulated (serotypes a through f) and nonencapsulated forms (nontypeable). The most important serotype is H. influenzae serotype b (Hib), which was a frequent cause of bacteremia, meningitis, and other invasive infections prior to the routine use of Hib conjugate vaccines in children . Other capsular serotypes and unencapsulated H. influenzae strains can also cause disease, mainly mucosal infections (sinusitis, otitis, bronchitis, and pneumonia), but occasionally cause more invasive infections.
The bacteriology, epidemiology, and treatment of H. influenzae are reviewed here. H. influenzae infections in children and prevention of H. influenzae are discussed separately. (See "Prevention of Haemophilus influenzae type b infection".)
H. influenzae are small, pleomorphic gram-negative rods that are oxidase positive, facultatively anaerobic, and nonmotile. In clinical specimens obtained from patients who have received beta-lactam antibiotics, H. influenzae can appear as filamentous rods. In vitro growth requires a CO2-enriched atmosphere, hemin (factor X), and nicotinamide adenine dinucleotide (NAD, factor V); therefore, isolation from clinical specimens on solid medium requires the use of chocolate agar or other X and V factor supplemented media. H. influenzae appear as transparent or slightly opaque colonies on solid media.
Capsule — The presence or absence of a polysaccharide capsule is an important distinguishing characteristic of H. influenzae species. The polysaccharide capsule can be serologically classified into six serotypes (a through f), while H. influenzae lacking a polysaccharide capsule are considered to be nontypeable . The type b capsule consists of a ribosyl and ribitol phosphate polymer and is the primary antigenic constituent of polysaccharide and polysaccharide conjugate H. influenzae serotype b (Hib) vaccines .
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