Haemophilus influenzae bacteria

Haemophilus influenzae

Haemohilus influenzae picture gram negative rods drawing

Encapsulated strain of Haemophilus influenzae on chocolate agar plate. Encapsulated strains may produce larger colonies with a glistening mucoid quality. Haemophilus influenzae requires two accessory growth factors: factor X (haemin or other porphyrins) and V factor (NAD). The X and V factor requirement is usually demonstrated by the absence of growth on porphyrin and NAD deficient but otherwise nutritionally adequate media except near paper disc impregnated with X and V factors.

Haemophilus influenzae, formerly called Pfeiffer's bacillus, is a non-motile Gram-negative pleomorphic rod-shaped bacterium first described in 1892 by Richard Pfeiffer during an influenza pandemic. It is facultatively aerobic . H. influenzae was mistakenly considered to be the cause of influenza until 1933, when the viral etiology of the flu became apparent. Still, H. influenzae is responsible for a wide range of clinical diseases.

Diseases

Most strains of H. influenzae are opportunistic pathogens - that is, they usually live in their host without causing disease, but cause problems only when other factors (such as a viral infection or reduced immune function) create an opportunity. Naturally-acquired disease caused by H. influenzae seems to occur in humans only. In infants and young children, H. influenzae type b (Hib) causes bacteremia, pneumonia, and acute bacterial meningitis. Occasionally, it causes cellulitis, osteomyelitis, epiglottitis, and infectious arthritis. Due to routine use of the Hib conjugate vaccine in the U.S. since 1990, the incidence of invasive Hib disease has decreased to 1.3/100,000 in children. However, Hib remains a major cause of lower respiratory tract infections in infants and children in developing countries where vaccine is not widely used. Unencapsulated H. influenzae causes ear (otitis media) and eye (conjunctivitis) infections and sinusitis in children, and is associated with pneumonia.

Culture

Bacterial culture of H. influenzae is performed on Chocolate agar at 37°C in an enriched CO2 incubator. Blood agar growth is only achieved as a satellite phenomenon around other bacteria. H. influenzae will grow in the hemolytic zone of Staphylococcus aureus on blood agar plates. The hemolysis of cells by S. aureus releases nutrients vital to the growth of H. influenzae. H. influenzae will not grow outside the hemolytic zone of S. aureus due to the lack of nutrients in these areas.

Colonies of H. influenzae appear as convex, smooth, pale, grey or transparent. Gram-stained and microscopic observation of a specimen of H. influenzae will show Gram-negative coccobacilli with no specific arrangement. Further serological is necessary to distinguish the capsular polysaccharide and differentiate between H. influenzae b and non-encapsulated species. H. influenzae is a finicky bacterium to culture, and any modification of culture procedures can greatly reduce isolation rates. Poor quality of laboratories in developing countries has resulted in poor isolation rates of H. influenzae.

Abbreviated from Wikipedia.

Haemophilus influenzae basic characteristics

  • GRAM-NEGATIVE RODS OR COCCOBACILLI
  • NONMOTILE
  • NON-SPORE-FORMING
  • CATALASE: POSITIVE
  • OXIDASE: POSITIVE
  • FACULTATIVELY ANAEROBIC

Identification of Haemophilus influenzae

  • requirement of X+V factor in cultivation media; X = hematin, V = nicotinamide adenine dinucleotide(NAD)
  • growth on chocolate agar but not on blood agar (when cultivated in pure culture)
  • satelite phenomenon with Staphylococcus aureus (on blood agar)

Antibiotic treatment of Haemophilus influenzae infections

Should be always guided by in vitro susceptibility tests!!
Selection of appropriate antibiotics depends on diagnosis!!

IF SUSCEPTIBLE:
  • ampicillin
  • amoxicillin
  • ampicillin/sulbactam
  • amoxicillin/clavulanate

  • cefuroxime
  • ceftriaxone
  • cefotaxime

  • ALTERNATIVES:
  • Trimethoprim-Sulfomethoxazole(TMP-SMX)
  • azithromycin
  • clarithromycin
  • doxycicline

  • List of antibiotics (Wikipedia)

Haemophilus influenzae colonies on agar cultivation media

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Haemophilus influenzae dependence on X and V factors

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Haemophilus influenzae satellite phenomenon

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Haemophilus influenzae Gram-stain

haemophilus influenzae

Haemophilus influenzae 3D

haemophilus influenzae

Useful Links

WIKIPEDIA
CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)
E-MEDICINE
VACCINATION