<i>Moraxella (Branhamella) catarrhalis:</i> Clinical, microbiological and immunological features in lower respiratory tract infections

Christensen, Jens Jørgen

doi:10.1111/j.1600-0463.1999.tb05670.x

Cited by 20 publications

(23 citation statements)

References 201 publications

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“…If the isolate comes from blood or another sterile body site culture (e.g., pleural fluid), treatment is clearly warranted. The organism is believed to be the third most common bacterium associated with acute exacerbations of chronic bronchitis and acute otitis media (4,5,14), both of which require antimicrobial treatment under certain circumstances. If resistance to commonly recommended agents is emerging, then regular testing would also be warranted.…”

Section: Discussionmentioning

confidence: 99%

“…Moraxella catarrhalis is a common commensal and occasionally pathogenic bacterium associated with a range of infections of the respiratory tract, including acute otitis media, acute sinusitis, and acute exacerbations of chronic bronchitis (5,22,34). Less commonly, this organism can cause more serious and invasive infection, including pneumonia, septicemia, and meningitis (4, 28).…”

Section: Currently There Is No Clinical and Laboratory Standards Insmentioning

confidence: 99%

“…Tentative zone diameter interpretive criteria were successfully developed for 19 antimicrobial agents, including nine ␤-lactams, using current MIC interpretive criteria where available or wild-type cutoff values where no prior criteria were available. The proposed interpretive criteria were highly accurate, with <0.7% very major (falsely susceptible) and <1.0% major (falsely resistant) errors, respectively.Moraxella catarrhalis is a common commensal and occasionally pathogenic bacterium associated with a range of infections of the respiratory tract, including acute otitis media, acute sinusitis, and acute exacerbations of chronic bronchitis (5,22,34). Less commonly, this organism can cause more serious and invasive infection, including pneumonia, septicemia, and meningitis (4, 28).…”

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Development of a Disk Diffusion Method for Testing Moraxella catarrhalis Susceptibility Using Clinical and Laboratory Standards Institute Methods: a SENTRY Antimicrobial Surveillance Program Report

2009

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Currently, there is no Clinical and Laboratory Standards Institute (CLSI) disk diffusion method for testingMoraxella catarrhalis susceptibility. We examined 318 clinical strains of M. catarrhalis obtained as part of the SENTRY (Asia-Pacific) Antimicrobial Surveillance Program, plus two ATCC strains. MICs were determined by the CLSI standard broth microdilution method, and zone diameters were determined on Mueller-Hinton agar incubated in 5% CO 2 . All strains were examined for the presence of BRO-1 and BRO-2 ␤-lactamases by using molecular techniques. Tentative zone diameter interpretive criteria were successfully developed for 19 antimicrobial agents, including nine ␤-lactams, using current MIC interpretive criteria where available or wild-type cutoff values where no prior criteria were available. The proposed interpretive criteria were highly accurate, with <0.7% very major (falsely susceptible) and <1.0% major (falsely resistant) errors, respectively.Moraxella catarrhalis is a common commensal and occasionally pathogenic bacterium associated with a range of infections of the respiratory tract, including acute otitis media, acute sinusitis, and acute exacerbations of chronic bronchitis (5,22,34). Less commonly, this organism can cause more serious and invasive infection, including pneumonia, septicemia, and meningitis (4, 28). A number of standards-setting organizations, including the Société Française de Microbiologie (29) and the British Society for Antimicrobial Chemotherapy (http://www .bsac.org.uk/susceptibility_testing.cfm), have developed disk diffusion tests and interpretive criteria for M. catarrhalis. Recently, the Clinical and Laboratory Standards Institute (CLSI) Subcommittee on Antimicrobial Susceptibility Testing published an interpretive guideline (6), but only for broth microdilution tests, using criteria essentially the same as those applied to Haemophilus spp. (10). Routine testing was not recommended by CLSI at the time of development of those guidelines.However, this species is frequently isolated from respiratory tract infection specimens and, when present in large numbers, can be assumed by the laboratory to be playing a pathogenic or copathogenic role and, therefore, can be reported to the clinician. For the many international laboratories using CLSI methods and standards, the lack of a disk diffusion method and interpretive criteria limits their ability to communicate useful information to the clinician for a common potential pathogen. We followed CLSI M23-A3 guidelines (7) for the development of a disk diffusion test for M. catarrhalis, supplemented with molecular tests for some resistance mechanisms to assist in the future enhancement of interpretive criteria.(This work was presented in part at the European Congress of Clinical Microbiology and Infectious Diseases, Munich, Germany, 2007.) MATERIALS AND METHODSIsolates. Clinical strains of M. catarrhalis isolated from lower respiratory tract specimens and blood cultures were collected in 17 diagnostic laboratories in nine countries par...

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Section: Discussionmentioning

confidence: 99%

Section: Currently There Is No Clinical and Laboratory Standards Insmentioning

confidence: 99%

mentioning

confidence: 99%

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Development of a Disk Diffusion Method for Testing Moraxella catarrhalis Susceptibility Using Clinical and Laboratory Standards Institute Methods: a SENTRY Antimicrobial Surveillance Program Report

2009

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“…Adults with COPD who experience respiratory tract infections due to M. catarrhalis develop serum IgG and mucosal IgA responses following infection (2,6,8,9). In addition, children develop serum and mucosal antibodies to M. catarrhalis following otitis media (11,12,(19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

Human Immune Response to Outer Membrane Protein CD of Moraxella catarrhalis in Adults with Chronic Obstructive Pulmonary Disease

et al. 2003

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Moraxella catarrhalis is a common cause of lower respiratory tract infection in adults with chronic obstructive pulmonary disease (COPD).Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States and in the world (1, 29, 39). The course of COPD is characterized by intermittent exacerbations of the disease, and many of these exacerbations are caused by bacterial infection (35). Bacterial infection of the respiratory tract is associated with substantial morbidity and mortality in adults with COPD, and strategies to prevent these infections would have an important impact on the course of the disease (27). One such strategy is the development of vaccines. Elucidating human immune responses to bacteria which cause exacerbations of COPD will serve as a guide for the development of vaccines to prevent bacterial infection in patients with COPD.Several lines of evidence implicate Moraxella catarrhalis as an important cause of exacerbations of COPD. (i) A subset of patients with exacerbations have sputum smears which show a predominance of gram-negative diplococci on Gram staining and yield nearly pure cultures of M. catarrhalis (6,22,30). (ii) Pure cultures of M. catarrhalis are recovered from samples collected from patients experiencing exacerbations by using methods which reliably reflect lower airway bacteriology (13,14,23,31,38,40) Outer membrane protein (OMP) CD is a 45-kDa protein which has been the subject of investigation as a potential vaccine antigen for M. catarrhalis. OMP CD has several characteristics to suggest that it will be an effective vaccine. It is present in all strains of M. catarrhalis and has epitopes that are present on the surface of the intact bacterium (24, 32). The presence of surface-exposed epitopes suggests that potentially protective antibodies would be able to bind OMP CD on the whole bacterial cell. OMP CD is highly conserved among strains of M. catarrhalis (18,25). Three lines of evidence suggest that immunization with OMP CD will induce protective antibodies. First, immunization of experimental animals with OMP CD induces bactericidal antibodies (41). Second, both mucosal and systemic immunization with recombinant OMP CD enhance pulmonary clearance of M. catarrhalis in a mouse pulmonary challenge model (26). Finally, the level of serum antibodies to OMP CD in infants and children is inversely correlated with the severity of otitis media with effusion, suggesting that antibodies to OMP CD play a protective role (15).In a previous study levels of immunoglobulin to OMP CD were measured in serum and sputum samples from three groups, including 10 healthy adults, 10 adults with COPD who were free of colonization by M. catarrhalis, and 10 adults with COPD who experienced exacerbations due to M. catarrhalis (24). The concentration of serum immunoglobulin G (IgG) to OMP CD was significantly higher in the COPD group with exacerbations than in the COPD group without colonization and the healthy controls. A clear-cut rise in levels of immuno-

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“…In the upper respiratory tract, M. catarrhalis is responsible for cases of sinusitis and is the third leading cause of otitis media in infants, after only Haemophilus influenzae and Streptococcus pneumoniae (5,10,18,24). In the lower respiratory tract, M. catarrhalis can cause respiratory infections in adults with chronic obstructive pulmonary disease, resulting in increased morbidity and mortality of these patients (27,28).…”

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Characterization of the Moraxella catarrhalis Opa-Like Protein, OlpA, Reveals a Phylogenetically Conserved Family of Outer Membrane Proteins

et al. 2007

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Moraxella catarrhalis is a human-restricted pathogen that can cause respiratory tract infections. In this study, we identified a previously uncharacterized 24-kDa outer membrane protein with a high degree of similarity to Neisseria Opa protein adhesins, with a predicted ␤-barrel structure consisting of eight antiparallel ␤-sheets with four surface-exposed loops. In striking contrast to the antigenically variable Opa proteins, the M. catarrhalis Opa-like protein (OlpA) is highly conserved and constitutively expressed, with 25 of 27 strains corresponding to a single variant. Protease treatment of intact bacteria and isolation of outer membrane vesicles confirm that the protein is surface exposed yet does not bind host cellular receptors recognized by neisserial Opa proteins. Genome-based analyses indicate that OlpA and Opa derive from a conserved family of proteins shared by a broad array of gram-negative bacteria.Moraxella catarrhalis is an obligate parasite of humans that can cause disease in both the upper and lower respiratory tracts. In the upper respiratory tract, M. catarrhalis is responsible for cases of sinusitis and is the third leading cause of otitis media in infants, after only Haemophilus influenzae and Streptococcus pneumoniae (5,10,18,24). In the lower respiratory tract, M. catarrhalis can cause respiratory infections in adults with chronic obstructive pulmonary disease, resulting in increased morbidity and mortality of these patients (27,28). M. catarrhalis is thought to be responsible for 2 to 4 million infectious exacerbations of chronic obstructive pulmonary disease in the United States each year (25), and there is significant cost in treating disease related to M. catarrhalis, which is complicated in part by a rise in antibiotic-resistant strains (2, 30). This makes development of a vaccine an exciting and important goal.The mechanisms involved in pathogenesis and virulence of M. catarrhalis remain poorly defined. Attachment to host mucosal surfaces is an important step in colonization. Recently, M. catarrhalis genes encoding the type IV pilus were identified and characterized (23), leading to speculation that this structure mediates initial attachment to mucosal epithelia in a manner similar to that of the closely related pathogenic Neisseria spp. (9). M. catarrhalis can also interact with the A549 human lung epithelial carcinoma cell line through the bacterium's outer membrane protein CD (16) and Hag (17) adhesins. Another adhesin, UspA1, promotes attachment to Chang human conjunctiva-derived epithelial cells (21) and was recently shown to mediate adherence via the host cellular receptor CEACAM1 (15). Human CEACAM1 is also engaged by the adhesins of other bacteria, including the Haemophilus influenzae P5 protein (14) and the Opa proteins of pathogenic and commensal Neisseria spp. (12,29,35). Remarkably, the UspA1, P5, and Opa proteins are not related, indicating a clear example of convergent evolution by these various human-restricted bacteria.Considering the importance of the Opa family of ...

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Moraxella (Branhamella) catarrhalis: Clinical, microbiological and immunological features in lower respiratory tract infections

Cited by 20 publications

References 201 publications

Development of a Disk Diffusion Method for Testing Moraxella catarrhalis Susceptibility Using Clinical and Laboratory Standards Institute Methods: a SENTRY Antimicrobial Surveillance Program Report

Development of a Disk Diffusion Method for Testing Moraxella catarrhalis Susceptibility Using Clinical and Laboratory Standards Institute Methods: a SENTRY Antimicrobial Surveillance Program Report

Human Immune Response to Outer Membrane Protein CD of Moraxella catarrhalis in Adults with Chronic Obstructive Pulmonary Disease

Characterization of the Moraxella catarrhalis Opa-Like Protein, OlpA, Reveals a Phylogenetically Conserved Family of Outer Membrane Proteins

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