title: Endogenous and exogenous reinfections by Haemophilus influenzae in patients with chronic obstructive pulmonary disease: the effect of antibiotic treatment on persistence.
abstract: To analyze whether exacerbations in chronic obstructive pulmonary disease (COPD) coincide with reinfection by Haemophilus influenzae, 16 COPD patients were studied longitudinally for 3 years. Exacerbations coincided with reinfection by H. influenzae, either endogenous, by a strain with a DNA fingerprint indistinguishable from the strain previously present but with another major outer membrane protein (MOMP) pattern (2 patients), or exogenous, by a strain with a different DNA fingerprint and MOMP pattern (3 patients). The other patients, remaining in an infectious state without clear exacerbations for longer periods, were persistently infected by a particular H. influenzae strain (median persistence time, 5.5 months; range, 2-23 months). Of 8 antibiotic-treated patients, 7 remained infected by H. influenzae with the same DNA fingerprint, although all strains were sensitive to the antibiotics prescribed. Results of the study suggested that exacerbations in COPD patients coincide with endogenous or exogenous reinfection by H. influenzae, persistently infected patients keep the same H. influenzae strain for longer periods, and antibiotic treatment was not effective in eradicating H. influenzae.
authors.affiliation: Department of Medical Microbiology, University of Amsterdam, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Groeneveld
authors.forename: L
authors.initials: L
authors.lastname: van Alphen
authors.forename: P P
authors.initials: PP
authors.lastname: Eijk
authors.forename: G
authors.initials: G
authors.lastname: Visschers
authors.forename: H M
authors.initials: HM
authors.lastname: Jansen
authors.forename: H C
authors.initials: HC
authors.lastname: Zanen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001425:Bacterial Outer Membrane Proteins / Q000032:analysis; D004269:DNA, Bacterial / Q000032:analysis; D004591:Electrophoresis, Polyacrylamide Gel; D006192:Haemophilus Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D006193:Haemophilus influenzae / Q000145:classification* / Q000235:genetics; D006801:Humans; D008137:Longitudinal Studies; D008173:Lung Diseases, Obstructive / Q000150:complications*; D008875:Middle Aged; D009710:Nucleotide Mapping; D010614:Pharynx / Q000382:microbiology; D012008:Recurrence; D013183:Sputum / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D001425:Bacterial Outer Membrane Proteins; D004269:DNA, Bacterial