title: Biochemical, genetic, and epidemiologic characterization of Haemophilus influenzae biogroup aegyptius (Haemophilus aegyptius) strains associated with Brazilian purpuric fever.
abstract: Brazilian purpuric fever (BPF) is a recently recognized fulminant pediatric disease characterized by fever, with rapid progression to purpura, hypotensive shock, and death. BPF is usually preceded by purulent conjunctivitis that has resolved before the onset of fever. Both the conjunctivitis and BPF are caused by Haemophilus influenzae biogroup aegyptius (formerly called H. aegyptius). Isolates from 15 BPF cases, mainly from blood or hemorrhagic cerebrospinal fluid, case-associated isolates from 42 persons in towns where BPF cases occurred, and control strains from 32 persons in towns without BPF cases were characterized biochemically, genetically, and epidemiologically. Results indicated that a single clone was responsible for all BPF cases identified in six Brazilian towns from 1984 through 1986. All of 15 (100%) case strains were the same clone as was 1 of 32 (3%) control strains (P = less than 10(-8). Isolates of the clone were preferentially intrarelated by DNA hybridization (99% relatedness, hydroxyapatite method at 60 and 75 degrees C) and were separable from other H. influenzae biogroup aegyptius strains (approximately 90% relatedness at 60 degrees C and 82% relatedness at 75 degrees C). All isolates of the BPF clone and no other strains contained a 24-megadalton plasmid of restriction endonuclease type 3031, were of a single multilocus enzyme mobility type, were of a single sodium dodecyl sulfate-polyacrylamide gel electrophoresis type, and were in one of two ribosomal DNA restriction patterns. All BPF clone isolates reacted with monoclonal antibodies produced from a case strain; only 3 of 62 (5%) other strains reacted with this monoclonal antibody. Ninety percent of BPF clone strains and 27% of other strains were relatively resistant to sulfamethoxazole-trimethoprim.
authors.affiliation: Division of Bacterial Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
authors.forename: D J
authors.initials: DJ
authors.lastname: Brenner
authors.forename: L W
authors.initials: LW
authors.lastname: Mayer
authors.forename: G M
authors.initials: GM
authors.lastname: Carlone
authors.forename: L H
authors.initials: LH
authors.lastname: Harrison
authors.forename: W F
authors.initials: WF
authors.lastname: Bibb
authors.forename: M C
authors.initials: MC
authors.lastname: Brandileone
authors.forename: F O
authors.initials: FO
authors.lastname: Sottnek
authors.forename: K
authors.initials: K
authors.lastname: Irino
authors.forename: M W
authors.initials: MW
authors.lastname: Reeves
authors.forename: J M
authors.initials: JM
authors.lastname: Swenson
mesh_terms: D001426:Bacterial Proteins / Q000032:analysis; D001938:Brazil; D002648:Child; D003234:Conjunctivitis, Bacterial / Q000382:microbiology*; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D004275:DNA, Ribosomal / Q000032:analysis; D004587:Electrophoresis, Agar Gel; D004591:Electrophoresis, Polyacrylamide Gel; D004797:Enzyme-Linked Immunosorbent Assay; D006192:Haemophilus Infections / Q000382:microbiology*; D006193:Haemophilus influenzae / Q000145:classification* / Q000235:genetics / Q000276:immunology / Q000472:pathogenicity; D006801:Humans; D008565:Membrane Proteins / Q000032:analysis; D009693:Nucleic Acid Hybridization; D010957:Plasmids; D011693:Purpura / Q000382:microbiology*; D009626:Terminology as Topic; D014774:Virulence
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D008565:Membrane Proteins