A PCR for protein D (hpd#3) was used to differentiate nontypeable Haemophilus influenzae (NTHI) from Haemophilus haemolyticus. While 90% of nasopharyngeal specimens and 100% of lower-airway specimens from 84 Indigenous Australian children with bronchiectasis had phenotypic NTHI isolates confirmed as H. influenzae, only 39% of oropharyngeal specimens with phenotypic NTHI had H. influenzae. The nasopharynx is therefore the preferred site for NTHI colonization studies, and NTHI is confirmed as an important lower-airway pathogen

A. B. Chang

A. J. Leach

Binks

Chang

H. Smith-Vaughan

Hare

K. Grimwood

K. M. Hare

King

Kirkham

Ledeboer

M. J. Binks

Morton

Murphy

Norskov-Lauritsen

Smith-Vaughan

Wang

PubMed

A PCR for protein D (hpd#3) was used to differentiate nontypeable Haemophilus influenzae (NTHI) from Haemophilus haemolyticus. While 90% of nasopharyngeal specimens and 100% of lower-airway specimens from 84 Indigenous Australian children with bronchiectasis had phenotypic NTHI isolates confirmed as H. influenzae, only 39% of oropharyngeal specimens with phenotypic NTHI had H. influenzae. The nasopharynx is therefore the preferred site for NTHI colonization studies, and NTHI is confirmed as an important lower-airway pathogen.Full Tex

Hare, K.

Binks, M.

Grimwood, K.

Chang, Anne B.

Leach, A.

Smith-Vaughan, H.

Griffith Research Online

Culture and PCR Detection of Haemophilus influenzae andHaemophilus haemolyticus in Australian Indigenous Children withBronchiectasisK. M. Hare,a M. J. Binks,a K. Grimwood,b,c A. B. Chang,a,b,d,e A. J. Leach,a and H. Smith-VaughanaChild Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory,a Queensland Children’s Medical Research Institute, TheUniversity of Queensland, Royal Children’s Hospital, Brisbane, Queensland,b Department of Infectious Diseases, Royal Children’s Hospital, Brisbane, Queensland,c RoyalDarwin Hospital, Darwin, Northern Territory,d and Department of Respiratory Medicine, Royal Children’s Hospital, Brisbane, Queensland,e AustraliaA PCR for protein D (hpd#3) was used to differentiate nontypeableHaemophilus influenzae (NTHI) fromHaemophilus haemo-lyticus. While 90% of nasopharyngeal specimens and 100% of lower-airway specimens from 84 Indigenous Australian childrenwith bronchiectasis had phenotypic NTHI isolates confirmed asH. influenzae, only 39% of oropharyngeal specimens with phe-notypic NTHI hadH. influenzae. The nasopharynx is therefore the preferred site for NTHI colonization studies, and NTHI isconfirmed as an important lower-airway pathogen.Nontypeable Haemophilus influenzae (NTHI) colonizes theupper airways, where it is an important cause of otitis media(10). It is also isolated frequently from the lower airways of adultswith chronic obstructive pulmonary disease (COPD) (8) and chil-dren and adults with bronchiectasis (3, 4).Accurate identification of NTHI is important, since nonhe-molytic strains of the closely related (primarily commensal)Haemophilus haemolyticus may be misidentified as NTHI byphenotypic methods used in most clinical microbiology labo-ratories (9). Molecular detection techniques have revealed that12 to 27% of nasopharyngeal isolates from healthy and otitis-prone children, which were initially identified by classical phe-notypic methods as NTHI isolates (here referred to as pheno-typic NTHI isolates), were actuallyH. haemolyticus (5, 9), whileH. haemolyticus was not identified in middle ear fluid samplesfrom children with acute otitis media (5). In contrast, H. hae-molyticus comprised 40% of phenotypic NTHI sputum isolatesfrom adults with COPD (9).These findings raise important questions about NTHI as a truelower respiratory pathogen.We therefore investigated the propor-tion of H. haemolyticus isolates among phenotypic NTHI isolatesin the upper and lower airways of Indigenous Australian childrenwith bronchiectasis, a population with high rates of NTHI colo-nization and associated respiratory disease (2, 3, 12).The Human Research Ethics Committee of the Northern Ter-ritory Department of Health and Menzies School of Health Re-search approved the study. Following written, informed parent/guardian consent, paired nasopharyngeal swabs andbronchoalveolar lavage (BAL) fluid specimens were collectedfrom a convenience sample of 84 (62%male) Indigenous childrenaged 5 to 155 (median, 27) months who were undergoing routinediagnostic evaluation following radiographic confirmation ofbronchiectasis at the Royal Darwin Hospital between July 2007and December 2010. Oropharyngeal swabs were also collectedfrom 56 of these children. Specimens were stored and culturedusing standard microbiologic methods (3). Lower-airway infec-tion was defined by a semiquantitative growth score of4, whichcorrelated with 104 CFU/ml BAL fluid, as determined by serialdilution and quantitative counts (3).Phenotypic NTHI isolates were identified by morphology, re-quirement for X and V growth factors, and failure to react withPhadebact (Bactus AB, Sweden) antisera specific for H. influ-enzae type b or types a and c through f. Up to 4 colonies (in-cluding any with differing morphology) were isolated fromeach culture-positive specimen and tested using PCR. Confir-mation of phenotypic NTHI isolates was performed using de-fined DNA extraction methods (12) and a TaqMan-based, real-time PCR assay targeting protein D (hpd#3), whichdiscriminates between H. influenzae and H. haemolyticus iso-lates (1, 13). Phenotypic NTHI isolates returning negative PCRresults were considered to be H. haemolyticus, since the onlyother X- and V-factor-dependent Haemophilus species (H. ae-gyptius, an important cause of conjunctivitis) has a differentappearance, requires additional growth factors, and is unlikelyto be cultured from these sites (6).Table 1 shows the numbers, proportions, and distribution ofphenotypic NTHI, hpd#3 PCR-confirmed H. influenzae, pre-sumptive H. haemolyticus, and concurrent H. influenzae and H.haemolyticus in the 224 specimens collected from the upper andlower airways. A total of 214 isolates from 108 phenotypic NTHI-positive specimens (an average of 1.8 colonies isolated per naso-pharyngeal and oropharyngeal swab and 2.4 colonies per BALspecimen)were tested.Most nasopharyngeal (87%) andBALfluid(88%) isolates were confirmed as H. influenzae, but almost two-thirds (65%) of oropharyngeal isolates were presumptive H. hae-molyticus.H. influenzae andH. haemolyticuswere isolated concur-rently from 10% (4/42) of nasopharyngeal swabs, 17% (6/36) oforopharyngeal swabs, and 27% (8/30) of BAL fluid cultures fromchildren with phenotypic NTHI carriage or lower-airway infec-tion.This study shows that, similar tohealthy andotitis-proneWesternReceived 1 March 2012 Returned for modification 27 March 2012Accepted 20 April 2012Published ahead of print 2 May 2012Address correspondence to K. M. Hare, kim.hare@menzies.edu.au.Copyright © 2012, American Society for Microbiology. All Rights Reserved.doi:10.1128/JCM.00566-122444 jcm.asm.org Journal of Clinical Microbiology p. 2444–2445 July 2012 Volume 50 Number 7Australian children (5),most phenotypic NTHI nasopharyngeal iso-lates from Indigenous children with bronchiectasis were confirmedasH. influenzae. In contrast,many apparentNTHI isolates fromoro-pharyngeal swabswereH. haemolyticus in our study population. Pre-vious oropharyngeal culture-based studies ofH. influenzaemay havethereforeoverestimatedNTHIcarriage, andourdata instead supportthenasopharynxas thepreferred site forH. influenzaecarriage studiesin children. Such studies are important tomonitor antimicrobial re-sistance and detect changes in pharyngeal biota that may result fromantibiotic administration or vaccination.Quantifying pathogens in BAL fluid helps adjust for upper-airway contamination during bronchoscopy. Our finding that100% of BAL specimens with phenotypic NTHI lower-airway in-fection (104 CFU/ml BAL fluid) were PCR positive forH. influ-enzae confirms NTHI as a lower-airway pathogen. However, therole of H. haemolyticus is unclear. Prior studies report that H.haemolyticus is rarely found in sterile sites, including middle earfluid, or associated with clinically defined infections (5, 7, 9, 11).While our findings suggest that H. haemolyticus has a propensityfor the oropharynx, without specific molecular detection andquantification, we cannot determine whether its presence in low-er-airway cultures represents upper-airway contamination or apathogenic role.In conclusion, we have used H. influenzae-specific PCR to re-affirm the importance of NTHI as a lower-airway pathogen inAustralian Indigenous children with bronchiectasis. In addition,we have shown that the nasopharynx, rather than the oropharynx,is the preferred site for NTHI carriage studies in this population.ACKNOWLEDGMENTSWe thank the children and their caregivers for participating in the study,Menzies staff (Gabrielle MacCallum, Kobi Schutz, and Susan Pizzutto)and Royal Darwin Hospital staff for assistance with specimen collection,Menzies laboratory staff (Vanya Hampton, Joanna Bugg, Estelle Carter,and Peter Christensen) for assistance with laboratory processing, andRobyn Marsh for helpful comments.This study was supported by NHMRC project grant 545223.REFERENCES1. Binks MJ, et al. 2012. Molecular surveillance of true nontypeable Hae-mophilus influenzae: an evaluation of PCR screening assays. PLoS One7:e34083. doi:10.1371/journal.pone.0034083.2. Chang AB, Masel JP, Boyce NC, Wheaton G, Torzillo PJ. 2003. Non-CFbronchiectasis: clinical and HRCT evaluation. Pediatr. Pulmonol. 35:477–483.3. Hare KM, et al. 2010. Respiratory bacterial pathogens in the nasopharynxand lower airways of Australian indigenous children with bronchiectasis.J. Pediatr. 157:1001–1005.4. King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW. 2007.Microbiologic follow-up study in adult bronchiectasis. Respir. Med. 101:1633–1638.5. Kirkham LA, et al. 2010. Nasopharyngeal carriage of Haemophilus hae-molyticus in otitis-prone and healthy children. J. Clin. Microbiol. 48:2557–2559.6. Ledeboer NA, Doern GV. 2012. Haemophilus, p 588–602. In VersalovicJ, et al (ed), Manual of clinical microbiology, 10th ed. ASM Press, Wash-ington, DC.7. Morton DJ, Hempel RJ, Whitby PW, Seale TW, Stull TL. 2012. An invasiveHaemophilus haemolyticus isolate. J. Clin. Microbiol. 50:1502–1503.8. Murphy TF. 2003. Respiratory infections caused by non-typeable Hae-mophilus influenzae. Curr. Opin. Infect. Dis. 16:129–134.9. Murphy TF, et al. 2007. Haemophilus haemolyticus: a human respiratorytract commensal to be distinguished from Haemophilus influenzae. J. In-fect. Dis. 195:81–89.10. Murphy TF, et al. 2009. NontypeableHaemophilus influenzae as a patho-gen in children. Pediatr. Infect. Dis. J. 28:43–48.11. Norskov-Lauritsen N. 2009. Detection of cryptic genospecies mis-identified as Haemophilus influenzae in routine clinical samples byassessment of marker genes fucK, hap, and sodC. J. Clin. Microbiol.47:2590–2592.12. Smith-Vaughan H, et al. 2006. Measuring nasal bacterial load and itsassociation with otitis media. BMC Ear Nose Throat Disord. 6:10.13. Wang X, et al. 2011. Detection of bacterial pathogens in Mongolia men-ingitis surveillance with a new real-time PCR assay to detectHaemophilusinfluenzae. Int. J. Med. Microbiol. 301:303–309.TABLE 1 Culture and PCR results for phenotypic NTHI isolates from nasopharyngeal and oropharyngeal swabs and bronchoalveolar lavage fluidspecimens from 84 Australian Indigenous children with bronchiectasisaIsolate sourceNo. ofspecimensNo. (%) of specimens with:Phenotypic NTHIPhenotypic NTHIconfirmed by PCR asH. influenzaePresumptive H.haemolyticusConcurrent H. influenzaeand presumptive H.haemolyticusNP swab 84 42 (50) 38 (45) 8 (10) 4 (5)OP swab 56 36 (64) 14 (25) 28 (50) 6 (11)BAL fluid 84 30b (36) 30 (36) 8 (10) 8 (10)Total 224 108 (48) 82 (37) 44 (20) 18 (8)a NP, nasopharyngeal; OP, oropharyngeal; BAL, bronchoalveolar lavage; NTHI, nontypeable Haemophilus influenzae.b Specimens with phenotypic NTHI lower-airway infection (104 CFU/ml BAL fluid).Haemophilus Species in the Upper and Lower AirwaysJuly 2012 Volume 50 Number 7 jcm.asm.org 2445

Journal of Clinical Microbiology

Culture and PCR Detection of Haemophilus influenzae and Haemophilus haemolyticus in Australian Indigenous Children with Bronchiectasis

Hare, KM

Binks, MJ

Grimwood, K

Chang, AB

Leach, AJ

Smith-Vaughan, H

Hare, K. M.

Binks, M. J.

Chang, A. B.

Leach, A. J.

University of Queensland eSpace

Culture and PCR Detection of Haemophilus influenzae and
Haemophilus haemolyticus in Australian Indigenous Children with
Bronchiectasis
K. M. Hare,a M. J. Binks,a K. Grimwood,b,c A. B. Chang,a,b,d,e A. J. Leach,a and H. Smith-Vaughana
Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory,a Queensland Children’s Medical Research Institute, The
University of Queensland, Royal Children’s Hospital, Brisbane, Queensland,b Department of Infectious Diseases, Royal Children’s Hospital, Brisbane, Queensland,c Royal
Darwin Hospital, Darwin, Northern Territory,d and Department of Respiratory Medicine, Royal Children’s Hospital, Brisbane, Queensland,e Australia
A PCR for protein D (hpd#3) was used to differentiate nontypeableHaemophilus influenzae (NTHI) fromHaemophilus haemo-
lyticus. While 90% of nasopharyngeal specimens and 100% of lower-airway specimens from 84 Indigenous Australian children
with bronchiectasis had phenotypic NTHI isolates confirmed asH. influenzae, only 39% of oropharyngeal specimens with phe-
notypic NTHI hadH. influenzae. The nasopharynx is therefore the preferred site for NTHI colonization studies, and NTHI is
confirmed as an important lower-airway pathogen.
Nontypeable Haemophilus influenzae (NTHI) colonizes theupper airways, where it is an important cause of otitis media
(10). It is also isolated frequently from the lower airways of adults
with chronic obstructive pulmonary disease (COPD) (8) and chil-
dren and adults with bronchiectasis (3, 4).
Accurate identification of NTHI is important, since nonhe-
molytic strains of the closely related (primarily commensal)
Haemophilus haemolyticus may be misidentified as NTHI by
phenotypic methods used in most clinical microbiology labo-
ratories (9). Molecular detection techniques have revealed that
12 to 27% of nasopharyngeal isolates from healthy and otitis-
prone children, which were initially identified by classical phe-
notypic methods as NTHI isolates (here referred to as pheno-
typic NTHI isolates), were actuallyH. haemolyticus (5, 9), while
H. haemolyticus was not identified in middle ear fluid samples
from children with acute otitis media (5). In contrast, H. hae-
molyticus comprised 40% of phenotypic NTHI sputum isolates
from adults with COPD (9).
These findings raise important questions about NTHI as a true
lower respiratory pathogen.We therefore investigated the propor-
tion of H. haemolyticus isolates among phenotypic NTHI isolates
in the upper and lower airways of Indigenous Australian children
with bronchiectasis, a population with high rates of NTHI colo-
nization and associated respiratory disease (2, 3, 12).
The Human Research Ethics Committee of the Northern Ter-
ritory Department of Health and Menzies School of Health Re-
search approved the study. Following written, informed parent/
guardian consent, paired nasopharyngeal swabs and
bronchoalveolar lavage (BAL) fluid specimens were collected
from a convenience sample of 84 (62%male) Indigenous children
aged 5 to 155 (median, 27) months who were undergoing routine
diagnostic evaluation following radiographic confirmation of
bronchiectasis at the Royal Darwin Hospital between July 2007
and December 2010. Oropharyngeal swabs were also collected
from 56 of these children. Specimens were stored and cultured
using standard microbiologic methods (3). Lower-airway infec-
tion was defined by a semiquantitative growth score of4, which
correlated with 104 CFU/ml BAL fluid, as determined by serial
dilution and quantitative counts (3).
Phenotypic NTHI isolates were identified by morphology, re-
quirement for X and V growth factors, and failure to react with
Phadebact (Bactus AB, Sweden) antisera specific for H. influ-
enzae type b or types a and c through f. Up to 4 colonies (in-
cluding any with differing morphology) were isolated from
each culture-positive specimen and tested using PCR. Confir-
mation of phenotypic NTHI isolates was performed using de-
fined DNA extraction methods (12) and a TaqMan-based, real-
time PCR assay targeting protein D (hpd#3), which
discriminates between H. influenzae and H. haemolyticus iso-
lates (1, 13). Phenotypic NTHI isolates returning negative PCR
results were considered to be H. haemolyticus, since the only
other X- and V-factor-dependent Haemophilus species (H. ae-
gyptius, an important cause of conjunctivitis) has a different
appearance, requires additional growth factors, and is unlikely
to be cultured from these sites (6).
Table 1 shows the numbers, proportions, and distribution of
phenotypic NTHI, hpd#3 PCR-confirmed H. influenzae, pre-
sumptive H. haemolyticus, and concurrent H. influenzae and H.
haemolyticus in the 224 specimens collected from the upper and
lower airways. A total of 214 isolates from 108 phenotypic NTHI-
positive specimens (an average of 1.8 colonies isolated per naso-
pharyngeal and oropharyngeal swab and 2.4 colonies per BAL
specimen)were tested.Most nasopharyngeal (87%) andBALfluid
(88%) isolates were confirmed as H. influenzae, but almost two-
thirds (65%) of oropharyngeal isolates were presumptive H. hae-
molyticus.H. influenzae andH. haemolyticuswere isolated concur-
rently from 10% (4/42) of nasopharyngeal swabs, 17% (6/36) of
oropharyngeal swabs, and 27% (8/30) of BAL fluid cultures from
children with phenotypic NTHI carriage or lower-airway infec-
tion.
This study shows that, similar tohealthy andotitis-proneWestern
Received 1 March 2012 Returned for modification 27 March 2012
Accepted 20 April 2012
Published ahead of print 2 May 2012
Address correspondence to K. M. Hare, kim.hare@menzies.edu.au.
Copyright © 2012, American Society for Microbiology. All Rights Reserved.
doi:10.1128/JCM.00566-12
2444 jcm.asm.org Journal of Clinical Microbiology p. 2444–2445 July 2012 Volume 50 Number 7
 o
n
 O
ctober 22, 2015 by UQ Library
http://jcm.asm.org/
D
ow
nloaded from
 
Australian children (5),most phenotypic NTHI nasopharyngeal iso-
lates from Indigenous children with bronchiectasis were confirmed
asH. influenzae. In contrast,many apparentNTHI isolates fromoro-
pharyngeal swabswereH. haemolyticus in our study population. Pre-
vious oropharyngeal culture-based studies ofH. influenzaemay have
thereforeoverestimatedNTHIcarriage, andourdata instead support
thenasopharynxas thepreferred site forH. influenzaecarriage studies
in children. Such studies are important tomonitor antimicrobial re-
sistance and detect changes in pharyngeal biota that may result from
antibiotic administration or vaccination.
Quantifying pathogens in BAL fluid helps adjust for upper-
airway contamination during bronchoscopy. Our finding that
100% of BAL specimens with phenotypic NTHI lower-airway in-
fection (104 CFU/ml BAL fluid) were PCR positive forH. influ-
enzae confirms NTHI as a lower-airway pathogen. However, the
role of H. haemolyticus is unclear. Prior studies report that H.
haemolyticus is rarely found in sterile sites, including middle ear
fluid, or associated with clinically defined infections (5, 7, 9, 11).
While our findings suggest that H. haemolyticus has a propensity
for the oropharynx, without specific molecular detection and
quantification, we cannot determine whether its presence in low-
er-airway cultures represents upper-airway contamination or a
pathogenic role.
In conclusion, we have used H. influenzae-specific PCR to re-
affirm the importance of NTHI as a lower-airway pathogen in
Australian Indigenous children with bronchiectasis. In addition,
we have shown that the nasopharynx, rather than the oropharynx,
is the preferred site for NTHI carriage studies in this population.
ACKNOWLEDGMENTS
We thank the children and their caregivers for participating in the study,
Menzies staff (Gabrielle MacCallum, Kobi Schutz, and Susan Pizzutto)
and Royal Darwin Hospital staff for assistance with specimen collection,
Menzies laboratory staff (Vanya Hampton, Joanna Bugg, Estelle Carter,
and Peter Christensen) for assistance with laboratory processing, and
Robyn Marsh for helpful comments.
This study was supported by NHMRC project grant 545223.
REFERENCES
1. Binks MJ, et al. 2012. Molecular surveillance of true nontypeable Hae-
mophilus influenzae: an evaluation of PCR screening assays. PLoS One
7:e34083. doi:10.1371/journal.pone.0034083.
2. Chang AB, Masel JP, Boyce NC, Wheaton G, Torzillo PJ. 2003. Non-CF
bronchiectasis: clinical and HRCT evaluation. Pediatr. Pulmonol. 35:477–
483.
3. Hare KM, et al. 2010. Respiratory bacterial pathogens in the nasopharynx
and lower airways of Australian indigenous children with bronchiectasis.
J. Pediatr. 157:1001–1005.
4. King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW. 2007.
Microbiologic follow-up study in adult bronchiectasis. Respir. Med. 101:
1633–1638.
5. Kirkham LA, et al. 2010. Nasopharyngeal carriage of Haemophilus hae-
molyticus in otitis-prone and healthy children. J. Clin. Microbiol. 48:
2557–2559.
6. Ledeboer NA, Doern GV. 2012. Haemophilus, p 588–602. In Versalovic
J, et al (ed), Manual of clinical microbiology, 10th ed. ASM Press, Wash-
ington, DC.
7. Morton DJ, Hempel RJ, Whitby PW, Seale TW, Stull TL. 2012. An invasive
Haemophilus haemolyticus isolate. J. Clin. Microbiol. 50:1502–1503.
8. Murphy TF. 2003. Respiratory infections caused by non-typeable Hae-
mophilus influenzae. Curr. Opin. Infect. Dis. 16:129–134.
9. Murphy TF, et al. 2007. Haemophilus haemolyticus: a human respiratory
tract commensal to be distinguished from Haemophilus influenzae. J. In-
fect. Dis. 195:81–89.
10. Murphy TF, et al. 2009. NontypeableHaemophilus influenzae as a patho-
gen in children. Pediatr. Infect. Dis. J. 28:43–48.
11. Norskov-Lauritsen N. 2009. Detection of cryptic genospecies mis-
identified as Haemophilus influenzae in routine clinical samples by
assessment of marker genes fucK, hap, and sodC. J. Clin. Microbiol.
47:2590–2592.
12. Smith-Vaughan H, et al. 2006. Measuring nasal bacterial load and its
association with otitis media. BMC Ear Nose Throat Disord. 6:10.
13. Wang X, et al. 2011. Detection of bacterial pathogens in Mongolia men-
ingitis surveillance with a new real-time PCR assay to detectHaemophilus
influenzae. Int. J. Med. Microbiol. 301:303–309.
TABLE 1 Culture and PCR results for phenotypic NTHI isolates from nasopharyngeal and oropharyngeal swabs and bronchoalveolar lavage fluid
specimens from 84 Australian Indigenous children with bronchiectasisa
Isolate source
No. of
specimens
No. (%) of specimens with:
Phenotypic NTHI
Phenotypic NTHI
confirmed by PCR as
H. influenzae
Presumptive H.
haemolyticus
Concurrent H. influenzae
and presumptive H.
haemolyticus
NP swab 84 42 (50) 38 (45) 8 (10) 4 (5)
OP swab 56 36 (64) 14 (25) 28 (50) 6 (11)
BAL fluid 84 30b (36) 30 (36) 8 (10) 8 (10)
Total 224 108 (48) 82 (37) 44 (20) 18 (8)
a NP, nasopharyngeal; OP, oropharyngeal; BAL, bronchoalveolar lavage; NTHI, nontypeable Haemophilus influenzae.
b Specimens with phenotypic NTHI lower-airway infection (104 CFU/ml BAL fluid).
Haemophilus Species in the Upper and Lower Airways
July 2012 Volume 50 Number 7 jcm.asm.org 2445
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ctober 22, 2015 by UQ Library
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nloaded from
 


Culture and PCR detection of Haemophilus influenzae and Haemophilus haemolyticus in Australian indigenous children with bronchiectasis

ABSTRACT
          
            A PCR for protein D (hpd#3) was used to differentiate nontypeable
            Haemophilus influenzae
            (NTHI) from
            Haemophilus haemolyticus
            . While 90% of nasopharyngeal specimens and 100% of lower-airway specimens from 84 Indigenous Australian children with bronchiectasis had phenotypic NTHI isolates confirmed as
            H. influenzae
            , only 39% of oropharyngeal specimens with phenotypic NTHI had
            H. influenzae
            . The nasopharynx is therefore the preferred site for NTHI colonization studies, and NTHI is confirmed as an important lower-airway pathogen.
          </jats:p

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http://espace.library.uq.edu.au/view/UQ:281594/UQ281594_OA.pdf

Culture and PCR detection of Haemophilus influenzae and Haemophilus haemolyticus in Australian indigenous children with bronchiectasis

Abstract

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