Open AccessEcology of Haemophilus influenzae and Haemophilus parainfluenzae in sputum and saliva and effects of antibiotics on their distribution in patients with lower respiratory tract infections
Author(s) -
Juliet Foweraker,
N. J. Cooke,
Peter M. Hawkey
Publication year - 1993
Publication title -
antimicrobial agents and chemotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.07
H-Index - 259
eISSN - 1070-6283
pISSN - 0066-4804
DOI - 10.1128/aac.37.4.804
Subject(s) - haemophilus parainfluenzae , sputum , ampicillin , haemophilus influenzae , microbiology and biotechnology , antibiotics , saliva , haemophilus , erythromycin , respiratory tract infections , biology , respiratory tract , medicine , respiratory system , bacteria , tuberculosis , pathology , genetics
Nine patients with lower respiratory tract infections were used to study in detail the effect of ampicillin or erythromycin on the colonization patterns of Haemophilus influenzae and Haemophilus parainfluenzae in sputum and saliva. H. influenzae was isolated from purulent sputum of eight patients before the start of treatment. Ampicillin was more effective than erythromycin at clearing H. influenzae from sputum and in decreasing purulence. By careful characterization of multiple strains, the changes in biotype distribution and antibiotic susceptibility patterns were shown. Five biotypes of H. influenzae were associated with chest infection, with type II predominating. Mixed biotype infections occurred in five patients. Most saliva contained multiple biotypes of H. parainfluenzae. Neither antibiotic selected resistant haemophili in saliva or sputum. After treatment with ampicillin, the mucoid sputum was colonized with ampicillin-susceptible H. parainfluenzae biotypes previously found in saliva. We postulate that as inflammation decreases at the bronchial mucosa, the ampicillin concentration drops, allowing ampicillin-susceptible oral H. parainfluenzae isolates to seed the residual mucoid sputum.