Murphy Timothy F
Department of Medicine, University at Buffalo, State University of New York, Buffalo, New York, USA.
Curr Opin Infect Dis. 2003 Apr;16(2):129-34. doi: 10.1097/00001432-200304000-00009.
This review will consider recent developments in the clinical aspects of infections due to non-typeable Haemophilus influenzae. In addition, newer developments in the areas of mechanisms of pathogenesis, host pathogen interaction, immune responses and efforts toward vaccine development will be reviewed briefly.
Non-typeable H. influenzae continues to be a common cause of otitis media in infants and children, sinusitis in children and adults, pneumonia in adults, and lower respiratory tract infection in adults with chronic obstructive pulmonary disease. While the rate of beta-lactamase production by isolates of H. influenzae varies geographically, most regions show a rate of 20-35% of isolates producing beta-lactamase. Recent studies have highlighted the possible role of bacterial biofilms formed by H. influenzae as a cause of otitis media. Several lines of evidence indicate that H. influenzae causes intracellular infection in the lower respiratory tract in chronic obstructive pulmonary disease and this observation has important implications in understanding the human immune response to the bacterium. Lipooligosaccharide is an important virulence factor for H. influenzae and research is generating new information on the complex role of this molecule in colonization and infection of the respiratory tract. Several surface molecules are under active evaluation as vaccine antigens.
Non-typeable H. influenzae is an important cause of respiratory tract infections in children and adults. Most strains are susceptible to amoxicillin/clavulanate, fluoroquinolones and the newer macrolides. Research in the next decade promises substantial progress in the challenge of developing vaccines for nontypeable H. influenzae.
本综述将探讨不可分型流感嗜血杆菌感染临床方面的最新进展。此外，还将简要回顾发病机制、宿主与病原体相互作用、免疫反应以及疫苗研发方面的新进展。
不可分型流感嗜血杆菌仍是婴幼儿中耳炎、儿童及成人鼻窦炎、成人肺炎以及慢性阻塞性肺疾病成人患者下呼吸道感染的常见病因。虽然流感嗜血杆菌分离株产生β-内酰胺酶的比例因地域而异，但大多数地区显示有20% - 35%的分离株产生β-内酰胺酶。近期研究强调了流感嗜血杆菌形成的细菌生物膜作为中耳炎病因的可能作用。多项证据表明，流感嗜血杆菌在慢性阻塞性肺疾病患者的下呼吸道引起细胞内感染，这一观察结果对理解人体对该细菌的免疫反应具有重要意义。脂寡糖是流感嗜血杆菌的一种重要毒力因子，关于该分子在呼吸道定植和感染中的复杂作用，研究正在产生新的信息。几种表面分子正在作为疫苗抗原进行积极评估。
不可分型流感嗜血杆菌是儿童和成人呼吸道感染的重要病因。大多数菌株对阿莫西林/克拉维酸、氟喹诺酮类和新型大环内酯类药物敏感。未来十年的研究有望在开发不可分型流感嗜血杆菌疫苗的挑战方面取得重大进展。
