Rubin L G, Moxon E R
Infect Immun. 1983 Jul;41(1):280-4. doi: 10.1128/iai.41.1.280-284.1983.
Possible route(s) by which encapsulated bacteria invade the blood from the nasopharynx include (i) the direct invasion of submucosal blood vessels and (ii) clearance via lymphatics to regional nodes followed by bloodstream invasion. These possibilities were investigated in rats after intranasal inoculation with 10(5) Haemophilus influenzae type b. Within 24 h of inoculation, 10 of 42 rats with sterile blood cultures had similar numbers of H. influenzae b recovered from both cervical (local) and periiliac (distant) lymph nodes, which suggested early bacteremic spread. When virtually continuous blood cultures were obtained for 30 min after inoculation with 10(8) H. influenzae b, early transient bacteremia was documented in four of eight rats. Also, we found no significant difference in bacteremia among rats whose cervical lymph nodes had been removed surgically compared with sham-operated rats. These findings favor the hypothesis of a rapid, perhaps direct invasion of pharyngeal blood vessels as an initial determinant of the systemic spread of H. influenzae b.
（i）直接侵入黏膜下血管；（ii）通过淋巴管清除至局部淋巴结，随后侵入血流。在用10⁵ b型流感嗜血杆菌经鼻接种大鼠后，对这些可能性进行了研究。接种后24小时内，42只血培养无菌的大鼠中有10只从颈部（局部）和髂周（远处）淋巴结中回收的b型流感嗜血杆菌数量相似，这表明早期菌血症传播。在用10⁸ b型流感嗜血杆菌接种后30分钟内进行几乎连续的血培养时，8只大鼠中有4只出现早期短暂菌血症。此外，我们发现与假手术大鼠相比，手术切除颈部淋巴结的大鼠在菌血症方面没有显著差异。这些发现支持了这样一种假说，即咽部血管的快速、可能是直接侵入是b型流感嗜血杆菌全身播散的初始决定因素。
