Bottone E J, Zhang D Y
Department of Medicine, Mount Sinai Hospital of Mount Sinai Medical Center, New York, New York 10029, USA.
J Clin Microbiol. 1995 Nov;33(11):3042-3. doi: 10.1128/jcm.33.11.3042-3043.1995.
Haemophilus parainfluenzae was isolated from a bile specimen of a 56-year-old patient with elevated liver enzymes and chronic cholecystitis. Several factors contributing to nonbacteremic H. parainfluenzae infection of the biliary tract include (i) the not infrequent occurrence of H. parainfluenzae in stool specimens, (ii) the presence of an outer membrane protein similar to those found in enteric bacteria which facilitates adherence to the colonic mucosa, and (iii) an adequate supply of V factor (nicotinamide adenine dinucleotide) supplied from bile and the local flora, which is necessary for H. parainfluenzae's growth. Because H. parainfluenzae rarely occurs in the biliary tract, direct cultivation of bile specimens on chocolate agar seems unwarranted. However, bile specimens showing a gram-negative coccobacillus on a Gram-stained smear that fails to grow on routine media should be subcultured on chocolate agar.
副流感嗜血杆菌是从一名56岁肝功能酶升高且患有慢性胆囊炎患者的胆汁标本中分离出来的。导致非菌血症性副流感嗜血杆菌胆道感染的几个因素包括：（i）粪便标本中副流感嗜血杆菌并不罕见；（ii）存在一种与肠道细菌中发现的外膜蛋白相似的蛋白，有助于黏附于结肠黏膜；（iii）胆汁和局部菌群提供充足的V因子（烟酰胺腺嘌呤二核苷酸），这是副流感嗜血杆菌生长所必需的。由于副流感嗜血杆菌很少出现在胆道中，因此在巧克力琼脂上直接培养胆汁标本似乎没有必要。然而，在革兰氏染色涂片中显示革兰氏阴性球杆菌且在常规培养基上不生长的胆汁标本，应在巧克力琼脂上进行传代培养。
