Haemophilus

Small pleomorphic gram ve.coccobacilli or rods .Non-motileRequire X factor or V factor or.both The genus includes the following:species H. influenzae, H. aegyptius, H. , haemolyticus H. suis, H. parainfluenzae, H.

Haemophilus influenzae
:Habitat Non capsulated types: normal.commensals in URT of man .Capsulated types: less frequent:Morphology .Small gram ve rods and coccobacilli.Show pleomorphismCapsules may be present (recently(. isolated, young cultures

Morphology of H. influenzae

:Cultural characters
.Aerobes and facultative anaerobes.Optimum temperature: 37C.Cannot grow on ordinary media.Requires both X and V factors.X factor: Haemin- 1 V factor: NAD- 2 Growth is better on chocolate agar orbetter on chocolate with Isovitalex
(NAD, and other growth factors (glucose, glutamine, adenine , guanine, cystine, cysteine, vit B12, thiamine, co-carboxylase (.para-amino benzoic acid and ferric nitrate

Colonies of H. influenzae on chocolate agar

Satellitism:

Colonies of H. influenzae growing near those of Staph. Aureus (which produce .V factor) are larger

:Antigenic structure

Non-capsulate strains: antigenically.heterogeneous

:Capsulated strains serological types (a,b,c,d,e,f) 6 according to capsular .polysaccharide The capsular Ag is .antiphagocytic Type b capsule is the major .virulence Ag

Acute epiglottitis: (type b) , mainly in- 1 , children .sometimes in adults Pneumonia in adults with old age,-2 chronic lung disease, alcoholism, immunodeficiency, sometimes in .healthy adults Otitis media: 10% by type b , 90% by- 3 .non-typable strains :The non-typable strains can cause.a) Acute sinusitis in adults b) Exacerbations of chronic bronchitis,

Respiratory Tract Diseases caused by H. influenzae

Laboratory diagnosis
Specimens: Nasopharyngeal swabs, .pus, blood, CSF Smears: Gram stain can detect organism if present in large numbers

Culture: On chocolate agar + .isovitalex Suspected colonies are tested for X, V, .X +V factors on agar plates

Testing for X and V requirement: Colonies of H. influenzae occur only where both X and V factors have .diffused

:Treatment
Many type b strains are- susceptible to ampicillin, 25% may be resistant ( produce beta (.lactamase plasmid mediated All strains are susceptible tonew cephalosporins
.(cefotaxime I.V)
-

:Prevention
:A conjugate vaccine for H. influenzae type b It is made of H.influenzae type b polysaccharide Conjugated with protein carrier mutant Corynebacterium diphtheria toxin protein or . with diphtheria toxoid

:Vaccine

:Chemoprophylaxis

Non-immune children less than 4y who .were close contacts should receive rifampin