Invasive Disease Due to Nontypeable Haemophilus influenzae among Children in Arkansas

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Journal of Clinical Microbiology, July 2003, p. 3064-3069, Vol. 41, No. 7
0095-1137/03/$08.00+0 DOI: 10.1128/JCM.41.7.3064-3069.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Invasive Disease Due to Nontypeable Haemophilus influenzae among Children in Arkansas

Joshua M. O'Neill,^1* Joseph W. St. Geme III,² David Cutter,² Elisabeth E. Adderson,³ Juliana Anyanwu,³ Richard F. Jacobs,¹ and Gordon E. Schutze^1,4

Department of Pediatrics,¹ Department of Pathology, University of Arkansas for Medical Sciences/Arkansas Children's Hospital, Little Rock, Arkansas,⁴ Departments of Pediatrics and Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri,² Department of Infectious Disease, St. Jude Children's Research Hospital, Memphis, Tennessee³

Received 11 October 2002/ Returned for modification 5 November 2002/ Accepted 6 May 2003

In this study, we reviewed cases of invasive disease due tonontypeable Haemophilus influenzae among children hospitalizedat Arkansas Children's Hospital from 1993 to 2001. A total of 28 cases were examined, including 21 associated with bacteremiaand 4 associated with meningitis. Of the patients examined,86% were

4 years of age, and 68% had underlying medical conditions.Characterization of the bacterial isolates by multilocus sequencetype genotyping revealed significant overall genetic diversity,similar to the diversity in the general population structurefor nontypeable H. influenzae. However, four separate pairsof isolates were closely related genetically, a relationshipconfirmed by pulsed-field gel electrophoresis and Southern hybridizationstudies using probes for the major H. influenzae adhesin genes.These results suggest that selected strains of nontypeable H.influenzae may have more invasive potential, especially in youngchildren and patients with underlying medical conditions. Atthis point, the specific factors that contribute to enhancedvirulence remain unclear.

* Corresponding author. Mailing address: Arkansas Children's Hospital, 800 Marshall St., Little Rock, AR 72202-3591. Phone: (501) 364-1416. Fax: (501) 364-3551. E-mail: ONeillJoshua@uams.edu.

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