Moraxella catarrhalis – patogen górnych dróg oddechowych
1. Wstęp. 2. Taksonomia. 3. Identyfikacja i hodowla. 4. Znaczenie kliniczne. 4.1. Zakażenia dzieci. 4.1.1. Ostre zapalenie ucha środkowego. 4.1.2. Zapalenie zatok. 4.1.3. Zapalenie płuc. 4.2. Zakażenia dorosłych. 4.2.1. Zapalenie krtani. 4.2.2. Zaostrzenie przewlekłej obturacyjnej choroby płuc. 4.2.3. Zapalenie płuc. 4.3. Zakażenia szpitalne. 4.4. Kolonizacja. 5. Mechanizmy patogenezy i czynniki wirulencji. 5.1. Adhezja. 5.2. Inwazja. 5.3. Tworzenie biofilmu. 5.4. Oporność na działanie dopełniacza 6. Lekooporność. 7. Potencjalna możliwość stosowania szczepień. 8. Podsumowanie
Abstract: Moraxella catarrhalis is an important, exclusively human respiratory tract pathogen. For many years, M. catarrhalis was considered a harmless commensal of the human upper respiratory tract. M. catarrhalis is an emerging pathogen responsible for acute otitis media in children, and also for recurrent and persistent respiratory tract infections in patients suffering from chronic obstructive pulmonary disease. The prevalence of colonization of the upper respiratory tract is high in children, and the risk factors are as follows: a large concentration of people, low social status, and genetic predisposition. M. catarrhalis resembles commensal Neisseria species in culture, and thus, may be overlooked in samples from the human respiratory tract. The bacteria is highly susceptible to most of the antibiotics commonly used in the treatment of respiratory infections, although inherent resistance to penicillin, vancomycin, trimethoprim, and clindamycin has been documented. The major virulence factors are numerous adhesins, invasion abilities, complement resistance and biofilm formation. The recent works have elucidated mechanisms of pathogenesis focusing on vaccine development to reduce colonization rate and to prevent infections. Due to the fact that for many years a little clinical significance has been attributed to these bacteria, they have not yet been sufficiently studied, and therefore, there is an urgent need to carry out further research, especially based on molecular analysis.
1. Introduction. 2. Taxonomy. 3. Identification and culture. 4. Clinical significance. 4.1. Infections in children. 4.1.1. Acute otitis media. 4.1.2. Sinusitis. 4.1.3. Pneumonia. 4.2. Infections in adults. 4.2.1. Laryngitis. 4.2.2. Exacerbations of chronic obstructive pulmonary disease. 4.2.3. Pneumonia. 4.3. Nosocomial infections. 4.4. Colonization. 5. Pathogenesis mechanisms and virulence factors. 5.1. Adherence. 5.2. Invasion. 5.3. Biofilm formation. 5.4. Complement resistance. 6. Drug resistance. 7. Vaccines. 8. Summary