Chapter 138. Moraxella Infections (Part 3) ppsx

Chapter 138. Moraxella Infections (Part 3) Other Moraxella Species Other Moraxella species are occasional causes of a wide range of infections, including bronchitis, pneumonia, empyema, endocarditis, meningitis, conjunctivitis, endophthalmitis, urinary tract infection, septic arthritis, and wound infection. In a report on all Moraxella isolates submitted to the Centers for Disease Control and Prevention between 1953 and 1980, certain clinical associations were apparent (Table 138-2). M. osloensis and M. nonliquefaciens, the most commonly isolated species, were cultured from various normally sterile body sites, including blood, cerebrospinal fluid, and joints. M. osloensis was the Moraxella species most frequently isolated from blood; M. nonliquefaciens tended to be isolated from the ears, nose, or throat (47%) or the sputum (8%) and has since been implicated as a cause of conjunctivitis and keratitis. M. urethralis was isolated most often from urine and the genital tract and probably represents the Moraxella species implicated previously in urethritis. More than half of isolates of M. phenylpyruvica and M. atlantae were obtained from normally sterile sites. One study found Moraxella spp., including M. catarrhalis, in 35% of infected cat-bite wounds and in 10% of infected dog-bite wounds. The clinical features of infections due to Moraxella spp. other than M. catarrhalis and the nature of the hosts in which they occur have not been fully characterized. Table 138-2 Moraxella Species Other Than M. catarrhalis Moraxella Species Number of Isolates Common Sites/Clinical Association Number (Percent) for Each Site Blood 44 (22) CSF 18 (9) Urine 17 (9) M. osloensis a 199 Respiratory tract 24 (12) Blood 27 (8) CSF 6 (2) M. nonliquefaciens 356 Respiratory tract 196 (55) M. canis 74 Dog-bite wound 53 (72) M-6 47 Blood, bone 15 (32) M. lacunata 33 Conjunctivitis, keratitis 23 (70) Urine 16 (57) M. urethralis 28 Genital tract 3 (11) Blood 19 (26) M. phenylpyruvica 73 CSF 8 (11) Urine 12 (16) Blood 20 (45) M. atlantae 44 CSF 5 (11) a Some of these isolates would now be distinguished as a new species, Moraxella lincolnii . Note: CSF, cerebrospinal fluid. Source: Adapted from a summary of CDC experience (Graham et al). Further Readings Graham DR et al: Infections caused by Moraxella, Moraxella urethralis , Moraxella -like groups M-5 and M-6, and Kingella kingae in the United States, 1953–1980. Rev Infect Dis 12:423, 1990 [PMID: 2359906] Ioannidis JPA et al: Spectrum and significance of bacteremia due to Moraxella catarrhalis . Clin Infect Dis 21:390, 1995 [PMID: 8562749] Maayan H et al: Infective endocarditis due to Moraxella lacunata: Report of 4 patients and review of published cases of Moraxella endocarditis. Scand J Infect Dis 36:878, 2005 Murphy TF et al: Moraxella catarrhalis in chronic obstructive pulmonary disease: Burden of disease and immune response. Am J Respir Crit Care Med 172:195, 2005 [PMID: 15805178] Sethi S et al: New strains of bacteria and exacerbations of chroni c obstructive pulmonary disease. N Engl J Med 347:465, 2002 [PMID: 12181400] Talan DA et al: Bacteriologic analysis of infected dog and cat bites. N Engl J Med 340:85, 1999 [PMID: 9887159] Verduin CM et al: Moraxella catarrhalis: From emerging to estab lished pathogen. Clin Microbiol Rev 15:125, 2002 [PMID: 11781271] Bibliography Wright PW et al: A descriptive study of 42 cases of Branhamella catarrhalis pneumonia. Am J Med 88(Suppl 5A):2S, 1990 . Chapter 138. Moraxella Infections (Part 3) Other Moraxella Species Other Moraxella species are occasional causes of a wide range of infections, including bronchitis,. clinical features of infections due to Moraxella spp. other than M. catarrhalis and the nature of the hosts in which they occur have not been fully characterized. Table 138- 2 Moraxella Species. Moraxella lincolnii . Note: CSF, cerebrospinal fluid. Source: Adapted from a summary of CDC experience (Graham et al). Further Readings Graham DR et al: Infections caused by Moraxella, Moraxella