May 1986

Branhamella catarrhalis as a Lower Respiratory Tract Pathogen in Patients With Chronic Lung Disease

Author Affiliations

From the Departments of Medicine, Pathology, and Microbiology, University of Texas Health Center at Tyler.

Arch Intern Med. 1986;146(5):890-893. doi:10.1001/archinte.1986.00360170090015

• To determine the possible role of Branhamella (formerly Neisseria) catarrhalis as a respiratory pathogen, we screened quality sputa (defined by cellular criteria) that showed numerous gram-negative cocci on Gram's stain for the presence of B catarrhalis. In an eight-month period, 52 isolates of B catarrhalis were identified in adults attending a hospital for chest diseases. During this period B catarrhalis was the third most common potential pathogen isolated from sputa. Twenty-two patients (42%) had associated patchy bronchopneumonic or lobar infiltrates. All had negative blood cultures and a generally mild clinical course. The majority of strains (73%) of B catarrhalis produced β-lactamase and were resistant to penicillin and ampicillin. Isolates (including β-lactamase-producing strains) were susceptible to erythromycin, tetracycline, and trimethoprim-sulfamethoxazole. These studies demonstrate that in patients with chronic lung disease, the presence of B catarrhalis in sputum can be suspected on the basis of a Gram's stain and may be associated with the development of new pneumonic infiltrates. Since these organisms frequently produce β-lactamase, empiric antimicrobial therapy should include agents other than the penicillins.

(Arch Intern Med 1986;146:890-893)