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Concentrations of ampicillin and sulbactam in serum and in various compartments of the respiratory tract of patients.

After infusion of 2 g ampicillin and 1 g sulbactam the concentrations of these two beta-lactams were determined in serum and various compartments of the respiratory tract of 22 patients. About 30 min after the end of the infusion in 15 patients the mean serum concentration of ampicillin was 97 +/- 9.5 mg/l and of sulbactam 37.6 +/- 3.8 mg/l; in the biopsy samples of bronchial mucosa the concentration of ampicillin was 38.6 +/- 7.2 mg/kg and of sulbactam 28.1 +/- 5.2 mg/kg; in bronchial fluid the concentration of ampicillin was 0.6 +/- 0.1 mg/l and of sulbactam 0.3 +/- 0.1 mg/l (n = 15). In a further seven patients serum and pleural empyema samples were analysed and compared. The mean values of Cmax attained 1 to 2 h after the end of the infusion in pleural empyema were 7.6 +/- 3.1 mg/l and 6.2 +/- 1.6 mg/l for ampicillin and sulbactam, respectively. The two beta-lactams were eliminated markedly more slowly from empyema than from serum. These results show that ampicillin and sulbactam rapidly penetrate into various compartments of the respiratory tract and reach therapeutically active concentrations. The ratio of their concentrations (2:1) is largely the same as that in serum. The pharmacokinetic data therefore support the use of ampicillin/sulbactam in the perioperative prophylaxis and the treatment of bacterial infections of the lower respiratory tract.

Adult↗

Prevalence of parainfluenza and influenza viruses amongst children with upper respiratory tract infection.

OBJECTIVE: The objective of this study was to determine the prevalence of Parainfluenza and Influenza causing upper respiratory tract infections and to evaluate shell vial culture assay and direct immunofluorescence assay. METHODS: A retrospective study during the period between November 1997 and May 1998. A total of 350 nasopharyngeal aspirates were obtained from children suffering from respiratory tract infections. Nasopharyngeal aspirates were investigated for the presence of Parainfluenza 1, 2 and 3, Influenza A and B using shell vial culture assay, conventional culture assay and direct immunofluorescence assay. RESULTS: Parainfluenza 1 were identified in 3%, Parainfluenza 2 in 5% and Parainfluenza 3 in 6%. Influenza A were identified in 4% and Influenza B in 2%. Parainfluenza 1, 2 and 3 were isolated in children less than 5 years old. Most of Parainfluenza cases were associated with other upper respiratory infections. Shell vial assay showed a sensitivity of 90-93% and specificity of 99-100% for detecting Parainfluenza 1, 2 and 3. CONCLUSION: These results emphasize that shell vial assay is important for the diagnosis of Parainfluenza and Influenza, although direct immunofluorescence assay is the superior diagnostic assay.

Acute Disease↗

Distribution of Pasteurella haemolytica in the respiratory tracts of carrier calves and those subsequently infected experimentally with Dictyocaulus viviparus.

Distribution of Pasteurella haemolytica in the respiratory tracts of calves with no apparent clinical signs of illness and those infected experimentally with Dictyocaulus viviparus was determined so as to define carrier sites for this organism. The calves had been positive by nasopharyngeal swab for either P haemolytica A2 or A1 for at least two months or for over a month, respectively, before slaughter. P haemolytica A1 was acquired following horizontal spread from other infected calves. It was observed post mortem that P haemolytica A1 or A2 resided in the tonsils and retropharyngeal lymph nodes of calves of both groups. In addition to these sites, P haemolytica A1 was also isolated from the right cranial lung lobe of one of the calves from the D viviparus infected group although there was no evidence of pasteurella associated pneumonia. It was concluded that tonsil and retropharyngeal lymph nodes appear to be the most important carrier sites for P haemolytica when compared to other tissues of the bovine respiratory tract.

Animals↗

Antibody responses in the lower respiratory tract and male urogenital tract in humans after nasal and oral vaccination with cholera toxin B subunit.

Nasal vaccine delivery is superior to oral delivery in inducing specific immunoglobulin A (IgA) and IgG antibody responses in the upper respiratory tract. Although an antibody response in the nasal passages is important in protecting against primary colonization with lung pathogens, antibodies in the lungs are usually required as well. We immunized 15 male volunteers twice nasally or orally with cholera toxin B subunit (CTB) and determined the specific antibody levels in serum, bronchoalveolar lavage (BAL) fluid, and urine before and 2 weeks after immunization. Nasal immunization induced fivefold increases in the levels of specific IgA antibodies in BAL fluid of most volunteers, whereas there were no significant specific IgA responses after oral immunization. The specific IgG antibody level increased eightfold in BAL fluid in the nasally vaccinated subjects, and the major part of IgG had most probably been transferred from serum. Since the specific IgG response in serum was lower in the individuals vaccinated orally, the IgG response in BAL fluid in this group was also lower and not significant. In conclusion, nasal immunization is also preferable to the oral route when vaccinating against lower respiratory tract infections, and a systemic immune response is considerably more important in the lower than in the upper respiratory tract. Moreover, both nasal and oral immunizations were able to stimulate 6- to 10-fold specific IgA and IgG responses in urine in about half of the individuals, which indicates that distant mucosal vaccination might be used to prevent adhesion of pathogens to the urogenital tract.

Administration, Intranasal↗

Sendai virus, a murine parainfluenza virus type 1, replicates to a level similar to human PIV1 in the upper and lower respiratory tract of African green monkeys and chimpanzees.

Human parainfluenza virus type 1 (HPIV1), a major cause of croup in infants and young children, accounts for 6% of hospitalizations for pediatric respiratory tract disease. The antigenically related Sendai virus, referred to here as murine PIV1 (MPIV1), is being considered for use as a live-attenuated vaccine to protect against HPIV1 (J. L. Hurwitz, K. F. Soike, M. Y., Sangster, A. Portner, R. E. Sealy, D. H. Dawson, and C. Coleclough, 1997, Vaccine 15(5), 533-540) and also as a recombinant vaccine vector expressing antigens to protect against viral disease in humans. However, in the 1950s MPIV1 was reported to have been isolated from humans, suggesting that zoonotic transmission might have occurred. It is therefore important to examine the ability of MPIV1 to replicate in nonhuman primates, i.e., surrogate hosts for humans. In the present study the level of replication of MPIV1 and HPIV1 was compared in African green monkeys and chimpanzees. Surprisingly, MPIV1 replicated as efficiently as HPIV1 in the upper and lower respiratory tract of African green monkeys at doses of 10(4) and 10(6) and replicated only slightly less efficiently at both sites in chimpanzees. African green monkeys immunized with MPIV1 were highly resistant to subsequent challenge with HPIV1 even though MPIV1 did not induce a detectable HPIV1-neutralizing antibody response. The high level of replication of MPIV1 observed in the upper and lower respiratory tract of these primates suggests that MPIV1 likely would require significant attenuation before it could be given to humans as a vaccine against HPIV1 or as a vaccine vector. Its ability to efficiently replicate in nonhuman primates suggests that MPIV1 lacks a significant host range restriction in primates and could theoretically cause zoonotic disease in humans.

Animals↗

[Clinical study of cefminox in respiratory tract infections].

A new cephem cefminox (CMNX, MT-141) was used in the treatment of 22 cases of respiratory tract infections without taking into account background factors of patients. The dosage was 2 to 4 g/day in 2 divided doses and the treatment was continued for a period 2 to 17 days. The breakdown of the diseases treated was; pneumonia in 7 cases, secondary lung abscess (rS3)+middle lobe syndrome in 1 case, chronic bronchitis in 3 cases, bronchiectasis in 10 cases and intrapulmonary lymphangitis carcinomatosa (suspected) in 1 case. The clinical results were rated as excellent in 7 cases, good in 11 cases, fair in 1 case and unknown in 3 cases, with an excellent rate of 36.8% and excellent+good rate of 94.7%. The causative organisms were identified in 10 cases and included H. influenzae for 8 cases, Klebsiella sp. for 1 case and S. aureus for 1 case. The analysis of bacteriological study revealed disappearance of all of these organisms. However, in 3 out of 8 cases where H. influenzae was isolated and in 1 case where Klebsiella sp. was isolated the changes of organisms to P. aeruginosa were observed. As the adverse reactions, rashes developed in 1 case and moreover laboratory test results revealed elevation in transaminase in 3 cases. All of these symptoms were mild in nature and none of our cases experienced serious adverse reactions attributable to CMNX. From these results, we believe that CMNX is one of the useful drugs for the treatment of respiratory tract infections.

Adult↗

Thrombocytosis at an early stage of respiratory tract viral infection.

AIM: To determine whether thrombocytosis, a platelet count of more than 500 x 10(9)/l, occurs at an early stage of respiratory tract viral infection. METHODS: The medical records of 345 patients with respiratory syncytial virus (RSV), influenza, measles, adenovirus or human herpes virus 6 infections were retrospectively reviewed. RESULTS: The mean platelet count was significantly higher in RSV patients than in patients with other respiratory infections. Among the 29 patients with thrombocytosis, 24 (82.8%) had RSV infection. CONCLUSION: When thrombocytosis is positive at an early stage of respiratory tract infection, RSV should be taken into account as a causative agent.

Humans↗

Time course of changes in ETB receptor density and function in tracheal airway smooth muscle during respiratory tract viral infection in mice.

1. In the current study, the density and function of ETA and ETB receptors in mouse tracheal airway smooth muscle were determined over the time course of respiratory tract infection with influenza A/PR-8/34 virus. 2. Quantitative autoradiographic studies using [125I]-endothelin-1 revealed that the tracheal airway smooth muscle from control mice contained ETA and ETB sites in the ratio of 49%:51% (+/- 2%, n = 29 mice). Respiratory tract viral infection was associated with increases in the density of ETA sites and decreases in the density of ETB sites at days 1, 2 and 4 post-inoculation which were reversible by day 19. For example, at day 4 post-inoculation, a time when the manifestations of viral infection were at or near their peak, the ratio of ETA:ETB sites was 72%:28% (+/- 4%, n = 6 mice, P < 0.05). In contrast, at day 19 post-inoculation, by which time viral infection had essentially resolved, the ratio of ETA:ETB sites was similar to control (51%:49% (+/- 3%), n = 6 mice). 3. Endothelin-1 was a potent spasmogen in isolated tracheal airway smooth muscle preparations from control mice (ED70 = concentration producing 70% of contraction induced by 10 microM carbachol = 6.3 nM (95% confidence limits, 4.0-10; n = 6 mice)). Neither the ETA receptor-selective antagonist, BQ-123 (3 microM), nor the ETB receptor-selective antagonist, BQ-788 (1 microM) alone had any significant inhibitory effect on endothelin-1-induced contractions of mouse isolated tracheal smooth muscle. However, simultaneous treatment with BQ-123 (3 microM) and BQ-788 (1 microM) resulted in a 10 fold rightward shift in the concentration-effect curve to endothelin-1 (ED70 = 60 nM, (44-90; n = 6 mice, P < 0.05)), indicating that contraction was mediated via both ETA and ETB receptors. 4. Endothelin-1 evoked similar concentration-dependent contractions of tracheal smooth muscle isolated from control and virus-inoculated mice. In the presence of the ETB receptor-selective-antagonist, BQ-788 (1 microM), the potency and maximum response to endothelin-1 were similar in preparations from control and virus-inoculated mice at all time points investigated. However, unlike control responses, endothelin-1-induced contractions in preparations from virus-infected mice were significantly inhibited by the ETA receptor-selective antagonist, BQ-123. For example, at day 4 post-inoculation, the contractile response to 30 nM endothelin-1, in the presence of BQ-123 (3 microM), was only 20 +/- 12% (n = 6 mice, P < 0.05) of that produced in control preparations under similar conditions. However, at day 19 post-inoculation, contraction evoked by 30 nM endothelin-1 in the presence of BQ-123 (3 microM), was similar to that in preparations from control mice. 5. In summary, during the early stages (days 1-8 post-inoculation) of respiratory tract infection with influenza A/PR-8/34 virus, we observed decreases in the density of tracheal airway smooth muscle ETB receptors which were reflected in decreases in ETB receptor-mediated airway smooth muscle contraction. In addition, during the same period of viral infection we observed increases in the density of tracheal airway smooth muscle ETA receptors which were not associated with increased function of the ETA receptor-effector system linked to contraction. Virus-associated modulation of ETA and ETB receptor density and function was reversible with recovery from infection.

Animals↗

Experimental bovine respiratory tract disease with Haemophilus somnus.

Eight calves were inoculated into the bronchus with H. somnus. Thirteen calves were inoculated with bovine respiratory syncytial virus (BRSV) and 8 days later with H. somnus. All calves developed necrotizing, suppurative, lobular bronchopneumonia and pleuritis. Clinical signs of disease and pneumonic lesions were significantly more severe in calves that were sequentially inoculated with BRSV followed by H. somnus. Pneumonic lesions in the inoculated calves were similar to those described for naturally occurring H. somnus-associated respiratory tract disease. Control calves inoculated with BRSV alone or sham-inoculated with medium did not develop clinical signs of respiratory tract disease. The BRSV-inoculated control calves developed minimal pneumonic lesions.

Animals↗

Efficacy of a twice-daily regimen of cefadroxil in the treatment of respiratory tract infections.

This multicentre open study evaluated the responses of 474 adult and paediatric patients with upper or lower respiratory tract infections to treatment with cefadroxil (25 to 50 mg/kg in children and 500 mg to 1 g in adults) twice daily for 10 to 30 days. Complete or partial cures seen in 81% to 100% of all patients correlated with the eradication of 87% to 100% of the causative pathogens, most commonly beta-haemolytic streptococci, S. aureus or S. pneumoniae. Mild, transient side effects, usually gastrointestinal disturbances or hypersensitivity reactions, were reported in 4.8% of patients. Thus, the safety and efficacy of this oral cephalosporin recommends its use in the treatment of infections of the respiratory tract.

Cefadroxil↗

A biphasic chamber system for maintaining polarity of differentiation of cultured respiratory tract epithelial cells.

A simple, disposable, biphasic cultivation chamber has been developed for respiratory tract epithelial cells. This chamber, the Whitcutt chamber, contains a movable, transparent, permeable gelatin membrane that can be employed either submerged in the culture medium, thereby feeding the cells by the traditional immersion method, or raised to the surface of the culture medium, to bring the apical surfaces of the cells into contact with air and provide nutrients only from below (basal feeding). The effects of biphasic cultivation on the growth and differentiation of respiratory tract epithelial cells from different sources have been studied in Whitcutt chambers. Primary hamster tracheal epithelial (HTE) cells grown to confluence with basal feeding developed a ciliated columnar morphology, with differentiated features (cilia and mucous granules) located in the apical region of the epithelial layer. These cells secreted mucinlike molecules from the apical surface (i.e. the surface in contact with air). Although the apical localization of differentiation features was greater, mucous cell differentiation achieved by basal feeding was quantitatively not greater than that achieved by continuous immersion feeding. Similarly, basal feeding did not alter the degree of epithelial cell differentiation in cultures derived from rat, rabbit, and monkey tracheas or from human bronchial and nasal tissues. In contrast, the differentiation of guinea pig tracheal epithelial cells in culture was significantly influenced by the feeding method employed. When fed basally, guinea pig tracheal epithelial cell cultures expressed various mucociliary functions with resemblance to mucociliary layers in vivo, whereas constantly immersed cultures seemed stratified and squamous. These results suggest that, at least for guinea pigs, the combination of feeding methods provided by the Whitcutt chamber can be used to achieve differentiated cultures of tracheal epithelial cells with a polarity of differentiation that is similar to that observed in intact airways in vivo.

Animals↗

Comparison of nebulized adrenaline versus salbutamol in wheeze associated respiratory tract infection in infants.

OBJECTIVE: (i) To assess the efficacy of bronchodilators in wheeze associated respiratory tract infection (WRTI); and (ii) To compare L-adrenaline with salbutamol in wheeze associated respiratory tract infection. DESIGN: Randomized controlled trial. METHOD: Ninety one children in age group of 2 months to 2 years with their 1st or 2nd episode of wheezing in association with fever and/or coryza were enrolled. Of these, 45 received L-adrenaline (0.1ml/kg/dose in 1 in 10,000 solution) (Group A) and 46 received salbutamol (0.1mg/kg/dose) (Group B). Three doses of each drug were given, nebulized with oxygen at 20 minutes intervals. Respiratory rate, RDAI score, clinical status and pulse oxymetry was recorded before intervention and 10 minutes after each dose. Patients who showed significant relief were discharged after an observation period of three hours while those who did not were admitted. RESULTS: Both L-adrenaline and salbutamol caused significant improvement in mean symptom score and oxygenation. However, the adrenaline group showed a significantly better improvement in the study parameters than the salbutamol group. More children in the adrenaline group could be sent home after the emergency treatment. CONCLUSION: Adrenergic agonists both specific and non specific are beneficial in WRTI. Adrenaline is more effective than salbutamol and is thus a better, inexpensive and relatively safe alternative.

Administration, Inhalation↗

[Clinical trials of flomoxef in patients with chronic respiratory tract infections].

Flomoxef (FMOX, 6315-S), a newly developed oxacephem drug, was administered to 6 patients with chronic respiratory tract infections. Bacteriological examination of these infections using quantitative sputum cultures revealed that 2 patients had Haemophilus influenzae, 2 had Branhamella catarrhalis and 2 had mixed pathogens (one was with H. influenzae + B. catarrhalis and the other with Streptococcus pneumoniae + B. catarrhalis). The administration of the drug was done by drip infusion, twice daily, with a daily dose of 1 to 2 g. As results, all the above mentioned pathogenic organisms were eradicated in 5 to 10 days after the initiation of the drug therapy. No undesirable symptoms were observed in these patients during the course of the chemotherapy. Serum drug concentrations after an intravenous administration of the drug reached their peak values averaging 134.32 +/- 40.32 micrograms/ml immediately after a single dose of 2 g of FMOX in 5 patients with chronic respiratory tract infections. Drug concentration in the sputum was at highest 1.86 micrograms/ml. Susceptibilities to FMOX of clinically isolated 49 strains of H. influenzae and 35 strains of B. catarrhalis from our clinic in the year of 1986 were compared to those to ampicillin and to latamoxef (LMOX). The study revealed that MICs of FMOX against H. influenzae were 0.10 to 1.56 micrograms/ml, hence H. influenzae strains seemed to be sensitive to FMOX regardless of beta-lactamase activities. LMOX had higher activities against H. influenzae than FMOX, however. Activities of FMOX against B. catarrhalis, on the other hand, were distributed from less than 0.05 to 0.39 microgram/ml which were also not as good as LMOX activities.

Aged↗

Evaluation of OPC-17116 against important pathogens that cause respiratory tract infections.

The antibacterial activity of OPC-17116, a new fluoroquinolone antibacterial agent, against important pathogens that cause respiratory tract infections was evaluated in vitro and in vivo and compared with those of ciprofloxacin, ofloxacin, and norfloxacin. The pharmacokinetic profiles of OPC-17116 were studied in both mice and rats given the drug orally at doses of 50 and 40 mg/kg of body weight, respectively. OPC-17116 showed a high degree of distribution in the lung tissues of both species, with maximum concentrations of 29.6 and 32.0 micrograms/g, respectively. Furthermore, the drug concentrations in lung tissue were about 10 to 15 times greater than the concentrations in plasma. OPC-17116 showed potent antibacterial activity against such pathogens as Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, Pseudomonas aeruginosa, Haemophilus influenzae, and Moraxella catarrhalis. The MICs of this compound for 90% of these organisms except methicillin-resistant S. aureus and P. aeruginosa ranged from < or = 0.006 to 0.78 microgram/ml. The in vitro antibacterial activity of OPC-17116 was reflected by the efficacy of a single oral dose against systemic bacterial infections in mice. OPC-17116 showed a superior effect against gram-positive bacteria, H. influenzae, and M. catarrhalis. In comparison with the other reference compounds, the efficacy of OPC-17116 was less than that of ciprofloxacin against K. pneumoniae and P. aeruginosa. OPC-17116 showed a greater therapeutic effect than the other drugs against experimental acute pneumonia caused by these organisms in mice or rats. This excellent therapeutic effect against respiratory tract infections may be a result of its high level of distribution in lung tissue.

Animals↗

Defective interferon-alpha production in children with recurrent respiratory tract infections. A primary or secondary deficiency?

Interferon-alpha and -gamma production was assayed in 44 children with recurrent respiratory tract infections, in 9 patients with recurrent stomatitis and in 32 control subjects. A partial, transitory deficiency in interferon-alpha production was found in 2 children with recurrent respiratory tract infections. The deficiency may be either cause or effect of the recurrent infections. Many data support the latter hypothesis.

Adolescent↗

Epidemiology of community-acquired respiratory tract infections in adults. Incidence, etiology, and impact.

Upper respiratory tract infections are the most common types of infectious diseases among adults. It is estimated that each adult in the United States experiences two to four respiratory infections annually. The morbidity of these infections is measured by an estimated 75 million physician visits per year, almost 150 million days lost from work, and more than $10 billion in costs for medical care. Serotypes of the rhinoviruses account for 20 to 30 percent of episodes of the common cold. However, the specific causes of most upper respiratory infections are undefined. Pneumonia remains an important cause of morbidity and mortality for nonhospitalized adults despite the widespread use of effective antimicrobial agents. There are no accurate figures on the number of episodes of pneumonia that occur each year in ambulatory patients. In younger adults, the atypical pneumonia syndrome is the most common clinical presentation; Mycoplasma pneumoniae is the most frequently identified causative agent. Other less common agents include Legionella pneumophila, influenza viruses, adenoviruses, and Chlamydia. More than half a million adults are hospitalized each year with pneumonia. Persons older than 65 years of age have the highest rate of pneumonia admissions, 11.5 per 1,000 population. Pneumonia ranks as the sixth leading cause of death in the United States. The pathogens responsible for community-acquired pneumonias are changing. Forty years ago, Streptococcus pneumoniae accounted for the majority of infections. Today, a broad array of community-acquired pathogens have been implicated as etiologic agents including Legionella species, gram-negative bacilli, Hemophilus influenzae, Staphylococcus aureus and nonbacterial pathogens. Given the diversity of pathogenic agents, it has become imperative for clinicians to establish a specific etiologic diagnosis before initiating therapy or to consider the diagnostic possibilities and treat with antimicrobial agents that are effective against the most likely pathogens.

Adolescent↗

Indoor air quality risk factors for severe lower respiratory tract infections in Inuit infants in Baffin Region, Nunavut: a pilot study.

Inuit infants have extremely high rates of lower respiratory tract infection (LRTI), but the causes for this are unclear. The aims of this study were to assess, in young Inuit children in Baffin Region, Nunavut, the feasibility of an epidemiologic study of the association between indoor air quality (IAQ) and respiratory health; to obtain data on IAQ in their housing; and to identify and classify risk factors for LRTI. Twenty houses in Cape Dorset, Nunavut with children below 2 years of age, were evaluated using a structured housing inspection and measurement of IAQ parameters, and a respiratory health questionnaire was administered. Twenty-five percent of the children had, at some time, been hospitalized for chest illness. Houses were very small, and had a median of six occupants per house. Forty-one percent of the houses had a calculated natural air change rate <0.35 air changes per hour. NO(2) concentrations were within the acceptable range. Smokers were present in at least 90% of the households, and nicotine concentrations exceeded 1.5 microg/m(3) in 25% of the dwellings. Particulates were found to be correlated closely with nicotine but not with NO(2) concentrations, suggesting that their main source was cigarette smoking rather than leakage from furnaces. Mattress fungal levels were markedly increased, although building fungal concentrations were low. Dust-mites were virtually non-existent. Potential risk factors related to IAQ for viral LRTI in Inuit infants were observed in this study, including reduced air exchange and environmental tobacco smoke exposure. Severe lower respiratory tract infection is common in Inuit infants. We found reduced air change rates and high occupancy levels in houses in Cape Dorset, which may increase the risk of respiratory infections. This suggests the measures to promote better ventilation or more housing may be beneficial. Further health benefits may be obtained by reducing bed sharing by infants and greater turnover of mattresses, which were found to have high levels of fungi.

Air Pollutants↗

Pertussis toxin plays an early role in respiratory tract colonization by Bordetella pertussis.

In this study, we sought to determine whether pertussis toxin (PT), an exotoxin virulence factor produced exclusively by Bordetella pertussis, is important for colonization of the respiratory tract by this pathogen by using a mouse intranasal infection model. By comparing a wild-type Tohama I strain to a mutant strain with an in-frame deletion of the ptx genes encoding PT (deltaPT), we found that the lack of PT confers a significant peak (day 7) colonization defect (1 to 2 log(10) units) over a range of bacterial inoculum doses and that this defect was apparent within 1 to 2 days postinoculation. In mixed-strain infection experiments, the deltaPT strain showed no competitive disadvantage versus the wild-type strain and colonized at higher levels than in the single-strain infection experiments. To test the hypothesis that soluble PT produced by the wild-type strain in mixed infections enhanced respiratory tract colonization by deltaPT, we coadministered purified PT with the deltaPT inoculum and found that colonization was increased to wild-type levels. This effect was not observed when PT was coadministered via a systemic route. Intranasal administration of purified PT up to 14 days prior to inoculation with deltaPT significantly increased bacterial colonization, but PT administration 1 day after bacterial inoculation did not enhance colonization versus a phosphate-buffered saline control. Analysis of bronchoalveolar lavage fluid samples from mice infected with either wild-type or deltaPT strains at early times after infection revealed that neutrophil influx to the lungs 48 h postinfection was significantly greater in response to deltaPT infection, implicating neutrophil chemotaxis as a possible target of PT activity promoting B. pertussis colonization of the respiratory tract.

Animals↗