Abstract
An enzyme-linked immunosorbent assay specific to outer membrane protein P6 (P6-ELISA) was applied for detecting Haemophilus influenzae in middle ear fluids (MEFs) from acute otitis media (AOM) patients and in nasopharyngeal secretions (NPSs) from acute rhinosinusitis patients. P6-ELISA had a sensitivity of 83.3% for MEFs and 71.5% for NPSs and a specificity of 85.6% for MEFs and 92.5% for NPSs, respectively. Real-time PCR exhibited significant differences in the number of ompP1 gene copies among samples determined by P6-ELISA to be positive and negative for H. influenzae. However, because the P6-ELISA test has the reactivity in Haemophilus species include two commensals H. haemolyticus and H. parainfluenzae, it is thus a weak method in order to detect only NTHi correctly. Consequently, diagnosis using the P6-ELISA should be based on an overall evaluation, including the results of other related examinations and clinical symptoms to prevent misleading conclusions in clinical setting.
Highlights
Haemophilus influenzae is one of the normal inhabitants of the human nasopharynx and is responsible for acute otitis media (AOM) as well as acute rhinosinusitis [1]
While the rapid antigen detection test is a successful diagnostic tool for pneumococci, that test is not yet useful for nontypeable H. influenzae [18,19,20,21]. This is the first study that has evaluated the applicability of P6-enzyme-linked immunosorbent assay (ELISA) for diagnosing AOM and acute rhinosinusitis in children and adults caused by nontypeable H. influenzae
Because H. influenzae can be indigenous to the human nasopharynx, nasopharyngeal secretions (NPSs) might frequently be positive by culture [22]
Summary
Haemophilus influenzae is one of the normal inhabitants of the human nasopharynx and is responsible for acute otitis media (AOM) as well as acute rhinosinusitis [1]. Diagnosis is important for appropriate antimicrobial treatment of infectious diseases, with bacterial culture continuing to be the gold standard of diagnostic methods. Accurate diagnosis of infections caused by H. influenzae is often difficult because the quality of samples appropriate for culture is frequently reduced by the presence of inflammatory products and/or antibiotics. H. influenzae is highly auxotrophic and facultatively anaerobic and requires carbon dioxide and X and V factors for its growth [2,3]. These bacteria frequently perish immediately from drying during the process of sample collection and culture
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