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This is a group of small, gram-negative, pleomorphic bacteria that require enriched media, usually containing blood or its derivatives, for isolation. Haemophilus influenzae type b is an important human pathogen; Haemophilus ducreyi, a sexually transmitted pathogen, causes chancroid; other Haemophilus species are among the normal microbiota of mucous membranes and only occasionally cause disease. Haemophilus aphrophilus and Haemophilus paraphrophilus have been combined into a single new species Aggregatibacter aphrophilus; likewise, Haemophilus segnis is now a member of the Aggregatibacter genus (Table 18-1).

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Table 18–1 Characteristics and Growth Requirements of the Haemophilus and Aggregatibacter Species Important to Humans
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Haemophilus influenzae

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Haemophilus influenzae is found on the mucous membranes of the upper respiratory tract in humans. It is an important cause of meningitis in children and causes upper and lower respiratory tract infections in children and adults.

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Morphology and Identification

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Typical Organisms
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In specimens from acute infections, the organisms are short (1.5 μm) coccoid bacilli, sometimes occurring in pairs or short chains. In cultures, the morphology depends both on the length of incubation and on the medium. At 6–8 hours in rich medium, the small coccobacillary forms predominate. Later there are longer rods, lysed bacteria, and very pleomorphic forms.

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Organisms in young cultures (6–18 hours) on enriched medium have a definite capsule. The capsule is the antigen used for "typing" H influenzae (see later discussion).

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Culture
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On chocolate agar, flat, grayish brown colonies with diameters of 1–2 mm are present after 24 hours of incubation. IsoVitaleX in media enhances growth. H influenzae does not grow on sheep blood agar except around colonies of staphylococci ("satellite phenomenon"). Haemophilus haemolyticus and Haemophilus parahaemolyticus are hemolytic variants of H influenzae and Haemophilus parainfluenzae, respectively.

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Growth Characteristics
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Identification of organisms of the Haemophilus group depends partly on demonstrating the need for certain growth factors called X and V. Factor X acts physiologically as hemin; factor V can be replaced by nicotinamide adenine nucleotide (NAD) or other coenzymes. Colonies of staphylococci on sheep blood agar cause the release of NAD, yielding the satellite growth phenomenon. The requirements for X and V factors of various Haemophilus species are listed in Table 18-1. Carbohydrates are fermented poorly and irregularly.

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In addition to serotyping on ...

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