Moraxella catarrhalis Infection

ByLarry M. Bush, MD, FACP, Charles E. Schmidt College of Medicine, Florida Atlantic University;
Maria T. Vazquez-Pertejo, MD, FACP, Wellington Regional Medical Center
Reviewed/Revised Jul 2024
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Moraxella catarrhalis is a gram-negative diplococcus that causes ear and upper and lower respiratory infections. Diagnosis is with culture. Treatment is with antibiotics.

    M. catarrhalis (formerly known as Branhamella catarrhalis) is a frequent cause of

    • Otitis media in children

    • Acute and chronic sinusitis at all ages

    • Lower respiratory infection in patients with chronic lung disease

    It is the second most common bacterial cause of COPD exacerbations after nontypeable Haemophilus influenzae.

    M. catarrhalis pneumonia resembles pneumococcal pneumonia.

    Bacteremia is rare and can be associated with prosthetic valve infection (1).

    The prevalence of M. catarrhalis colonization depends on age. About 1 to 5% of healthy adults have upper respiratory tract colonization (2, 3). Nasopharyngeal colonization with M. catarrhalis is common throughout infancy, may be increased during winter months, and is a risk factor for acute otitis media; early colonization is a risk factor for recurrent otitis media. Substantial regional differences in colonization rates occur. Living conditions, hygiene, environmental factors (eg, household smoking), genetic characteristics of the populations, host factors, and other factors may contribute to these differences.

    The organism appears to spread contiguously from its colonizing position in the respiratory tract to the infection site.

    There is no pathognomonic feature of M. catarrhalis otitis media, acute or chronic sinusitis, or pneumonia. In lower respiratory disease, patients have increased cough, purulent sputum production, and increased dyspnea.

    These gram-negative diplococci resemble Neisseria species but can be readily distinguished by routine biochemical tests after culture isolation from infected fluids or tissues.

    References

    1. 1. Sano N, Matsunaga S, Akiyama T, et al. Moraxella catarrhalis bacteraemia associated with prosthetic vascular graft infection. J Med Microbiol. 2010;59(Pt 2):245-250. doi:10.1099/jmm.0.013789-0

    2. 2. Ejlertsen T, Thisted E, Ebbesen F, Olesen B, Renneberg J. Branhamella catarrhalis in children and adults. A study of prevalence, time of colonisation, and association with upper and lower respiratory tract infections. J Infect. 1994;29(1):23-31. doi:10.1016/s0163-4453(94)94979-4

    3. 3. Vaneechoutte M, Verschraegen G, Claeys G, Weise B, Van den Abeele AM. Respiratory tract carrier rates of Moraxella (Branhamella) catarrhalis in adults and children and interpretation of the isolation of M. catarrhalis from sputum. J Clin Microbiol. 1990;28(12):2674-2680. doi:10.1128/jcm.28.12.2674-2680.1990

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