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 Sep 2022
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    Moraxella catarrhalis is a gram-negative diplococcus that causes ear and upper and lower respiratory infections.

    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 adults 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.

    Although bacteremia is rare, half of patients die within 3 months because of intercurrent diseases.

    The prevalence of M. catarrhalis colonization depends on age. About 1 to 5% of healthy adults have upper respiratory tract colonization. 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.

    All strains now produce beta-lactamase. The organism is generally susceptible to beta-lactam/beta-lactamase inhibitors, sulfamethoxazole, tetracyclines, extended-spectrum oral cephalosporins, aminoglycosides, macrolides, and fluoroquinolones.

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