HAEMOPHILUS-INFLUENZAE IN LUNG EXPLANTS OF PATIENTS WITH END-STAGE PULMONARY-DISEASE

In order to determine the presence and distribution of Haemophilus inf luenzae in lung tissue sections, we obtained lung explants from 49 lun g transplant recipients with cystic fibrosis (CF) (n = 16), chronic ob structive pulmonary disease (COPD) including emphysema (n = 16), bronc hiectasis (n = 5), pulmonary hypertension (n = 9), Langerhans cell his tiocytosis (n = 1), and idiopathic pulmonary fibrosis (n = 2). Analysi s was done by selective culturing, immunoperoxidase (IF) staining, and by polymerase chain reaction (PCR). H. influenzae was cultured from s pecimens of the lung explants from one CF and one COPD patient. IP sta ining of tissue sections was positive in 24 patients (10 CF patients, eight COPD patients, two bronchiectasis patients, and four patients wi th noninfectious pulmonary diseases). IF-positive tissue sections were PCR-positive, and IF-negative sections were PCR-negative. H. influenz ae was more frequently detected in tissue sections of lung explants fr om CF and COPD patients than from patients with bronchiectasis or noni nfectious pulmonary diseases. H., influenzae was diffusely present in the epithelium, the submucosa of the bronchi, the bronchioles, the int erstitium, and the alveolar epithelium. H. influenzae was localized ex tracellularly alone and in bacterial clusters, and was also associated with macrophages in CF patients. The results of this study demonstrat e that H. influenzae is often present in the lungs of patients with en d-stage pulmonary disease, especially CF and COPD patients. H. influen zae is diffusely present in the respiratory epithelium and subepitheli al layers of the lungs of these patients.