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Invasion of the inner ear by Haemophilus influenzae type b in experimental meningitis
S L Kaplan1, E P Hawkins, M W Kline
1Myers-Black Infectious Disease Section, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030.
Abstract:
Bacterial interstrain variation for cochlear invasion was studied by intraperitoneal inoculation of infant rats with Haemophilus influenzae type b. Eight pairs of CSF isolates from children with or without deafness due to meningitis were injected into half of each litter in separate experiments. At 48 h, quantitative CSF culture results and CSF white blood cell counts were equivalent for the two groups. Organisms within the cochlea were detected in four of eight animals in each group. There was no difference between the deaf and nondeaf isolates in the degree or frequency of inner ear inflammation in formalin-fixed sections. In separate experiments, animals were inoculated with H. influenzae type b and 24 h later treated with ampicillin, or ampicillin plus dexamethasone. At 48 h, although CSF white blood cell counts were significantly reduced in the steroid group, no difference was noted in the degree of cochlear inflammation between the two groups. The ability of H. influenzae type b to invade the inner ear of infant rats does not correlate with the development of sensorineural deafness in children following H. influenzae type b meningitis. Steroid administration does not appear to diminish the inflammatory reaction within the cochlea more than antibiotics alone in this model, but may delay CSF sterilization by ampicillin.
Insights
Bacterial invasion of the inner ear by Haemophilus influenzae type b does not predict deafness in children. Steroids did not reduce cochlear inflammation more than antibiotics alone in infant rats.
Area of Science:
- Otorhinolaryngology
- Infectious Diseases
- Pediatrics
Background:
- Haemophilus influenzae type b meningitis can lead to sensorineural deafness.
- The mechanisms of cochlear invasion and subsequent inflammation remain unclear.
Purpose of the Study:
- To investigate bacterial interstrain variation in cochlear invasion.
- To determine if cochlear invasion correlates with deafness development.
- To evaluate the effect of steroid treatment on cochlear inflammation.
Main Methods:
- Infant rats were inoculated with Haemophilus influenzae type b isolates from children with or without deafness.
- Cochlear invasion, inflammation, and cerebrospinal fluid (CSF) parameters were assessed.
- Separate experiments evaluated ampicillin and dexamethasone treatment effects.
Main Results:
- No difference in cochlear invasion or inflammation was observed between isolates from deaf and non-deaf children.
- Steroid treatment reduced CSF white blood cell counts but not cochlear inflammation.
- Steroids may delay CSF sterilization by ampicillin.
Conclusions:
- Haemophilus influenzae type b cochlear invasion in rats does not correlate with childhood deafness.
- Steroid administration does not appear to reduce inner ear inflammation more than antibiotics alone in this model.