Epidemiology and pathogenesis of Moraxella catarrhalis colonization and infection

Moraxella catarrhalis is part of the normal bacterial flora in the nasopharynx of children, although over the past two decades, it has emerged as a significant bacterial pathogen and not simply a commensal colonizer. The bacterium rapidly colonizes the nasopharynx soon after birth and many factors affect nasopharyngeal carriage of this human-specific pathogen, including for example, the presence of siblings, day-care attendance and respiratory illness. Otitis media (OM) is a particularly important respiratory illness during early childhood and the primary reason for children to visit a physician. The most common bacterial species cultured from the nasopharynx of children during OM episodes are Streptococcus pneumoniae, Haemophilus influenzae and M. catarrhalis, either as single pathogens or as co-cultures, with the patterns of nasopharyngeal colonization by microorganisms being important determinants for OM disease. There is increasing information regarding the biological mechanisms facilitating M. catarrhalis-mediated colonization and disease development, with most publications stressing the importance of bacterial adherence as an essential step in this process.

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