Interaction of Haemophilus influenzae with mucus, cilia, and respiratory epithelium.

One nontypeable laboratory strain and five nontypeable clinical isolates of Haemophilus influenzae from sputum were investigated. Bacteria replicated from 10(4) to 10(8) cfu/ml over 24 h in an organ culture of human respiratory mucosa with only the intact mucosal surface exposed. By transmission electron microscopy, bacteria were not seen in association with normal respiratory epithelium, even after incubation for 24 h. H. influenzae infection caused patchy and occasionally confluent damage to epithelium, and the bacteria associated only with structurally damaged cells. Scanning electron microscopy revealed increased mucus, and slowed ciliary beat frequency was measured by photometry. Fimbriation of H. influenzae increased buccal cell adherence but did not facilitate association with normal or damaged respiratory epithelium or increase epithelial damage, indicating that adhesins other than fimbriae are present. Interactions with mucus, cilia, and epithelium are likely to be important in the pathogenesis of H. influenzae respiratory infections.