Moraxella catarrhalis

Definitions & Key takeaways

Moraxella catarrhalis is a type of gram-negative, diplococcus, aerobic bacteria, which is commonly found in human respiratory tract. It is a common cause of otitis media and respiratory infections, such as bronchitis, rhinosinusitis, laryngitis, and pulmonary exacerbations in people with COPD. It is diagnosed by isolating it from cultures, and its treatment requires antibiotics such as amoxicillin plus clavulanate.

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Moraxella catarrhalis is a Gram-negative diplococcus, which means it’s a spherical-shaped bacteria that usually hangs out in pairs of two.
Moraxella has had a bunch of names over the last century. When it was first discovered it was named Micrococcus catarrhalis, then its name was changed into Neisseria catarrhalis.
Later it was moved to another genus, called Branhamella, and finally it was moved again to genus Moraxella, species Moraxella catarrhalis.
It normally colonizes the upper respiratory tract, and usually causes otitis media in children. Now, Moraxella catarrhalis has a thin peptidoglycan layer, so it doesn’t retain the crystal violet dye during Gram staining.
Instead, like any other Gram-negative bacteria, it stains pink with safranin dye.Moraxella catarrhalis is also non-motile, non-spore forming, aerobic, which means it needs oxygen to survive, and oxidase positive, which means it produces an enzyme called oxidase.
However, it’s maltose fermentation negative which means it cannot ferment maltose. To check for this, a pure sample from the culture is transferred to a sterile tube containing a mix of phenol red and maltose, which is then incubated at 36 degree Celsius for 24 hours.
If acidic fermentation of maltose occurs, the resulting byproducts make the solution go yellow. With Moraxella catarrhalis, the solution stays red.
Finally, it grows well on blood and chocolate agar and it doesn’t grow on modified Thayer-Martin agar, like other Gram-negative diplococci, such as Neisseria species.
So, on blood and chocolate agar it grows into round, gray-white colonies. Finally, Moraxella catarrhalis colonies are positive for the hockey puck test, which means a loop is used to push the colonies across the plate.
Moraxella colonies are sturdy, and can be slid across the plate without breaking, which means a positive hockey puck test.
Now, Moraxella catarrhalis is an opportunistic pathogen, which means that it doesn’t usually cause disease, but it may take advantage of an opportunity like a weakened immune system to cause an infection.
This is more common in children, the elderly, people with chronic respiratory disease, or following a viral respiratory infection.
So, in these situations, it causes an infection by attaching to host cells using trimeric autotransporter adhesins, or TAAs, which are proteins found on the outer membrane.
We know that’s how the process starts - but unfortunately, the full sequence of intracellular events that culminate in an infection is still unknown.
We also know that Moraxella catarrhalis produces beta-lactamase, which is an enzyme that provides multi-resistance to beta-lactam antibiotics such as penicillins or cephalosporins.
But that’s about it!Now, in children, Moraxella catarrhalis typically causes otitis media and other respiratory tract infections, such as bronchitis, rhinosinusitis and laryngitis.
In elderly people with chronic obstructive pulmonary disease it could cause pulmonary exacerbations, meaning an acute infection like bronchopneumonia that arises over preexisting lung disease.
Finally, Moraxella catarrhalis is one of the two most common gram-negative bacteria causing a bacterial superinfection after acute viral rhinosinusitis.So, with otitis media, symptoms include fever, ear pain and a bulging tympanic membrane.
With rhinosinusitis there’s fever, nasal obstruction, purulent nasal discharge, facial pain and headache. With bronchitis there may be a cough, wheezing, shortness of breath and chest pain, and with laryngitis there may be fever, a hoarse voice, and also pain during swallowing.
Finally, symptoms of bronchopneumonia in individuals with preexisting COPD include increased coughing, increased sputum production or change in color, as well as dyspnea, or difficulty breathing.
Diagnosis is done by isolating Moraxella catarrhalis from respiratory secretions or sputum cultures. Treatment is done using amoxicillin plus clavulanate as the drug of choice.
Other antibiotics that can be used are trimethoprim-sulfamethoxazole or macrolides such as azithromycin and clarithromycin.##SummaryAlright, as a quick recap.
Moraxella catarrhalis is a Gram-negative diplococcus, non-motile, non-spore forming, aerobic, oxidase positive and maltose fermentation negative.
It grows well on blood and chocolate agar into round, gray-white colonies positive for the hockey puck test. It’s an opportunistic pathogen which uses trimeric autotransporter adhesins to infect host cells and it causes otitis media, respiratory infections such as bronchitis, rhinosinusitis and laryngitis and also, pulmonary exacerbations in elderly people with COPD.
It’s diagnosed by isolating it from cultures and is treated with amoxicillin plus clavulanate.