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Observation of Viable Nontypeable Haemophilus Influenzae Bacteria within Neutrophil Extracellular Traps in Clinical Samples from Chronic Otitis Media

Lauren B King ,Bing Pang ,Antonia C Perez ,Jennifer L Reimche ,Daniel J Kirse ,Amy S Whigham ,Adele K Evans ,W Edward Swords *

Bacterial otitis media is an inherently inflammatory condition and often features an influx of neutrophils and other phagocytes into the middle-ear chamber. Neutrophils undergo a specific death pathway that results in formation of Neutrophil Extracellular Traps or “NETs”, which have been postulated as an antimicrobial defense mechanism that both mediates direct bacterial killing and facilitates phagocytic uptake and killing. However, we have shown that some mucosal pathogens within the airway including nontypeable Haemophilus influenzae survive within NETs in animal and in vitro models. In this report, we utilize exudate samples obtained from patients with chronic otitis media to show that nontypeable H. influenzae bacteria survive within NET structures within human patients.