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A total of 28 cases were examined, including 21 associated with bacteremia and 4 associated with meningitis. Of the patients examined, 86% were \u22644 years of age, and 68% had underlying medical conditions. Characterization of the bacterial isolates by multilocus sequence type genotyping revealed significant overall genetic diversity, similar to the diversity in the general population structure for nontypeable\n            <jats:italic>H. influenzae<\/jats:italic>\n            . However, four separate pairs of isolates were closely related genetically, a relationship confirmed by pulsed-field gel electrophoresis and Southern hybridization studies using probes for the major\n            <jats:italic>H. influenzae<\/jats:italic>\n            adhesin genes. These results suggest that selected strains of nontypeable\n            <jats:italic>H. influenzae<\/jats:italic>\n            may have more invasive potential, especially in young children and patients with underlying medical conditions. At this point, the specific factors that contribute to enhanced virulence remain unclear.\n          <\/jats:p>","DOI":"10.1128\/jcm.41.7.3064-3069.2003","type":"journal-article","created":{"date-parts":[[2003,7,3]],"date-time":"2003-07-03T19:05:48Z","timestamp":1057259148000},"page":"3064-3069","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":66,"title":["Invasive Disease Due to Nontypeable\n            <i>Haemophilus influenzae<\/i>\n            among Children in Arkansas"],"prefix":"10.1128","volume":"41","author":[{"given":"Joshua M.","family":"O'Neill","sequence":"first","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Joseph W.","family":"St. Geme","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cutter","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth E.","family":"Adderson","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, St. Jude Children's Research Hospital, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Anyanwu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, St. Jude Children's Research Hospital, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard F.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon E.","family":"Schutze","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"},{"name":"Department of Pathology, University of Arkansas for Medical Sciences\/Arkansas Children's Hospital, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.60.4.1302-1313.1992"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2958.1996.tb02467.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid0402.980210"},{"key":"e_1_3_2_5_2","first-page":"117","volume":"140","year":"1986","unstructured":"Campognone, P., and D. 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