Experimental Infection of Human Volunteers withHaemophilus ducreyi:Fifteen Years of Clinical Data and Experience

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Haemophilus ducreyicauses chancroid, which facilitates transmission of human immunodeficiency virus type 1. To better understand the biology ofH. ducreyiwe developed a human inoculation model. In the present article, we describe clinical outcomes for 267 volunteers who were infected withH. ducreyi. There was a relationship between papule formation and estimated delivered dose. The outcome (either pustule formation or resolution) of infected sites for a given subject was not independent; the most important determinants of pustule formation were sex and host effects. When 41 subjects were infected a second time, their outcomes segregated toward their initial outcome, confirming the host effect. Subjects with pustules developed local symptoms that required withdrawal from the study after a mean of 8.6 days. There were 191 volunteers who had tissue biopsy performed, 173 of whom were available for follow-up analysis; 28 (16.2%) of these developed hypertrophic scars, but the model was otherwise safe. Mutant-parent trials confirmed key features inH. ducreyipathogenesis, and the model has provided an opportunity to study differential human susceptibility to a bacterial infection.

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