influenzae colonizes differently in adults than it does young children. Because this bacterium colonizes more rapidly in young children, they are capable of carrying more than one strain of the same bacterium. Once in the adult stage of life, a human is likely to only be carrying one strain as this bacterium does not colonize as aggressively in adults. Nearly all infants will undergo colonization of this bacteria within their first year of life. Treatment Some strains of Haemophilus influenzae produce beta-lactamases, and are also able to modify its penicillin-binding proteins, so the bacteria have gained resistance to the penicillin family of antibiotics. In severe cases, cefotaxime and ceftriaxone delivered directly into the bloodstream are the elected antibiotics, and, for the less severe cases, an association of ampicillin and sulbactam, cephalosporins of the second and third generation, or fluoroquinolones are preferred. (Fluoroquinolone-resistant Haemophilus influenzae have been observed.) Macrolides and fluoroquinolones have activity against non-typeable H. influenzae and could be used in patients with a history of allergy to beta-lactam antibiotics. However, macrolide resistance has also been observed. Serious and chronic complications The serious complications of HiB are brain damage, hearing loss, and even death. This is commonly associated with HiB but however the Hi non-typable doesn't often cause serious conditions but it has more risks to a chronic infection because it has the ability to change its surface antigens. Chronic infections are usually not as serious than acute infections. There are a few other possible diseases and conditions that can arise from the Haemophilus influenzae depending on the areas that they exist in within the human body. This bacterium can exist in the nasal passages (especially the nasopharynx), the ear canal, and the lungs. The bacterium's presence in these areas can lead to some conditions such as otitis media (which is the inflammation of the middle ear), chronic obstructive pulmonary disorder, which causes decreased air flow to the lungs, epiglotitis (which is the swelling of the epiglottis) and asthma which can become severe. Metabolism H. influenzae uses the Embden–Meyerhof–Parnas (EMP) pathway for glycolysis and the pentose phosphate pathway, which is anabolic rather than catabolic. The citric acid cycle is incomplete and lacks several enzymes that are found in a fully functioning cycle. This partially functional cycle is not unique to the H. influenzae. The enzymes missing from the TCA cycle are citrate synthase, aconitate hydratase, and isocitrate dehydrogenase. Haemophilus influenzae