The Pneumococcus: Population Biology and Virulence

Chapter 46 The Pneumococcus: Population Biology and Virulence Mark C. Enright, Mark C. Enright Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, Old Medical School Building, St. Mary's Hospital, Norfolk Place, London, United KingdomSearch for more papers by this author Mark C. Enright, Mark C. Enright Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, Old Medical School Building, St. Mary's Hospital, Norfolk Place, London, United KingdomSearch for more papers by this author Book Editor(s):Fernando Baquero, Fernando Baquero Department of Microbiology, Ramón y Cajal University Hospital and Laboratory for Microbial Evolution, Center for Astrobiology (CAB-INTA-CSIC), Madrid, SpainSearch for more papers by this authorCésar Nombela, César Nombela Department of Microbiology II, School of Pharmacy, Universidad Complutense de Madrid, Madrid, SpainSearch for more papers by this authorGail H. Cassell, Gail H. Cassell Eli Lilly and Company, Indianapolis, IndianaSearch for more papers by this authorJosé A. Gutiérrez-Fuentes, José A. Gutiérrez-Fuentes Fundación Lilly, Madrid, SpainSearch for more papers by this author First published: 19 October 2007 https://doi.org/10.1128/9781555815639.ch46 AboutPDFPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShareShare a linkShare onEmailFacebookTwitterLinkedInRedditWechat Summary Streptococcus pneumoniae disease has been a major cause of mortality throughout human history, causing serious invasive diseases such as pneumonia, bacteremia, septicemia, and meningitis. In common with other bacteria colonizing the nasopharynx, S. pneumoniae rarely causes invasive disease despite its prevalence in the population. The precise regulation of virulence factors in pneumococci is essential as the organism changes from colonizing the nasopharynx and surviving in and invading the lung before entering the bloodstream and cerebrospinal fluid. Studies have found 13 putative two-component signal-transduction systems in S. pneumoniae, and early studies suggest that these systems regulate expression of virulence loci in response to environmental stimuli as has been found in other bacterial pathogens. The S. pneumoniae capsule is an obvious feature of the organism when viewed on blood agar, and it serves a key role in both virulence and immune evasion. Increasing rates of antibiotic resistance have been found in studies in many countries, prompting the most alarmist of commentators to speculate about a return to the preantibiotic era. The pneumococcal capsular polysaccharide was the first virulence factor identified in the species. 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