1887

Abstract

is a human-restricted opportunistic bacterial pathogen of the respiratory mucosa. It frequently colonizes the nasopharynx asymptomatically, but is also an important causative agent of otitis media (OM) in children, and plays a significant role in acute exacerbations of chronic obstructive pulmonary disease (COPD) in adults. As the current treatment options for infection in OM and exacerbations of COPD are often ineffective, the development of an efficacious vaccine is warranted. However, no vaccine candidates for have progressed to clinical trials, and information regarding the distribution of virulence factors and vaccine candidates is inconsistent in the literature. It is largely unknown if virulence is associated with particular strains or subpopulations of , or if differences in clinical manifestation can be attributed to the heterogeneous expression of specific virulence factors in the circulating population. Further investigation of the distribution of virulence factors in the context of carriage and disease is required so that vaccine development may be targeted at relevant antigens that are conserved among disease-causing strains. The challenge of determining which of the proposed virulence factors are relevant to human disease is amplified by the lack of a standardized typing system to facilitate direct comparisons of worldwide isolates. Here we summarize and evaluate proposed relationships between subpopulations and specific virulence factors in the context of colonization and disease, as well as the current methods used to infer these associations.

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2017-10-01
2024-03-28
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