Streptococcus pneumoniae: virulence factors, pathogenesis, and vaccines.

Although pneumococcal conjugate vaccines are close to being licensed, a more profound knowledge of the virulence factors responsible for the morbidity and mortality caused by Streptococcus pneumoniae is necessary. This review deals with the major structures of pneumococci involved in the pathogenesis of pneumococcal disease and their interference with the defense mechanisms of the host. It is well known that protection against S. pneumoniae is the result of phagocytosis of invading pathogens. For this process, complement and anticapsular polysaccharide antibodies are required. Besides, relatively recent experimental data suggest that protection is also mediated by the removal of disintegrating pneumococci and their degradation products (cell wall, pneumolysin). These structures seem to be major contributors to illness and death caused by pneumococci. An effective conjugate vaccine should therefore preferably include the capsular polysaccharide and at least one of these inflammatory factors.     

The role of Streptococcus pneumoniae virulence factors in host respiratory colonization and disease

Streptococcus pneumoniae is a Gram-positive bacterial pathogen that colonizes the mucosal surfaces of the host nasopharynx and upper airway. Through a combination of virulence-factor activity and an ability to evade the early components of the host immune response, this organism can spread from the upper respiratory tract to the sterile regions of the lower respiratory tract, which leads to pneumonia. In this Review, we describe how S. pneumoniae uses its armamentarium of virulence factors to colonize the upper and lower respiratory tracts of the host and cause disease.     

Streptococcus pneumoniae serotype 3 genotypes in invasive isolates from Colombia

Introduction: Streptococcus pneumoniae serotype 3 is an important cause of pneumonia, bacteremia, and meningitis.Objective: To establish the circulating genotypes of S. pneumoniae serotype 3 isolates recovered from the invasive disease between 1994 to 2015 in Colombia.Materials and methods: Of the 365 S. pneumoniae serotype 3 isolates recovered through the laboratory national surveillance program, 117 isolates were analyzed. Pulsed-field gel electrophoresis was used for genotyping, and multilocus sequence typing was determined in representative isolates.Results: The frequency of this serotype increased from 2.7% between 1994 and 1998 to 9.1% between 2011 and 2015 (p=0.000); 91.7% of the isolates showed a genetic similarity greater than 77% and were related to the Netherlands³-31(PMEN31) clone CC180. Several subtypes were identified, two of which showed antimicrobial resistance.Conclusion: In Colombia, the pneumococcal population of the capsular type 3 shows a continuous and homogeneous circulation relating to the clonal group ST-180.     

The effect of transformation on the virulence of Streptococcus pneumoniae

Although pneumococcus is one of the most frequently encountered opportunistic pathogen in the world, the mechanisms responsible for its infectiveness have not yet been fully understood. In this paper, we have attempted to characterize the effects of pneumococcal transformation on the pathogenesis of the organism. We constructed three transformation-deficient pneumococcal strains, which were designated as Nos. 1d, 2d, and 22d. The construction of these altered strains was achieved via the insertion of the inactivated gene, comE, to strains 1, 2 and 22. We then conducted a comparison between the virulence of the transformation-deficient strains and that of the wild-type strains, via an evaluation of the ability of each strain to adhere to endothelial cells, and also assessed psaA mRNA expression, and the survival of hosts after bacterial challenge. Compared to what was observed with the wild-type strains, our results indicated that the ability of all of the transformation-deficient strains to adhere to the ECV304 cells had been significantly reduced (p < 0.05), the expression of psaA mRNA was reduced significantly (p < 0.05) in strains 2d and 22d, and the median survival time of mice infected with strains 1d and 2d was increased significantly after intraperitoneal bacterial challenge (p < 0.05). The results of our study also clearly indicated that transformation exerts significant effects on the virulence characteristics of S. pneumoniae, although the degree to which this effect is noted appears to depend primarily on the genetic background of the bacteria.     

clpE基因缺失对肺炎链球菌毒力的影响

【目的】 探索clpE基因缺失对肺炎链球菌毒力的影响。【方法】 用长臂同源多聚酶链式反应(LFH-PCR)方法失活clpE基因,用PCR、测序鉴定缺失菌株,通过动物实验观察clpE基因缺失株毒力改变情况, 同时用细胞实验比较clpE基因缺失株和野生菌对宿主细胞的粘附和侵袭能力,最后用实时荧光定量PCR分析自溶素(major autolysin A,lytA)、表面黏附素A(pneumococcal surface adhesion A,psaA)、溶血素(pneumolysin,ply)、肺炎球菌表面蛋白A（pneumococcal surface protein A, pspA)和神经氨酸酶（neuraminidase, nanA）的表达。 【结果】小鼠毒力实验表明野生菌株半数致死时间54h,而缺失株半数致死时间为21d,两者比较有统计学差异（P<0 .0l）;缺失菌在对宿主细胞的粘附能力明显低于野生菌株（P<0.05）。实时荧光定量PCR显示clpE缺失株的五个毒力因子mRNA表达水平均低于野生菌,两者比较有统计学差异（P<0. 05）;【结论】ClpE通过调控肺炎链球菌多种毒力因子表达,而影响其毒力。     

应用whaF基因序列鉴定20型肺炎链球菌血清型

目的应用wha F基因测序方法,对20型肺炎链球菌进行血清型鉴定。方法采用血清凝集法和用20型肺炎链球菌型特异性基因(wci L基因)合成的引物进行PCR扩增,对中国医学细菌保藏管理中心所保藏的20型肺炎链球菌进行血清学鉴定;根据Gen Bank上发表的wha F基因设计合成引物,PCR扩增wha F基因,利用测序获得基因序列,分析wha F基因多态性。结果 7株20型肺炎链球菌菌株均能与20型血清产生血清凝集反应,wci L基因PCR扩增产物,可见与预期相符大小500 bp的特异性条带。wha F基因PCR扩增产物,除20-3外,其余6株菌均可见1 000bp大小与预期相符的PCR扩增产物。wha F基因测序和分析显示:20-2、20-4、20-5、20-7与20B亚型(Gen Bank accession No.:CR931679和JQ653093)的wha F基因序列相同;20-6与20A亚型(Gen Bank accession No.:JQ653094)的wha F基因序列相同;20-1与CR931679和JQ653093相比,在898有点突变(A→C)。20-3的wha F基因比20A亚型和20B亚型的wha F基因均少了约600 bp。结论 20-6为20A亚型肺炎链球菌,20-2、20-4、20-5、20-7均为20B亚型肺炎链球菌。     

Capsular serotype and antibiotic resistance of Streptococcus pneumoniae isolates in Malaysia

Background

Streptococcus pneumoniae is a major causative agent of severe infections, including sepsis, pneumonia, meningitis, and otitis media, that has since become a major public health concern. In this study, the serotypes distribution of pneumococcal isolates was investigated to predict the efficacy of the 7-valent pneumococcal conjugate vaccine (PCV7) among the Malaysian populations.

Methodology/Principal Findings

A total of 151 clinical isolates were serotyped using multiplex PCR assays. Out of them, there were 21.2% penicillin-resistant, 29.1% penicillin-intermediate, and 49.7% penicillin-susceptible S.pneumoniae strains. Serotypes detected among the Malaysian isolates were 1, 3, 10A, 11A/11D, 12F/12A, 14, 15A, 15B/15C, 16F, 18C/18B/18A/18F, 19A, 19F, 23F, 35B, 35F/47F, 6A/6B, 7C/7B/40, 7F/7A, 9V/9A, and 34. Serotype 19F and 23F were the two most prevalent serotypes detected. Serotypes are highly associated with invasiveness of isolates (p = 0.001) and penicillin susceptibility (p<0.001). Serotype 19F was observed to have increased resistance against penicillin while serotype 19A has high invasive tendency. Age of patients was an important factor underlying the pneumococcal serotypes (p = 0.03) and clinical sites of infections (p<0.001). High prevalence of pneumococcal isolates were detected among children <5 years old at nasopharyngeal sites while elderly adults ≥60 years old were at increased risk for pneumococcal bacteremia.

Conclusion/Significance

Current study revealed that a number of serotypes, especially those associated with high penicillin resistance, have been formulated in the PCV7. Therefore, the protections expected from the routine use of PCV7 would be encouraging for the Malaysian. However, it is not possible to predict serotypes that might become predominant in the future and hence continued surveillance of circulating serotypes will be needed.     

A functional genomic analysis of type 3 Streptococcus pneumoniae virulence

Streptococcus pneumoniae remains a serious cause of morbidity and mortality in humans, but relatively little is known about the molecular basis of its pathogenesis. We used signature-tagged mutagenesis together with an analysis of S. pneumoniae genome sequence to identify and characterize genes required for pathogenesis. A library of signature-tagged mutants was created by insertion-duplication mutagenesis, and 1786 strains were analysed for their inability to survive and replicate in murine models of pneumonia and bacteraemia. One hundred and eighty-six mutant strains were identified as attenuated, and 56 were selected for further genetic characterization based on their ability to excise the integrated plasmid spontaneously. The genomic DNA inserts of the plasmids were cloned in Escherichia coli and sequenced. These sequences were subjected to database searches, including the S. pneumoniae genome sequence, which allowed us to examine the chromosomal regions flanking these genes. Most of the insertions were in probable operons, but no pathogenicity islands were found. Forty-two novel virulence loci were identified. Five strains mutated in genes involved in gene regulation, cation transport or stress tolerance were shown to be highly attenuated when tested individually in a murine respiratory tract infection model. Additional experiments also suggest that induction of competence for genetic transformation has a role in virulence.     

Virulence of Streptococcus pneumoniae serotype 6C in experimental otitis media

Increases in colonization with serotypes of Streptococcus pneumoniae not contained within the 7-valent pneumococcal conjugate vaccine (PCV) have been reported among children following introduction. Serotype 6C has emerged as prevalent in nasopharyngeal colonization and acute otitis media (AOM), though it is uncommonly recovered from children with invasive pneumococcal disease. Vaccine serotypes within PCV7 have been replaced by nonvaccine serotypes without significant changes in the overall carriage rate. We hypothesize 1) that serotypes vary in their ability to evade host defenses and establish AOM following colonization and 2) the observed reduction in pneumococcal otitis results from a reduced disease potential by some ‘replacement serotypes’. We compared the capacity of S. pneumoniae serotypes 6C and 19A to produce experimental otitis media (EOM) in a chinchilla model. The proportion of chinchillas that developed culture positive EOM and density of middle ear infection was evaluated. EOM was found in 28/82 (34%) ears challenged with 6C compared to 13/18(72.2%) with 19A [p = 0.0003]. When disease due to 6C did occur, it was characterized by low-density infection. Our findings demonstrate that challenge with serotype 6C results in EOM less frequently than 19A. These data support the need for greater knowledge regarding differences among serotypes to produce AOM.     

Purification of capsular polysaccharide produced by Streptococcus pneumoniae serotype 19A

Streptococcus pneumoniae is a major cause of invasive infection in young infants and older adults. There are currently 90 capsular serotypes identified and 23 serotypes (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F) are responsible for about 90% of invasive disease. Among the more than 90 different S. pneumoniae serotypes, serotype 19A is globally very prevalent. A simplified purification procedure including adjustment of cell lysate pH to 4.5, fractionation with 50- 80% ethanol, and dialysis rendered capsular polysaccharide (CPS) in a yield of 31.32 +/- 3.11 mg from 1 l culture (75% recovery after lyses). The product contained only 69.6 microng of protein (99.78% purity) and 0.8 mg (sum of the precipitants from 50~60%, 60~70%, and 70~80%) of nucleic acid (97.45% purity). The purified CPS was conjugated with bovine serum albumin; the product size ranged from 100 to 180 kDa.     

2型猪链球菌新毒力因子PlcR的发现

<正>2型猪链球菌(SS2)是一种重要的人畜共患传染病病原体。SS2感染不仅可致猪急性败血症、脑膜炎、关节炎、心内膜炎及急性死亡,并且可通过伤口和呼吸道等传播途径,导致人的感染发病和死亡。1998年和2005年在我国江苏"苏中"地区和四川资阳等市县人群中曾先后两次暴发大规模SS2感染人的事件。人感染病例中出现了从未报道过的链球菌中毒性休克综合征(Streptococcal toxic shock syndrome,STSS),病死率高达80%以上,已成为重要的新发传染病病原体[1-4]。     

Blood group antigen recognition by a Streptococcus pneumoniae virulence factor

The Streptococcus pneumoniae fucose utilization operon includes a gene encoding a virulence factor that belongs to family 98 in the glycoside hydrolase classification. This protein contains a C-terminal triplet of fucose binding modules that have significant amino acid sequence identity with the Anguilla anguilla fucolectin. Functional studies of these fucose binding modules reveal binding to fucosylated oligosaccharides and suggest the importance of multivalent binding. The high resolution crystal structures of ligand bound forms of one fucose binding module uncovers the molecular basis of fucose, ABH blood group antigen, and Lewisy antigen binding. These studies are extended by fluorescence microscopy to show specific binding to mouse lung tissue. These modules define a new family of carbohydrate binding modules now classified as family 47.     

Genetic identification of exported proteins in Streptococcus pneumoniae

A strategy was developed to mutate and genetically identify exported proteins in Streptococcus pneumoniae. Vectors were created and used to screen pneumococcal DNA in Escherichia coli and S. pneumoniae for translational gene fusions to alkaline phosphatase (PhoA), Twenty five PhoA⁺ pneumococcal mutants were isolated and the loci from eight of these mutants showed similarity to known exported or membrane-associated proteins. Homologues were found to: (i) protein-dependent peptide permeases, (ii) penicillin-binding proteins, (iii) Cip proteases, (iv) two-component sensor regulators, (v) the phospho-enolpyruvate:carbohydrate phosphotransferase permeases, (vi) membrane-associated dehydrogenases, (vii) P-type (E₁E₂-type) cation transport ATPases, (viii) ABC transporters responsible for the translocation of the RTX class of bacterial toxins. Unexpectedly one PhoA⁺ mutant contained a fusion to a member of the DEAD protein family of ATP-dependent RNA helicases suggesting export of these proteins.     

假想的脂蛋白连接酶对肺炎链球菌毒力的影响

【目的】探索假想脂蛋白连接酶(putative lipoate-protein ligase,LPL)对肺炎链球菌毒力的影响。【方法】采用长臂同源多聚酶链式反应(LFH-PCR)的方法失活lpl基因,通过PCR、测序鉴定缺陷菌株,采用细胞实验比较缺陷菌和野生菌对宿主细胞的粘附能力,并通过动物实验观察lpl基因缺陷后菌株毒力的变化。【结果】小鼠毒力实验表明野生菌株和缺陷株半数致死时间均为12h,两者比较无统计学差异;缺陷菌在对宿主细胞的粘附能力明显高于野生菌株(P0.01);体外荚膜染色实验表明,野生菌和缺陷菌均有荚膜。【结论】实验结果提示lpl基因对细菌粘附宿主细胞有抑制作用,但不影响其腹腔感染小鼠的能力。     

Pyruvate oxidase, as a determinant of virulence in Streptococcus pneumoniae

Pneumococcus has been shown to bind to epithelial cells of the nasopharynx and lung, and to endothelial cells of the peripheral vasculature. To characterize bacterial elements required for attachment to these cell types, a library of genetically altered pneumococci with defects in exported proteins was screened for the loss of attachment to glycoconjugates representative of the nasopharyngeal cell receptor, type II lung cells (LC) and human endothelial cells (EC). A mutant was identified which showed a greater than 70% loss in the ability to attach to all cell types. This mutant also showed decreased adherence to the glycoconjugates containing the terminal sugar residues GalNAcβ1-3Gal, GalNAcβ1-4Gal and the carbohydrate GlcNAc, which are proposed components of the pneumococcal receptors specific to the surfaces of LC and EC. Analysis of the locus altered in this mutant revealed a gene, spxB, that encodes a member of the family of bacterial pyruvate oxidases which decarboxylates pyruvate to acetyl phosphate plus H₂O₂ and CO₂. This mutant produced decreased concentrations of H₂O₂ and failed to grow aerobically in a chemically defined medium, unless supplemented with acetate which presumably restores acetyl phosphate levels by the action of acetate kinase, further suggesting that spxB encodes a pyruvate oxidase. The addition of acetate to the growth medium restored the adherence properties of the mutant indicating a link between the enzyme and the expression of bacterial adhesins. A defect in spxB corresponded to impaired virulence of the mutant in vivo. Compared to the parent strain, an spxB mutant showed reduced virulence in animal models for nasopharyngeal colonization, pneumonia, and sepsis. We propose that a mutation in spxB leads to down-regulation of the multiple adhesive properties of pneumococcus which, in turn, may correlate to diminished virulence in vivo