Nonencapsulated Streptococcus pneumoniae causes otitis media during single-species infection and during polymicrobial infection with nontypeable Haemophilus influenzae.
Nonencapsulated Streptococcus pneumoniae causes otitis media during single-species infection and during polymicrobial infection with nontypeable Haemophilus influenzae.
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DOI：
10.1093/femspd/ftu011
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发表时间：
2015-07
影响因子：
3.3
通讯作者：
Kyle A Murrah;B. Pang;S. Richardson;Antonia C. Perez;Jennifer L. Reimche;Lauren B. King;J. Wren;W. E. Swords
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文献类型：
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作者：
Kyle A Murrah;B. Pang;S. Richardson;Antonia C. Perez;Jennifer L. Reimche;Lauren B. King;J. Wren;W. E. Swords
在携带和疾病环境中越来越多地报道缺乏荚膜多糖的肺炎链球菌菌株。由于大多数中耳炎病例涉及不止一种细菌物种，我们的目的是确定非包膜肺炎链球菌临床分离株在单一物种感染和不可分型流感嗜血杆菌的多种微生物感染的情况下诱发疾病的能力。使用龙猫中耳炎模型，我们发现非包膜肺炎链球菌在鼻内接种后定植于鼻咽部，但不易上升到中耳。然而，当我们将非包膜肺炎链球菌直接接种到中耳时，细菌在接种后持续存在两周，并诱发与慢性中耳炎一致的症状。在与无法分型的流感嗜血杆菌共感染期间，两种物种均持续感染一周并诱发多种微生物中耳炎。我们还观察到，不可分型的流感嗜血杆菌在体外对多微生物生物膜内的肺炎链球菌提供了被动保护，使其免于被阿莫西林杀死。因此，根据这些结果，我们得出结论，非包膜肺炎球菌是慢性/复发性中耳炎的潜在病原体，并且还可能导致与其他机会菌的共生感染，这可能使治疗结果复杂化。
Streptococcus pneumoniae strains lacking capsular polysaccharide have been increasingly reported in carriage and disease contexts. Since most cases of otitis media involve more than one bacterial species, we aimed to determine the capacity of a nonencapsulated S. pneumoniae clinical isolate to induce disease in the context of a single-species infection and as a polymicrobial infection with nontypeable Haemophilus influenzae. Using the chinchilla model of otitis media, we found that nonencapsulated S. pneumoniae colonizes the nasopharynx following intranasal inoculation, but does not readily ascend into the middle ear. However, when we inoculated nonencapsulated S. pneumoniae directly into the middle ear, the bacteria persisted for two weeks post-inoculation and induced symptoms consistent with chronic otitis media. During coinfection with nontypeable H. influenzae, both species persisted for one week and induced polymicrobial otitis media. We also observed that nontypeable H. influenzae conferred passive protection from killing by amoxicillin upon S. pneumoniae from within polymicrobial biofilms in vitro. Therefore, based on these results, we conclude that nonencapsulated pneumococci are a potential causative agent of chronic/recurrent otitis media, and can also cause mutualistic infection with other opportunists, which could complicate treatment outcomes.