Abstract

Two main patterns of gene expression of Streptococcus pneumoniae were observed during infection in the host by quantitative real time RT-PCR; one was characteristic of bacteria in blood and one of bacteria in tissue, such as brain and lung. Gene expression in blood was characterized by increased expression of pneumolysin, pspA and hrcA, while pneumococci in tissue infection showed increased expression of neuraminidases, metalloproteinases, oxidative stress and competence genes. In vitro situations with similar expression patterns were detected in liquid culture and in a newly developed pneumococcal model of biofilm respectively. The biofilm model was dependent on addition of synthetic competence stimulating peptide (CSP) and no biofilm was formed by CSP receptor mutants. As one of the differentially expressed gene sets in vivo were the competence genes, we exploited competence-specific tools to intervene on pneumococcal virulence during infection. Induction of the competence system by the quorum-sensing peptide, CSP, not only induced biofilm formation in vitro, but also increased virulence in pneumonia in vivo. In contrast, a mutant for the ComD receptor, which did not form biofilm, also showed reduced virulence in pneumonia. These results were opposite to those found in a bacteraemic sepsis model of infection, where the competence system was downregulated. When pneumococci in the different physiological states were used directly for challenge, sessile cells grown in a biofilm were more effective in inducing meningitis and pneumonia, while planktonic cells from liquid culture were more effective in inducing sepsis. Our data enable us, using in vivo gene expression and in vivo modulation of virulence, to postulate the distinction – from the pneumococcal point of view – between two main types of disease. During bacteraemic sepsis pneumococci resemble planktonic growth, while during tissue infection, such as pneumonia or meningitis, pneumococci are in a biofilm-like state.

Highlights

  • Streptococcus pneumoniae is the main cause of community-acquired pneumonia and meningitis in children and the elderly and of septicaemia in HIV-infected individuals

  • Two main patterns of gene expression of Streptococcus pneumoniae were observed during infection in the host by quantitative real time RT-PCR; one was characteristic of bacteria in blood and one of bacteria in tissue, such as brain and lung

  • Gene expression in blood was characterized by increased expression of pneumolysin, pspA and hrcA, while pneumococci in tissue infection showed increased expression of neuraminidases, metalloproteinases, oxidative stress and competence genes

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Summary

Introduction

Streptococcus pneumoniae is the main cause of community-acquired pneumonia and meningitis in children and the elderly and of septicaemia in HIV-infected individuals. It is one of the principal causes of otitis media. In places with high HIV positivity, there is a significant increase in the rate of pneumococcal bacteraemia and the increase is most marked in young adults (Karstaedt et al, 2001). In addition to these more classical situations, pneumococci are reported in a variety of other diseases, including arthritis, osteomyelitis, endocarditis, endophthalmitis, abscesses, necrotizing fasciitis, and sinusitis. Unsolved issues include (i) the mechanism of shifting from a colonizer organism to an invader, (ii) the mechanism of translocation across the blood–brain barrier to cause meningitis, (iii) the difference between sepsis with a primary focus of disease and sepsis without focal disease and (iv) differences in bacterial behaviour during the diverse clinical diseases

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