Streptococcus pneumoniae is the leading infectious cause of death in children in the world. However, the mechanisms that drive the progression from asymptomatic colonization to disease are poorly understood. Two virulence-associated genomic accessory regions (ARs) were deleted in a highly virulent serotype 1 clinical isolate (strain 4496) and examined for their contribution to pathogenesis. Deletion of a prophage encoding a platelet-binding protein (PblB) resulted in reduced adherence, biofilm formation, reduced initial infection within the lungs, and a reduction in the number of circulating platelets in infected mice. However, the region's overall contribution to the survival of mice was not significant. In contrast, deletion of the variable region of pneumococcal pathogenicity island 1 (vPPI1) was also responsible for a reduction in adherence and biofilm formation but also reduced survival and invasion of the pleural cavity, blood, and lungs. While the 4496⌬PPI1 strain induced higher expression of the genes encoding interleukin-10 (IL-10) and CD11b in the lungs of challenged mice than the wild-type strain, very few other genes exhibited altered expression. Moreover, while the level of IL-10 protein was increased in the lungs of 4496⌬PPI1 mutant-infected mice compared to strain 4496-infected mice, the levels of gamma interferon (IFN-␥), CXCL10, CCL2, and CCL4 were not different in the two groups. However, the 4496⌬PPI1 mutant was found to be more susceptible than the wild type to phagocytic killing by a macrophage-like cell line. Therefore, our data suggest that vPPI1 may be a major contributing factor to the heightened virulence of certain serotype 1 strains, possibly by influencing resistance to phagocytic killing.
Streptococcus pneumoniae (the pneumococcus) is a significant cause of human morbidity and mortality and is a leading cause of pneumonia, bacteremia, meningitis, and otitis media (1). However, the mechanism by which the pathogen progresses from asymptomatic colonization to disease is poorly understood. Moreover, significant variations in virulence exist even between strains of the same serotype (2-5). For example, outbreaks of unusually severe invasive pneumococcal disease (IPD) caused by serotype 1 strains belonging to clonal lineage group B have been reported in parts of Africa (6, 7), while clustered cases of carriage without disease caused by serotype 1 strains belonging to clonal lineage A, which include the common clonal complex (CC) CC227, have been reported within Australia (8). Furthermore, disease caused by invasive lineage A strains has been reported to be of relatively low severity (9). These naturally occurring differences in virulence provide opportunities to investigate the molecular processes that drive progression to disease by comparing closely related invasive and noninvasive strains. In previous work, the pathogenesis of noninvasive and invasive serotype 1 clinical isolates was characterized in mice (10,11 CC615]), belonging to serotype 1 lineages B and C, respectively, were foun...