Nontypeable Haemophilus influenzae (NTHI) has four loci, lic-1 to lic-3 and lgtC, that generate phase-variable lipooligosaccharide (LOS) structures. lic-1, which is required for the expression of phosphorylcholine (ChoP), is the best characterized and is associated with an enhanced ability of H. influenzae to persist within the nasopharynges of infant rats. Recent data indicate that LOS impacts various aspects of NTHI virulence in the chinchilla model of nasopharyngeal colonization and otitis media (OM). In this study the effects of ChoP expression and the sequences of lic-1 to lic-3 and lgtC of NTHI strain 2019 were evaluated in the chinchilla OM model. Nasopharyngeal colonization data showed that a switch from the ChoP ؊ to the ChoP ؉ phenotype was observed as early as day 3 after intranasal inoculation. Chinchillas colonized by strains with the ChoP Otitis media (OM) or inflammation of the middle ear (ME), in one of its various clinical forms, is one of the most common childhood diseases. Nontypeable Haemophilus influenzae (NTHI) is a major OM pathogen and accounts for 25 to 30% of all cases of this disease. The initial event in the pathogenesis of NTHI OM is the colonization of the host mucosal surface; however, the bacterial factors that contribute to the colonization of the nasopharynx, retrograde ascension of the eustachian tube, and invasion of the ME during the natural progression of the disease are not well characterized. NTHI cells are frequently isolated from the upper respiratory tract, especially the nasopharynges of healthy children, with a reported rate of colonization of approximately 80% (8). Recent data suggested that there is a strong relationship between the frequency of colonization and the incidence of OM in children (5).NTHI lipooligosaccharide (LOS) is a major virulence determinant and may play a role in colonization and invasion of mucosal surfaces in the respiratory tract (3, 16, 23). NTHI LOS is analogous to the lipopolysaccharide (LPS) of enteric gramnegative bacteria in that it contains lipid A linked by 3-deoxy-D-manno-octulosonic acid to a heterogeneous sugar polymer (7). NTHI LOS, however, differs from classic enterobacterial LPS in that it does not contain repeating O-antigen units and is therefore more similar to that derived from Neisseria and Bordetella species (14). Moreover, H. influenzae cells demonstrate a propensity to alter or modulate their surface-expressed antigens including LOS (10, 12). NTHI cells express, on their outer surfaces, a number of LOS core oligosaccharide epitopes, and the expression of these epitopes is subject to frequent, reversible phase variation. Four chromosomal loci, lic-1 to lic-3 and lgtC, which contain long stretches of 4-bp tandem repeats within their 5Ј coding regions, have been reported to generate phase-variable LOS structures (9,11,19). lic-1 functions to add phosphorylcholine (ChoP) to the LOS molecule (22), lic-2 and lgtC are necessary for the expression of , and the effect of variation in lic-3 is unknown. Phase variation may represen...