Journal
ANNUAL REVIEW OF MICROBIOLOGY, VOL 69
Volume 69, Issue -, Pages 425-444Publisher
ANNUAL REVIEWS
DOI: 10.1146/annurev-micro-091014-104209
Keywords
nasopharynx; commensal; opportunistic pathogen; Streptococcus pneumoniae; inflammation
Categories
Funding
- NHLBI NIH HHS [F30 HL119030, HL119030] Funding Source: Medline
- NIAID NIH HHS [AI105168, R01 AI105168, AI038446, R01 AI038446, R37 AI038446] Funding Source: Medline
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Respiratory tract infections are an important cause of morbidity and mortality worldwide. Chief among these are infections involving the lower airways. The opportunistic bacterial pathogens responsible for most cases of pneumonia can cause a range of local and invasive infections. However, bacterial colonization (or carriage) in the upper airway is the prerequisite of all these infections. Successful colonizers must attach to the epithelial lining, grow on the nutrient-limited mucosal surface, evade the host immune response, and transmit to a susceptible host. Here, we review the molecular mechanisms underlying these conserved stages of carriage. We also examine how the demands of colonization influence progression to disease. A range of bacteria can colonize the upper airway; nevertheless, we focus on strategies shared by many respiratory tract opportunistic pathogens. Understanding colonization opens a window to the evolutionary pressures these pathogens face within their animal hosts and that have selected for attributes that contribute to virulence and pathogenesis.
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