In vitro biofilm formation by Streptococcus pneumoniae as a predictor of post-vaccination emerging serotypes colonizing the human nasopharynx

The increasing use of the 7-valent pneumococcal conjugate vaccine has been accompanied by the rise of non-vaccine serotypes colonizing the human nasopharynx. The vast majority of infections are caused by microorganisms that grow in biofilms. It has recently been shown that the formation of Streptococcus pneumoniae biofilms in vivo and in vitro is hindered by the presence of capsular polysaccharide. The biofilm-forming capacity of pneumococcal clinical isolates with different types of capsular polysaccharide and various isogenic transformants was examined. Strains of serotypes 19A and 19F, but not 19B and 19C, formed >= 80% of the quantity of biofilm associated with a non-encapsulated control strain. Strains of serogroup 6 also showed significant biofilm-forming capacity. The capsules of serotypes 19A and 19F, and serogroup 6 contain the disaccharides alpha-D-Glcp-(1 -> 2)-alpha-L-Rhap-(1 -> and alpha-D-Glcp-(1 -> 3)-alpha-L-Rhap-(1 ->. Serotype 18A and serotypes 18B/18C have very similar capsular disaccharides: alpha-D-GlcpNAc-(1 -> 3)-beta-L-Rhap-(1 -> and alpha-D-Glcp-(1 -> 3)-beta-L-Rhap-(1 -> respectively. However, the strains of serogroup 18 showed impaired biofilm formation. These results indicate that the chemical composition/structure of the capsular polysaccharide is crucial to the biofilm-forming capacity of pneumococcal serotypes. Testing of the in vitro biofilm-forming ability of isogenic transformants expressing different capsular polysaccharides may help predict the emergence of colonizing, non-vaccine serotypes.