The respiratory tract microflora and disease

  • Jean O. Kim
  • Jeffrey N. Weiser
Chapter

Abstract

The human respiratory tract harbors hundreds of different bacterial species. The purpose of the following chapter is to review some of the bacterial and host factors that contribute to the normal microflora and the infections that originate in this site. There is generally a peaceful state of coexistence between humans and the multitude of organisms that occupy the mucosal surfaces of the upper respiratory tract. Many bacterial species appear to be highly adapted to colonize this site, and in many cases humans are their only natural host. These are considered to be commensal organisms because in the absence of underlying mucosal damage or immunological dysfunction they live in the upper respiratory tract without causing disease. Several of these species are also common etiologic agents of disease both within the respiratory tract and at more distant host sites following hematogenous dissemination. The respiratory tract is also a common point of entry for many strict pathogens such as Mycobacterium tuberculosis and Streptococcus pyogenes (group A beta-hemolytic streptococcus) whose presence usually correlates with disease. These organisms are not a part of the normal microflora and will not be discussed in this chapter. Three species, Streptococcus pneumoniae (the pneumococcus), Haemophilus influenzae and Neisseria meningitidis (the meningococcus) will be reviewed in detail. These have been selected because they are members of the normal microflora as well as being etiologic agents of common respiratory tract and disseminated infections. Many of the host and bacterial factors involved in the diseases caused by these organisms are understood and will be reviewed.

Keywords

Respiratory Tract Otitis Medium Bacterial Meningitis Streptococcus Pneumoniae Neisseria Gonorrhoeae 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Andersson, B., Dahmen, J. et al (1983) Identification of an active disaccharide unit of a glycoconjugate receptor for pneumococci attaching to human pharyngeal epithelial cells. Journal of Experimental Medicine, 158, 559–570.PubMedCrossRefGoogle Scholar
  2. Austrian, R. (1986) Some aspects of the pneumococcal carrier state. Journal of Antimicrobial Chemotherapy, 18 (Suppl. A), 35–45.PubMedGoogle Scholar
  3. Austrian, R. (1994) Confronting drug-resistant pneumococci. Annals of Internal Medicine, 121, 807–809.PubMedGoogle Scholar
  4. Barenkamp, S. J. and St Geme, J. W. (1996) Identification of a second family of high-molecular weight adhesion proteins expressed by non-typable Haemophilus influenzae. Molecular Microbiology, 19 (6), 1215–1223.CrossRefGoogle Scholar
  5. Berry, A. M., Yother, J. et al (1989) Reduced virulence of a defined pneumolysinnegative mutant of Streptococcus pneumoniae. Infection and Immunity, 57(7), 20372042.Google Scholar
  6. Broud D. D., Griffiss, J. M. and Baker C. J. (1979) Heterogeneity of serotypes of Neisseria meningitidis that cause endemic disease. Journal of Infectious Diseases, 140, 465–470.PubMedCrossRefGoogle Scholar
  7. Butler, J. C. et a/.(1993) Pneumococcal polysaccharide vaccine efficacy. Journal of the American Medical Association,270(15), 1826–1831.Google Scholar
  8. Cooperstock, M. (1992) Indigenous flora in host economy and pathogenesis, in Textbook of Pediatric Infectious Diseases, 3rd edn, (eds R. D. Feigin and J. D. Cherry ), W. B. Saunders, Philadelphia, PA, vol. 1, pp. 91–119.Google Scholar
  9. Cundell, D. R., Gerard, N. P. et al (1995) Streptococcus pneumoniae anchor to activated human cells by the receptor for platelet-activating factor. Nature, 377, 435–438.Google Scholar
  10. Densen, P. (1991) Complement deficiencies and meningococcal disease. Clinical and Experimental Immunology, 86 (Suppl. 1), 57–62.PubMedGoogle Scholar
  11. Diamond, G., Zasloff, M. et al (1991) Tracheal antimicrobial peptide, a cysteinerich peptide from mammalian tracheal mucosa: peptide isolation and cloning of a cDNA. Proceedings of the National Academy of Sciences of the USA, 88, 3952–3956.PubMedCrossRefGoogle Scholar
  12. Fischer, W., Behr, T. et al (1993) Teichoic acid and lipoteichoic acid of Streptococcus pneumoniae possess identical structures: investigation of teichoic acid (C polysaccharide). Biochemistry, 215, 851–857.Google Scholar
  13. Fleischmann, R. D. et al (1995) Whole-genome random sequencing and assembly of Haemophilus influenzae Rd. Science, 269, 497–512.CrossRefGoogle Scholar
  14. Geelen, S., Bhattacharyya, C. et al (1993) The cell wall mediates pneumococcal attachment to and cytopathology in human endothelial cells. Infection and Immunity, 61 (4), 1538–1543.PubMedGoogle Scholar
  15. Goldschneider I., Gotschlich, E. C. and Artenstein, M. S. (1969) Human immunity to the meningococcus. I. The role of the humoral antibody. Journal of Experimental Medicine, 129, 1307–1326.PubMedCrossRefGoogle Scholar
  16. Gotschlich, E. C. (1994) Genetic locus for the biosynthesis of the variable portion of Neisseria gonorrhoeae lipooligosaccharide. Journal of Experimental Medicine, 180, 2181–2190.PubMedCrossRefGoogle Scholar
  17. Gwaltney, J. (1996) Acute community-acquired sinusitis. Clinical Infectious Diseases, 23, 1209–1225.PubMedCrossRefGoogle Scholar
  18. Hood, D. W., Deadman, M. E. et al (1996) DNA repeats identify novel virulence genes in Haemophilus influenzae. Proceedings of the National Academy of Sciences of the USA, 93, 11121–11125.CrossRefGoogle Scholar
  19. Horowitz, J., Volanakis, J. E. et al (1987) Blood clearance of Streptococcus pneumoniae by C-reactive protein. Journal of Immunology, 138 (8), 2598–2603.Google Scholar
  20. Klein, J. O. (1994) Otitis media. Clinical Infectious Diseases, 19, 823–833.Google Scholar
  21. Koomey, J. M. and Falkow, S. S. (1984) Nucleotide sequence homology between the immunoglobulin Al protease genes of Neisseria gonorrhoeae, N. meningitides and Haemophilus influenzae. Infection and Immunity, 43, 101–107.Google Scholar
  22. Mandrell, R. E., Kim, J. J. et al (1991) Endogenous sialylation of the lipooligosaccharides of Neisseria meningitidis. Journal of Bacteriology, 173, 2823–2832.Google Scholar
  23. Moxon, E. R. and Wilson, R. (1991) The role of Haemophilus influenzae in the pathogenesis of pneumonia. Reviews in Infectious Diseases, 13 (6), S518 — S527.CrossRefGoogle Scholar
  24. Plaut, A. G. (1983) The IgA1 proteases of pathogenic bacteria. Annual Review of Microbiology, 37, 603–622.PubMedCrossRefGoogle Scholar
  25. Rice, P. A., Vayo, H. E., Tam, M. R. and Blake, M. S. (1986) Immunoglobulin G antibodies directed against protein III block killing of serum resistant Neisseria gonorrhoeae by immune sera. Journal of Experimental Medicine, 164, 1735–1748.PubMedCrossRefGoogle Scholar
  26. Rosenow, C., Ryan, P. et al (1997) Contribution of novel choline-binding proteins to adherence, colonization and immunogenicity of Streptococcus pneumoniae. Molecular Microbiology, 25, 819–829.CrossRefGoogle Scholar
  27. Tomasz, A. (1981) Surface components of Streptococcus pneumoniae. Reviews of Infectious Diseases, 3 (2), 190–210.CrossRefGoogle Scholar
  28. Tomasz, A. (1995) Pneumococcus at the gates. New England Journal of Medicine, 333 (8), 514–515.PubMedCrossRefGoogle Scholar
  29. Tramont, E. C. and Hoover, D. L. (1995) Host defense mechanisms, in Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases, 4th edn, (eds G. L. Mandell, J. E. Bennett and R. Dolin ), Churchill Livingstone, New York, vol. 1, pp. 30–35.Google Scholar
  30. Tuomanen, E. I., Austrian, R. et al (1995) Pathogenesis of pneumococcal infection. New England Journal of Medicine, 332, 1280–1284.PubMedCrossRefGoogle Scholar
  31. van Dam, J. E. G., Fleer, A. et al (1990) Immunogenicity and immunochemistry of Streptococcus pneumoniae capsular polysaccharides. Antonie van Leeuwenhoek, 58, 1–47.PubMedCrossRefGoogle Scholar
  32. van Ham, S. M., van Alphen, L. et al (1993) Phase variation of H. influenzae fimbriae: transcriptional control of two different genes through a variable combined promoter region. Cell, 73, 1187–1196.PubMedCrossRefGoogle Scholar
  33. Virji, M., Saunders, J. R. et al (1993) Pilus-facilitated adherence of Neisseria meningitidis to human epithelial and endothelial cells: modulation of adherence phenotype occurs concurrently with changes in primary amino acid sequence and the glycosylation status of pilin. Molecular Microbiology, 10 (5), 1013–1028.PubMedCrossRefGoogle Scholar
  34. Virji, M., Watt, S., Barker, S. et al (1996) The N-domain of the human CD66a adhesion molecule is a target for Opa proteins of Neisseria meningitidis and Neisseria gonorrhoeae. Molecular Microbiology, 22 (5), 929–939.CrossRefGoogle Scholar
  35. Wani, J., Gilbert, J. et al (1996) Identification, cloning and sequencing of the immunoglobulin Al protease gene of Streptococcus pneumoniae. Infection and Immunity, 64, 3967–3974.Google Scholar
  36. Weiser, J. N. (1993) The oligosaccharide of Haemophilus influenzae. Microbial Pathogenesis, 13, 335–342.CrossRefGoogle Scholar
  37. Weiser, J. N., Love, J. M. et al (1989) The molecular mechanism of phase variation of H. influenzae lipopolysaccharide. Cell, 59, 657–665.PubMedCrossRefGoogle Scholar
  38. Weiser, J. N., Austrian, R. et al (1994) Phase variation in pneumococcal opacity: relationship between colonial morphology and nasopharyngeal colonization. Infection and Immunity, 62 (6), 2582–2589.PubMedGoogle Scholar
  39. Youmans, G. (1986) Host—bacteria interactions: external defense mechanisms, in The Biological and Clinical Basis of Infectious Diseases, 3rd edn, W. B. Saunders, Philadelphia, PA. pp. 8–17.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1999

Authors and Affiliations

  • Jean O. Kim
  • Jeffrey N. Weiser

There are no affiliations available

Personalised recommendations