title: Heterogeneity of pneumococcal phase variants in invasive human infections.
abstract: BACKGROUND
  Streptococcus pneumoniae can be carried asymptomatically in the nasopharynx of its human host but can also cause a wide range of infections. A role for pneumococcal phase variants in the different lifestyles of this bacterium has been suggested but no systematic survey of the colony phenotypes of isolates associated with human infections has been undertaken.
  
  
  RESULTS
  We report the colony opacity phenotypes of a genetically diverse set of 304 invasive isolates representing 10 serotypes. Over half of the isolates (52%) presented the opaque phenotype whereas transparent variants accounted for only 26% of the total. However, the frequency of recovery of each phase variant was not uniform, while serotypes 1, 4, 12B and 23F presented the opaque phenotype more frequently than expected by chance, serotypes 3 and 14 where less frequently associated with this phenotype.
  
  
  CONCLUSIONS
  The opaque phenotype was the most frequent phenotype found among invasive isolates. An unexpected and equally important finding is the variability of the dominant opacity phenotype found among serotypes. This observation highlights the heterogeneity of opacity phenotypes in invasive isolates and lends further support to the proposal that other factors, in addition to the site of isolation, determine the opacity phenotype of a given isolate. The association between serotype and colonial opacity could help explain epidemiological differences observed among pneumococcal serotypes such as a higher invasive disease potential.
authors.affiliation: Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Lisboa, Portugal. isaserrano@fm.ul.pt
authors.forename: I
authors.initials: I
authors.lastname: Serrano
authors.forename: J
authors.initials: J
authors.lastname: Melo-Cristino
authors.forename: M
authors.initials: M
authors.lastname: Ramirez
mesh_terms: D000818:Animals; D006801:Humans; D051379:Mice; D010641:Phenotype; D011008:Pneumococcal Infections / Q000382:microbiology*; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000166:cytology* / Q000235:genetics* / Q000472:pathogenicity