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Genetic Analysis of Diverse Disease-Causing Pneumococci Indicates High Levels of Diversity within Serotypes and Capsule Switching

Institute of Biomedical and Life Sciences, Division of Infection & Immunity, University of Glasgow,¹ Scottish Meningococcus and Pneumococcus Reference Laboratory, Stobhill Hospital,³ Infection & Immunity Group, Glasgow Dental School, Glasgow,² Department of Biological Sciences, University of Warwick, Coventry, United Kingdom⁴

Received 2 July 2004/ Returned for modification 20 August 2004/ Accepted 30 August 2004

We have used multilocus sequence typing (MLST) and serotyping to build a phylogenetic framework for pneumococcal disease isolates in Scotland that provides a snapshot of the relationships between capsular type and genotype. The results show that while the MLST type correlates with the serotype, isolates within a serotype can belong to a number of individual clonal complexes or sequence types (STs). We also show that isolates of the same ST can express different capsular polysaccharides, i.e., display capsular switching, and that this phenomenon is observed both for capsular types commonly isolated from patients with invasive disease and for serogroups less commonly isolated from patients with invasive disease but which may commonly be carried asymptomatically in the human nasopharynx.

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