Molecular determinants of the pathogenesis of disease due to non-typable Haemophilus influenzae

Non-typable Haemophilus influenzae is a common commensal organism in the hu man upper respiratory tract and an important cause of localized respiratory tract disease. The pathogenesis of disease begins with bacterial colonizat ion of the nasopharynx, a process that involves establishment on the mucosa l surface and evasion of local immune mechanisms. Under the proper circumst ances, the organism spreads contiguously to the middle ear, the sinuses, or the lungs, and then stimulates a brisk inflammatory response, producing sy mptomatic infection. In this review, we summarize our present understanding of the molecular determinants of this sequence of events. Continued invest igation of the molecular mechanism of non-typable H. influenzae pathogenici ty should facilitate development of novel approaches to the treatment and p revention of H. influenzae disease. (C) 1999 Federation of European Microbi ological Societies. Published by Elsevier Science B.V. All rights reserved.