References 1. Rudan I, Boschi-Pinto C, Mulholland K, Campbell H: Epidemiology and ethiology of childhood pneumoniae. Bull World Health Organ 2008, 86:408–416.PubMedCrossRef 2. Gray BM, Converse GM, Dillon HCJ: Epidemiologic studies of Streptococcus pneumoniae in infants: acquisition, carriage, and infection during the first 24 months of life. J Infect Dis 1980, 142:923–933.PubMedCrossRef

3. Hogberg L, Geli P, Ringberg H, Melander E, Lipsitch M, Ekdahl K: Age- and serogroup-related differences in observed durations of nasopharyngeal carriage of penicillin-resistant pneumococci. J Clin Microbiol 2007, 45:948–952.PubMedCrossRef 4. Hall-Stoodley L, Hu FZ, Gieseke A, Nistico L, Nguyen D, Hayes J, et al.: Direct detection of bacterial biofilms on the middle-ear mucosa of children with chronic otitis media. JAMA 2006, 296:202–211.PubMedCrossRef 5. Sanderson AR, Leid JG, Hunsaker D: 26s Proteasome structure Bacterial biofilms on the sinus mucosa of human subjects with chronic rhinosinusitis. Laryngoscope 2006, 116:1121–1126.PubMedCrossRef 6. Hoa M, Tomovic S, Nistico L, Hall-Stoodley L, Stoodley P, Sachdeva L, et al.: Identification of adenoid biofilms with middle ear pathogens in otitis-prone children utilizing SEM this website and FISH. International Journal of Pediatric Otorinolaryngology 2009, 73:1242–1248.CrossRef 7. Sanchez CJ, Shivshankar P, Stol K, Trakhtenbroit S, Sullam LM, Sauer K,

et al.: The pneumococcal serine-rich repeat protein is an intra-species bacterial adhesin that promotes bacterial aggregation in vivo and in biofilms. PloS Pathog 2010, 6:e1001044.PubMedCrossRef 8. Oggioni MR, Trappetti C, Kadioglu A, Cassone M, Iannelli F, Ricci S, et al.: Switch

from planktonic to sessile life: a major event in pneumococcal pathogenesis. Mol Microbiol 2006, 61:1196–1210.PubMedCrossRef 9. Munoz-Elias E, Marcaro J, Camilli A: Isolation of Streptococcus pneumoniae biofilm mutans and their characterization durin nasopharyngeal colonization. Infect Immun 2008, 76:5049–5061.PubMedCrossRef 10. Trappetti C, Kadioglu A, Carter M, Athwal J, Iannelli F, Pozzi G, et al.: Sialic acid: a preventable signal for pneumococcal biofilm, colonisation and invasion of the host. J Infect Dis 2009, 199:1497–1505.PubMedCrossRef 11. Hoa M, Syamal M, Sachdeva L, Berk R, Coticchia much J: Demostration of Nasopharyngeal and middle ear mucosal biofilms in an animal model of acute otitis media. Ann Otol Rhinol Laryngol 2009,118(4):292–298.PubMed 12. Reid SD, Hong W, Dew KE, Winn DR, Pang B, Watt J, et al.: Streptoccocus pneumoniae forms surface-attached communities in the middle ear of experimentally infected VX-689 molecular weight chinchillas. J Infect Dis 2009, 199:786–794.PubMedCrossRef 13. Trappetti C, Ogunniyi AD, Oggioni MR, Paton JC: Extracellular matrix fromation enhances the ability of Streptococcus pneumoniae to form biofilm. PLoS ONE 2011, in press. 14. Oggioni MR, Iannelli F, Ricci S, Chiavolini D, Parigi R, Trappetti C, et al.