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They can form part of the resident upper airway microbiota, but under certain environmental circumstances become pathogenic and induce disease. In children, both organisms have a considerable impact on the healthcare system, commonly causing acute otitis media and pneumonia. They are also associated with chronic biofilm\u2010mediated respiratory infections, such as persistent middle ear effusions and chronic suppurative otitis media, and in the lower airways with protracted bacterial bronchitis and bronchiectasis. Consequently, both organisms are responsible for large numbers of antibiotic prescriptions and substantial healthcare costs. The complex relationship between NTHi and pneumococcal co\u2010interaction during colonization, infection and biofilm formation is poorly understood and a greater understanding is needed to facilitate development of future therapies, and novel interventions and prevention strategies. Co\u2010infections with both bacteria can result in more severe disease, with disease severity likely mediated by their ability to cooperate in some in vivo niches. However, this relationship is not always straightforward, as under certain conditions, these two bacteria compete rather than cooperate. Current opinion supports developing a vaccine targeting NTHi strains, as well as a combined vaccine targeting both NTHi and pneumococci to decrease the respiratory disease burden in young children. This review summarizes our current knowledge of the interactions between NTHi and pneumococci and speculates on the future directions of research to understand how these bacteria co\u2010exist and how to better prevent and treat NTHi and pneumococcal infection.\n                  <\/jats:p>","DOI":"10.1002\/ppul.27318","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T08:15:04Z","timestamp":1728634504000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["<i>Haemophilus influenzae<\/i>\n                    and pneumococci: Co\u2010colonization, interactions, cooperation and competition"],"prefix":"10.1002","volume":"60","author":[{"given":"Finn","family":"McMahon","sequence":"first","affiliation":[{"name":"Institute for Biomedicine and Glycomics Griffith University Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Ware","sequence":"additional","affiliation":[{"name":"Health Group Griffith University Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Grimwood","sequence":"additional","affiliation":[{"name":"School of Medicine and Dentistry Griffith University Gold Coast Queensland Australia"},{"name":"NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Child Health Division, Menzies School of Health Research Charles Darwin University Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7994-6995","authenticated-orcid":false,"given":"John M.","family":"Atack","sequence":"additional","affiliation":[{"name":"Institute for Biomedicine and Glycomics Griffith University Gold Coast Queensland Australia"},{"name":"School of Environment and Science Griffith University Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)02185-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.63"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1405870"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30721-4"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41479-017-0033-2"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-063039"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad054"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12710"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00259-9"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23952"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(21)00300-1"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0036226"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24190"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2018.10.060"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(24)00176-2"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2725"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.13950"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2023.06.040"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000001112"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02724-0"},{"issue":"9","key":"e_1_2_8_22_1","article-title":"The return of Pfeiffer's bacillus: rising incidence of ampicillin resistance in Haemophilus influenzae","volume":"4","author":"Heinz E","year":"2018","journal-title":"Microb Genom"},{"key":"e_1_2_8_23_1","unstructured":"Centers for Disease Control and Prevention. 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