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While some capsular serotypes are more often found in invasive disease, high case fatality rates are associated with those serotypes more commonly found in asymptomatic colonization. We tested whether growth patterns and capsule size in human cerebrospinal fluid depends on serotype using a clinical isolate of<jats:italic>S. pneumoniae<\/jats:italic>and its capsule switch mutants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that the growth pattern differed markedly from that in culture medium by lacking the exponential and lysis phases. Growth in human cerebrospinal fluid was reduced when strains lost their capsules. When a capsule was present, growth was serotype-specific: high carriage serotypes (6B, 9\u2009V, 19F and 23F) grew better than low carriage serotypes (7F, 14, 15B\/C and 18C). Growth correlated with the case-fatality rates of serotypes reported in the literature. Capsule size in human cerebrospinal fluid also depended on serotype.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We propose that serotype-specific differences in disease severity observed in meningitis patients may, at least in part, be explained by differences in growth and capsule size in human cerebrospinal fluid. This information could be useful to guide future vaccine design.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12866-020-1700-7","type":"journal-article","created":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T15:02:43Z","timestamp":1579532563000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Pneumococcal serotype determines growth and capsule size in human cerebrospinal fluid"],"prefix":"10.1186","volume":"20","author":[{"given":"Annelies","family":"M\u00fcller","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anke","family":"Salmen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Aebi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"de Gouveia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"von Gottberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5361-5397","authenticated-orcid":false,"given":"Lucy J.","family":"Hathaway","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,1,20]]},"reference":[{"issue":"7","key":"1700_CR1","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1086\/423820","volume":"190","author":"AB Brueggemann","year":"2004","unstructured":"Brueggemann AB, Peto TE, Crook DW, Butler JC, Kristinsson KG, Spratt BG. 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