Bacterial adherence to pharyngeal cells in smokers, nonsmokers, and chronic bronchitics.

Selective adherence to host mucosal surfaces is probably a requirement for colonization and infection by bacteria. Since pharyngeal colonization may be an important determinant in the pathogenesis of pneumonia, we studied the adherence of 10 different bacteria to pharyngeal cells obtained from nonsmokers, smokers, and chronic bronchitics. Various patterns of adherence among the different groups of subjects were found. Young healthy smokers had increased adherence of Streptococcus pneumoniae type I and, to a lesser extent, S. pneumoniae type III and Staphylococcus aureus when compared with nonsmokers. Middle-aged smokers with a long history of chronic bronchitis had significantly increased adherence only of untypable Haemophilus influenzae when compared with age-matched nonsmokers. The acquisition of pneumococcal pneumonia by smokers and the role of nontypable Haemophilus species in chronic bronchitis may be determined, in part, by bacterial adherence to pharyngeal cells.