Haemophilus influenzae is an obligate human pathogen that persistently colonizes the nasopharynx and causes disease when it invades the bloodstream, lungs, or middle ear. Proteins that mediate critical interactions with the host during invasive disease are likely to be secreted. Many secreted proteins require addition of disulfide bonds by the DsbA disulfide oxidoreductase for activity or stability. In this study, we evaluated the role in H. influenzae pathogenesis of DsbA, as well as HbpA, a substrate of DsbA. Mutants of H. influenzae Rd and type b strain Eagan having nonpolar deletions of dsbA were attenuated for bacteremia in animal models, and complemented strains exhibited virulence equivalent to that of the parental strains. Comparison of predicted secreted proteins in H. influenzae to known DsbA substrates in other species revealed several proteins that could contribute to the role of dsbA in virulence. One candidate, the heme transport protein, HbpA, was examined because of the importance of exogenous heme for aerobic growth of H. influenzae. The presence of a dsbA-dependent disulfide bond in HbpA was verified by an alkylation protection assay, and HbpA was less abundant in a dsbA mutant. The hbpA mutant exhibited reduced bacteremia in the mouse model, and complementation restored its in vivo phenotype to that of the parental strain. These results indicate that dsbA is required in vivo and that HbpA and additional DsbA-dependent factors are likely to participate in H. influenzae pathogenesis.Haemophilus influenzae efficiently colonizes the human nasopharyngeal mucosa in a primarily asymptomatic manner, and the carriage frequency is ϳ80% in healthy adults (48). However, it can disseminate to other anatomical sites and cause otitis media, upper and lower respiratory tract infections, septicemia, and meningitis in children (13,22,37,44,(48)(49)(50)63). The incidence of H. influenzae meningitis has dramatically declined in populations immunized with a vaccine against the type b capsular polysaccharide. The vaccine has not affected the incidence of infection with nontypeable H. influenzae (NTHi) strains, which lack the capsule. NTHi strains predominantly cause respiratory tract infections and otitis media but in rare cases can invade the bloodstream, leading to meningitis. This disease profile raises the possibility that genes promoting intravascular invasion could be present in NTHi strains (15,18,53,54). However, the molecular basis for the invasive properties of H. influenzae that promote transmission from the nasopharynx to the bloodstream or middle ear is not fully understood.Secreted bacterial proteins mediate critical aspects of pathogenesis, including attachment, nutrient utilization, and subversion of host defenses. Many secreted proteins of gram-negative bacteria acquire disulfide bonds in the periplasm that stabilize their mature, folded structures (9). Formation of such linkages has been most extensively studied in Escherichia coli, in which a series of disulfide oxidoreductases (Dsb) create and e...