Description of the Pathogenic Features of Streptococcus pyogenes Isolates from Invasive and Non-Invasive Diseases in

Masakado Matsumoto1, Kazuhiro Yamada, Masahiro Suzuki

  • 1Department of Microbiology and Medical Zoology, Aichi Prefectural Institute of Public Health.

Insights

Hypervirulent Streptococcus pyogenes strains, particularly emm1 genotype, were identified in Aichi, Japan, potentially explaining the 2011 rise in streptococcal toxic shock syndrome (STSS). These strains possess specific genetic mutations affecting virulence factor production.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genetics

Background:

  • Streptococcal toxic shock syndrome (STSS) prevalence increased suddenly in Aichi Prefecture, Japan, during 2011.
  • Understanding the microbial factors driving this increase is crucial for public health.
  • Streptococcus pyogenes is a significant human pathogen responsible for various infections.

Purpose of the Study:

  • To investigate the characteristics of Streptococcus pyogenes isolates from invasive and non-invasive diseases in Aichi Prefecture between 2003 and 2012.
  • To determine if specific hypervirulent strains of Streptococcus pyogenes contributed to the observed increase in STSS.
  • To elucidate the genetic and phenotypic traits of these potentially hypervirulent strains.

Main Methods:

  • Identification and characterization of Streptococcus pyogenes isolates from patient samples.
  • Genotyping of isolates, focusing on the emm genotype and mutations in covR/S genes.
  • Analysis of virulence factor gene expression and protein production, including streptococcal exotoxin B, streptococcal exotoxin A, streptococcal DNase, NAD-glycohydrolase, and streptolysin O.

Main Results:

  • Hypervirulent Streptococcus pyogenes strains, predominantly emm1 genotype, were identified in both invasive (27 isolates) and non-invasive (420 isolates) disease cases.
  • These hypervirulent strains exhibited mutations in covR/S genes, leading to the absence of streptococcal exotoxin B and production of key virulence factors (streptococcal exotoxin A, streptococcal DNase, NAD-glycohydrolase, streptolysin O).
  • Hypervirulent-like strains lacking the sda1 gene and a non-emm1 strain with similar phenotypic and genetic traits to hypervirulent emm1 strains were also identified, particularly in 2011.

Conclusions:

  • Hypervirulent and hypervirulent-like Streptococcus pyogenes strains likely played a role in the 2011 surge of STSS in Aichi.
  • The genetic makeup of these strains, including covR/S mutations and specific virulence factor production, contributes to their hypervirulence.
  • These findings highlight the importance of molecular surveillance for understanding and controlling outbreaks of invasive streptococcal diseases.

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