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Extensive genetic diversity among clinical isolates of Streptococcus pyogenes serotype M5

Meeta Desai1, Asha Tanna2, Androulla Efstratiou2

  • 1Molecular Biology Unit, Virus Reference Division.

Insights

Genetic diversity was high in Streptococcus pyogenes M5 clinical isolates, challenging homogeneous population assumptions. This finding impacts group A streptococcus epidemiology and vaccine development strategies.

Area of Science:

  • Microbiology
  • Genetics
  • Epidemiology

Background:

  • Streptococcus pyogenes (group A Streptococcus) is a significant human pathogen.
  • Serotyping, particularly M protein (emm) gene typing, is crucial for understanding GAS epidemiology.
  • Previous studies suggested homogeneity in certain serotypes, but M5 diversity was less understood.

Purpose of the Study:

  • To genetically characterize clinical isolates of Streptococcus pyogenes serotype M5.
  • To assess the genetic diversity within the M5 serotype using multiple molecular markers.
  • To evaluate the implications of observed genetic diversity on current classification schemes and vaccine development.

Main Methods:

  • Macrorestriction profiling using pulsed-field gel electrophoresis (PFGE).
  • 16S ribosomal RNA (16S rRNA) gene ribotyping.
  • emm gene subtyping via polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).
  • Insertion sequence (IS) element profiling (IS1239).
  • Exotoxin gene determinant analysis.
  • DNA sequencing of emm gene hypervariable regions.
  • Serological and hybridization studies.

Main Results:

  • Clinical isolates of M5 displayed significant genetic diversity, forming multiple strain clusters rather than a homogeneous population.
  • While a single IS1239 profile was common (85%), high diversity was observed in ribotype and macrorestriction profiles.
  • Eighteen different emm gene subtypes were detected, with 14 showing up to 6% sequence divergence in the hypervariable region.
  • Four emm gene amplicons exhibited highly divergent sequences, corresponding to previously identified emm types (emm6, emm11, emm18, emm77).
  • Discrepancies were noted between Lancefield serotype (M5) and emm genotype in some isolates.

Conclusions:

  • Serotype M5 of Streptococcus pyogenes is genetically diverse, contradicting assumptions of homogeneity.
  • The observed genetic heterogeneity has implications for the accuracy of the Lancefield serotyping scheme.
  • Understanding this diversity is critical for accurate epidemiology of group A streptococci.
  • The genetic variability necessitates careful consideration for developing effective M protein-based vaccines.

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