Abstract
Streptococcus pyogenes (group A streptococcus) is one of the most important bacterial pathogen in human. In light of recent reports suggesting global changes in the epidemiology of streptococcal infections, and given the increase in severe clinical manifestations of GAS infection, attention to GAS infections and its laboratory diagnosis is in the rise. This paper describes epidemiology of GAS infections, general characteristics of the pathogen, and virulence factors. Modern classification of beta-hemolytic streptococci and methods of isolation and identification of S. pyogenes are also described. Susceptibility testing and mechanisms of antimicrobial resistance are characterized.
-
1.
Brock T.D., editor. Milestones in microbiology: 1546 to 1940. ASM Press, 1999.
-
2.
Stevens D.L., Tanner M.H., Winship J. et al. Severe group A streptococcal infections associated with a toxic shocklike syndrome and scarlet fever toxin A. N Engl J Med 1989; 321:1-7.
-
3.
Stevens D.L. Group A bete-haemolytic streptococci: virulence factors, pathogenesis and spectrum of clinical infections. In: Stevens D.L., Kaplan E.L., editors. Streptococcal infections: clinical aspects, microbiology and molecular pathogenesis. Oxford university press; 2000.
-
4.
Ruoff K.L., Whiley R.A., Beighton D. Streptococcus. In: Murray P.R., Baron E.J., Jorgensen J.H., Pfaller M.A., Yolken R.H., editors. Manual of clinical microbiology. 8th ed. Washington: ASM press; 2003. p. 405-421.
-
5.
Peterson P.K., Schmeling D., Cleary P.P., et al. Inhibition of alternative complement pathway opsonization by group A Streptococcal M protein. J Infect Dis 1979; 139:575-85.
-
6.
Hanski E., Caparon M. Protein F, a fibronectin-binding protein, is an adhesin of the group A streptococcus Streptococcus pyogenes. Proc Natl Acad Sci USA 1992; 89:6172-6.
-
7.
Bisno A.L., Brito M.O., Collins C.M. Molecular basis of group A streptococcal virulence. Lancet Infect Dis 2003; 3:191-200.
-
8.
Lottcnberg R., Broder C.C., Boyle M.D. Identification of a specific receptor for plasmin on a group A streptococcus. Infect Immun 1987; 55:1914-28.
-
9.
Alouf J.E., Gcoffroy С. Structure activity relationships in sulfhydryl-activated toxins. In: Freer J.H., Jeljaszewicz J., eds. Bacterial Protein Toxins. London: Academic Press; 1984. p. 165-71.
-
10.
Stevens D.L., Salmi D.B., McIndoo E.R., Bryant A.E. Molecular epidemiology of nga and NAD glycohydrolase/ ADP-ribosyltransferase activity among Streptococcus pyogenes causing streptococcal toxic shock syndrome. J Infect Dis 2000; 182:1117-28.
-
11.
Barsumian E.L., Schlievert P.M., Watson D.W. Non-specific and specific immunological mitogenicity by group A streptococcal pyrogenic exotoxins. Infect Immun 1978; 22:681-8.
-
12.
Stevens D.L., Tanner M.H., Winship J., et al. Reappearance of scarlet fever toxin A among streptococci in the Rocky Mountain West: Severe group A streptococcal infections associated with a toxic shock-like syndrome. N Engl J Med 1989; 321:1-7.
-
13.
Mollick J.A., Rich R.R. Characterization of a superantigen from a pathogenic strain of Streptococcus pyogenes. Clin Res 1991; 39:213A.
-
14.
Burns E.H., Marciel A.M., Musser J.M. Activation of a 66-kilodalton human endothelial cell matrix metalloprotease by Streptococcus pyogenes extracellular cysteine protease. Infect Immun 1996; 64:4744-50.
-
15.
Nida S.K., Ferretti J.J. Phage influence on the synthesis of extracellular toxins in group A streptococci. Infect Immun 1982; 36:745-50.
-
16.
Hauser A.R., Stevens D.L., Kaplan E.L., Schlievert P.M. Molecular analysis of pyrogenic exotoxins from Streptococcus pyogenes isolates associated with toxic shock-like syndrome. J Clin Microbiol 1991; 29:1562-7.
-
17.
Campos J. Group A streptococcus culture and direct antigen detection. In: Isenberg H., ed. Clinical Microbiology Procedures Handbook, 2nd edition. Section 3. Washington: ASM Press; 2004.
-
18.
Leclercq R, Courvalin P. Bacterial resistance to macrolide, lincosamide, and streptogramin antibiotics by target modification. Antimicrob Agents Chemother 1991; 35:1267-72.
-
19.
Clancy J., Petitpas J., Dib-Hajj F., et al. Molecular cloning and functional analysis of a novel macrolide-resistance determinant, mefA, from Streptococcus pyogenes. Mol Microbiol 1996; 22:867-79.
-
20.
R. Kozlov, O. Sivaja. Antimicrobial resistance of S. pyogenes in Russia: results of prospective multicentre study PEHASus. Proceedings of the 17th ECCMID; Munich, Germany, March 31-April 3, 2007. Abstract P757.
-
21.
Quintiliani R., Sahm D.F., Courvalin P. Mechanisms of resistance to antimicrobial agents. In: Murray P.R., Baron E.J., Pfaller M.A., Tenover F.C., Yolken R.H., editors. Manual of clinical microbiology. 7th ed. Washington: ASM Press; 1999.
-
22.
Speer B.S., Shoemaker N.B., Salyers A.A. Bacterial resistance to tetracycline: mechanisms, transfer, and clinical significance. Clin Microbiol Rev 1992; 5:387-99.
-
23.
Matsumoto M., Sakae K., Ohta M., et al. Molecular mechanisms of high level tetracycline-resistance in group A streptococcal isolates, T serotypes 4 and 11. Int J Antimicrob Agents 2005; 25:142-7.
-
24.
Определение чувствительности микроорганизмов к антибактериальным препаратам. Методические указания МУК 4.2.1890-04. Клин микробиол антимикроб химиотер 2004; 6:306-59.