Streptococcus pyogenes causing toxic-shock-like syndrome and other invasive diseases: Clonal diversity and pyrogenic exotoxin expression

James M. Musser, Alan R. Hauser, Michael H. Kim, Patrick M. Schlievert, Kimberlyn Nelson, Robert K. Selander*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

313 Scopus citations

Abstract

Genetic diversity and relationships among 108 isolates of the bacterium Streptococcus pyogenes recently recovered from patients in the United States with toxic-shock-like syndrome or other invasive diseases were estimated by multilocus enzyme electrophoresis. Thirty-three electrophoretic types (ETs), representing distinctive multilocus clonal genotypes, were identified, but nearly half the disease episodes, including more than two-thirds of the cases of toxic-shock-like syndrome, were caused by strains of two related clones (ET 1 and ET 2). These two clones were also represented by recent pathogenic European isolates. A previous report of a relatively high frequency of expression of exotoxin A among isolates recovered from toxic-shock-like syndrome patients in the United States was confirmed; and the demonstration of this association both within clones and among distantly related clones supports the hypothesis that exotoxin A is a causal factor in pathogenesis of this disease. Near identity of the nucleotide sequences of the exotoxin A structural gene of six isolates of five ETs in diverse phylogenetic lineages was interpreted as evi-dence that the gene has been horizontally distributed among clones, presumably by bacteriophage-mediated transfer.

Original languageEnglish (US)
Pages (from-to)2668-2672
Number of pages5
JournalProceedings of the National Academy of Sciences of the United States of America
Volume88
Issue number7
DOIs
StatePublished - Apr 1 1991

Keywords

  • Clones
  • DNA sequencing
  • Horizontal gene transfer
  • Multilocus enzyme genotypes
  • PCR

ASJC Scopus subject areas

  • General

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