Genetic Relatedness and Superantigen Expression in Group A Streptococcus Serotype M1 Isolates from Patients with Severe and Nonsevere Invasive Diseases

doi:10.1128/IAI.68.6.3523-3534.2000

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Infection and Immunity, June 2000, p. 3523-3534, Vol. 68, No. 6
0019-9567/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Genetic Relatedness and Superantigen Expression in Group A Streptococcus Serotype M1 Isolates from Patients with Severe and Nonsevere Invasive Diseases

Sonia Chatellier,¹^,² Nahla Ihendyane,³ Rita G. Kansal,¹^,² Farukh Khambaty,⁴ Hesham Basma,¹^,² Anna Norrby-Teglund,³ Donald E. Low,⁵ Allison McGeer,⁵ and Malak Kotb¹^,²^,^*

Departments of Surgery and of Microbiology and Immunology, University of Tennessee, Memphis, Tennessee 38163¹; Veterans Affairs Medical Center, Research Service, Memphis, Tennessee 38104²; Division of Infectious Diseases, Karolinska Institute, Huddinge University Hospital, Huddinge, Sweden³; Federal Drug Administration, Washington, D.C. 20204⁴; and Department of Microbiology, Mount Sinai Hospital, and the University of Toronto, Toronto, Ontario M5G 1X5, Canada⁵

Received 24 November 1999/Returned for modification 10 March 2000/Accepted 19 March 2000

The relatedness of group A streptococcal (GAS) strains isolated from 35 Canadian patients with invasive disease of differentseverity was investigated by a variety of molecular methods. Allpatients were infected with M1T1 strains and, based on clinicalcriteria, were classified as severe (n = 21) and nonsevere (n= 14) invasive GAS infection cases. All the M1 strains studiedhad the emm1.0 allele and the same streptococcal pyrogenic exotoxin(Spe) genotype, speA⁺ speB⁺ speC speF⁺ speG⁺ speH smeZ⁺ ssa. All isolates had the same speA allotype, speA2. The randomlyamplified polymorphic DNA banding pattern with two different primerswas identical for all strains, and pulsed field gel electrophoresisanalysis showed that 33 and 30 isolates had identical bandingpatterns after DNA digestion with SfiI or SmaI, respectively;the nonidentical isolates differed from the main pattern by onlyone band. A relatively high degree of polymorphism in specificregions of the sic gene was observed among isolates; however,this polymorphism was not associated with disease severity. Likewise,although the phenotypic expression of SpeA, SpeB, and SpeF proteinsvaried among the M1T1 isolates, there was no correlation betweenthe amount of Spe expressed and disease severity. Importantly,mitogenic and cytokine responses induced by partially purifiedbacterial culture supernatants containing a mixture of expressedsuperantigens were very similar for isolates from severe and nonseverecases (P > 0.1). Together, the data indicate that highly relatedinvasive M1T1 isolates, some indistinguishable, can cause diseaseof varying severity in different individuals. These findings underscorethe contribution of host factors to the outcome of invasive GASinfections.

^* Corresponding author. Mailing address: University of Tennessee, Memphis, 956 Court Ave., Suite A-202, Memphis, TN 38163. Phone:(901) 448-7247. Fax: (901) 448-7208. E-mail: mkotb{at}utmem.edu.

Infection and Immunity, June 2000, p. 3523-3534, Vol. 68, No. 6
0019-9567/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

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