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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 different severity was investigated by a variety of molecular methods. All patients were infected with M1T1 strains and, based on clinical criteria, were classified as severe (n = 21) and nonsevere (n = 14) invasive GAS infection cases. All the M1 strains studied had 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 randomly amplified polymorphic DNA banding pattern with two different primers was identical for all strains, and pulsed field gel electrophoresis analysis showed that 33 and 30 isolates had identical banding patterns after DNA digestion with SfiI or SmaI, respectively; the nonidentical isolates differed from the main pattern by only one band. A relatively high degree of polymorphism in specific regions 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 proteins varied among the M1T1 isolates, there was no correlation between the amount of Spe expressed and disease severity. Importantly, mitogenic and cytokine responses induced by partially purified bacterial culture supernatants containing a mixture of expressed superantigens were very similar for isolates from severe and nonsevere cases (P > 0.1). Together, the data indicate that highly related invasive M1T1 isolates, some indistinguishable, can cause disease of varying severity in different individuals. These findings underscore the contribution of host factors to the outcome of invasive GAS infections.

* 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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