Characterization of Group C and G Streptococcal Strains That Cause Streptococcal Toxic Shock Syndrome

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<jats:title>ABSTRACT</jats:title> <jats:p> Twelve strains (the largest number ever reported) of group C and G <jats:sub>1</jats:sub> streptococci (GCS and GGS, respectively) that caused streptococcal toxic shock syndrome (STSS) were collected and characterized. Eleven strains were identified as <jats:italic>Streptococcus dysgalactiae</jats:italic> subsp. <jats:italic>equisimilis</jats:italic> , and one strain was identified as <jats:italic>Streptococcus equi</jats:italic> subsp. <jats:italic>zooepidemicus</jats:italic> . We found that it was the first reported case of STSS caused by <jats:italic>S. equi</jats:italic> subsp. <jats:italic>zooepidemicus</jats:italic> . Cluster analysis according to the 16S rRNA gene (rDNA) sequences revealed that the <jats:italic>S. dysgalactiae</jats:italic> strains belonged to clusters I and II, both of which were closely related. The <jats:italic>emm</jats:italic> types and the restriction patterns of chromosomal DNA measured by pulsed-field gel electrophoresis were highly variable in these strains except BL2719 and N1434. The 16S rDNA sequences and other characteristics of these two strains were indistinguishable, suggesting the clonal dissemination of this particular <jats:italic>S. dysgalactiae</jats:italic> strain in Japan. As the involvement of superantigens in the pathogenesis of group A streptococcus-related STSS has been suggested, we tried to detect known streptococcal superantigens in GCS and GGS strains. However, only the <jats:italic>spegg</jats:italic> gene was detected in seven <jats:italic>S. dysgalactiae</jats:italic> strains, with none of the other superantigen genes being detected in any of the strains. However, the <jats:italic>sagA</jats:italic> gene was detected in all of the strains except Tokyo1291. In the present study no apparent factor(s) responsible for the pathogenesis of STSS was identified, although close genetic relationships of GCS and GGS strains involved in this disease were suggested. </jats:p>

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