Transduction of the genetic determinant for streptolysin S in group A streptococci.

Studies were carried out to determine the effects of treatment with killed suspensions of Propionibacterium acnes (formerly designated Corynebacterium parvum) on the course of Mycobacterium leprae infection in mice. Systemic (intravenous or intraperitoneal) treatment with P. acnes failed to significantly alter the growth of M. leprae in the mouse footpad. In contrast, injections of P. acnes directly into the infected footpad markedly inhibited the growth of the leprosy bacilli regardless of whether the local treatments were administered before infection or 3 months after infection with M. leprae. The effects of local treatment with P. acnes appeared to be bactericidal and not merely bacteriostatic. Clearance of the organism from the tissues was not enhanced by P. acnes treatment.     

Antibodies against a synthetic peptide of SagA neutralize the cytolytic activity of streptolysin S from group A streptococci

Virtually all group A streptococci (GAS) produce streptolysin S (SLS), a cytolytic toxin that is responsible for the beta-hemolysis surrounding colonies of the organisms grown on blood agar. SLS is an important virulence determinant of GAS, and recent studies have identified a nine-gene locus that is responsible for synthesis and transport of the toxin. SLS is not immunogenic; thus, no neutralizing antibodies are evoked during the course of natural infection. In the present study, we show that a synthetic peptide containing amino acid residues 10 to 30 of the putative SLS (SagA) propeptide [SLS(10-30)] coupled to keyhole limpet hemocyanin evoked antibodies in rabbits that completely neutralized the hemolytic activity of the toxin in vitro. Inhibition of hemolysis was reversed by preincubation of the immune serum with soluble, unconjugated peptide, indicating the specificity of the antibodies. In addition, antibodies that were affinity purified over an SLS(10-30) peptide column completely inhibited SLS-mediated hemolysis. The SLS(10-30) antisera did not opsonize group A streptococci; however, when combined with type-specific M protein antisera, the SLS antibodies significantly enhanced phagocytosis mediated by M protein antibodies. Thus, we have shown for the first time that it is possible to raise neutralizing antibodies against one of the most potent bacterial cytolytic toxins known. Our data also provide convincing evidence that the sagA gene actually encodes the SLS peptide of GAS. The synthetic peptide may prove to be an important component of vaccines designed to prevent GAS infections.     

Spa contributes to the virulence of type 18 group A streptococci

Streptococcal protective antigen (Spa) is a newly described surface protein of group A streptococci that was recently shown to evoke protective antibodies (J. B. Dale, E. Y. Chiang, S. Liu, H. S. Courtney, and D. L. Hasty, J. Clin. Investig. 103:1261--1268, 1999). In this study, we have determined the complete sequence of the spa gene from type 18 streptococci. Purified, recombinant Spa protein evoked antibodies that were bactericidal against type 18 streptococci, confirming the presence of protective epitopes. Sera from patients with acute rheumatic fever contained antibodies against recombinant Spa, indicating that the Spa protein is expressed in vivo and is immunogenic in humans. To determine the role of Spa in the virulence of group A streptococci, we created a series of insertional mutants that were (i) Spa negative and M18 positive, (ii) Spa positive and M18 negative, and (iii) Spa negative and M18 negative. The mutants and the parent M18 strain (18-282) were used in assays to determine resistance to phagocytosis, growth in human blood, and mouse virulence. The results show that Spa is a virulence determinant of group A streptococci and that expression of both Spa and M18 is required for optimal virulence of type 18 streptococci.     

Relationship of cellular potential hemolysin in group A streptococci to extracellular streptolysin S.

The relationship of streptolysin S (SLS) and a cellular potential hemolysin (PH) activatable by sonication was examined in strain C203S (a known high producer of SLS), its SLS(-) mutant (C203U), and in 20 other group A streptococci of various M and T serotypes. All strains shown to form SLS (ribobycleic acid (RNA)-core SLS) contained PH. The two strains lacking PH were the only ones that did not produce SLS In strain C203S, formation of SLS bycells incubated with RNA-core for 60 min at 47 C in a nongrowth basal medium (Bernheimer's basal medium) was followed by a marked decrease (99.6% loss) of PH titer. Without stimulation of SLS production by addition of RNA-sore, the same incubation resulted in a progressive but less marked fall (38.8%loss in 60 min) of PH titer: these cells produced disproportionately low titers of SLS on subsequent addition of RNA-core. This effect of prior incubation in Bernheimer's basal medium on SLS titer was partially nullified by use of fresh medium after 30 min, but not after 60 min, and did not occur during 60 min of incubation at OC. These results provide additional evidence for a precursor-product relationship between PH and SLS. They also suggest that a medium factor (or factors) is utilized or destroyed at 37 C and that this factor is essential to both the stability of PH and its efficient conversion to SLS.     

Virulence of group A streptococci in fertile hens eggs is mainly effected by M protein and streptolysin O

In this study we have investigated whether streptolysin O contributes to the virulence of group A streptococci. For this purpose we generated M-negative and SLO-negative mutants by insertion mutagenesis into the chromosome of an M type 1 strain. The inactivation of M1 protein expression was achieved by the construction of the integrative plasmid pSFABS, which contains the internal fragment abs of the emm1 gene. Integration of pSFABS by homologous recombination into the chromosome of strain 38 541 resulted in the generation of mutant EMM1. Inactivation of slo with plasmid pFWSLOD resulted in two different mutant forms. The homologous recombination with plasmid pFWSLOD carrying the two slo fragments slo1 (899 base pairs in the 5' region) and slo2 (709 base pairs in the downstream part) resulted in mutants SLO3, SLO4 and SLO17. In SLO17 a double crossover event took place with insertion of the spectinomycin resistance gene aad9 between the slo fragments 1 and 2. In mutants SLO3 and SLO4 the homologous recombination with the same plasmid led to the integration of the whole plasmid construct into the chromosome of strain 38 541. Both forms of mutation failed to express SLO. In mutant SLO4 additionally M1 protein expression was significantly decreased. The mutants EMM1 (M-, SLO+) and SLO4 (M decreased, SLO-) showed a reduced binding to collagen-coated surfaces. In contrast the mutants SLO3 and SLO17 (both M+, SLO-) and the wild-type strain 38 541 (M+, SLO+) showed an affinity to collagen similar to purified M1 protein. All mutants were less virulent for chicken embryos compared to the wild-type strain after infection by intravenous injection as well as by application onto the chorioallantoic membrane. The results show that besides M protein SLO can also influence virulence of group A streptococci. Moreover, it became obvious that streptococci need more than one tool to fully develop their infectious potential.     

Combined contributions of streptolysin O and streptolysin S to virulence of serotype M5 Streptococcus pyogenes strain Manfredo

Streptolysin O (SLO) and streptolysin S (SLS) are potent cytolytic toxins produced by almost all clinical isolates of group A streptococci (GAS). Allele-replacement mutagenesis was used to construct nonpolar (in-frame) deletion mutations in the slo and sagB genes of the serotype M5 GAS strain Manfredo, producing isogenic single and double SLO- and SLS-defective mutants. In contrast to recent reports on SLS-defective insertion mutants (I. Biswas, P. Germon, K. McDade, and J. Scott, Infect. Immun. 69:7029-7038, 2001; Z. Li, D. Sledjeski, B. Kreikemeyer, A.Podbielski, and M. Boyle, J. Bacteriol. 181:6019-6027, 1999), none of the mutants described here had notable pleiotropic effects on the expression of other virulence factors examined. Comparison of isogenic parent and mutant strains in various virulence models revealed no differences in their abilities to multiply in human blood or in their 50% lethal doses (LD(50)s) upon intraperitoneal infection of BALB/c mice. A single log unit difference in the LD(50)s of the parent and SLS-defective mutant strains was observed upon infection by the subcutaneous (s.c.) route. Comparisons over a range of infective doses showed that both SLO and SLS contributed to the early stages of infection and to the induction of necrotic lesions in the murine s.c. model. Individually, each toxin made an incremental contribution to virulence that was not apparent at higher infective doses, although the absence of both toxins reduced virulence over the entire dose range examined. Interestingly, in some cases, the contribution of SLO to virulence was clear only from an analysis of the double-mutant strain, highlighting the value of not confining virulence studies to mutant strains defective in the expression of only single virulence factors.     

Epidemiology and virulence gene expression of intracellular group A streptococci in tonsils of recurrently infected adults

Intracellularly persistent group A streptococci (GAS, Streptococcus pyogenes) have been associated with recurrent tonsillopharyngitis and antibiotic treatment failure. As a supplementation of the published in vitro data, conventional bacteriology and molecular epidemiology was performed on material from 29 adult patients of a German army hospital with anamnestic signs of recurrent tonsillopharyngitis. Pre-surgery tonsil swabs and the surgically removed tonsils were examined with respect to growth of aerobic bacteria in absence and presence of antibiotics with exclusively extracellular activity. Under such antibiotic selection, Staphylococcus aureus and GAS were cultured from specimens of 13 and 3 patients, respectively. In every material GAS-positive by culture methods, the intracellular location of the penicillin-susceptible GAS isolates was confirmed by immunohistologic examination of tonsillar sections using a GAS-specific IgG antibody. The three intracellular GAS isolates were typed by emm gene sequencing and could be associated to types M6 and M49 (two isolates). The bacteria were serially passaged on sheep blood agar, and semiquantitative mRNA analysis from virulence genes was performed using bacteria of the 4th and 25th passage after isolation. An M-type-specific pattern of virulence gene expression and different gene expression levels in relation to the passage number were observed.     

Biosynthetic capacity for type-specific antigen synthesis determines the virulence of serotype III strains of group B streptococci

The level of type-specific antigen (that covalently associated with the cell wall peptidoglycan and that released extracellularly) synthesized by virulent and avirulent strains of type III group B streptococci was quantitated and compared. Additionally, the effect of the physiological age of the cells and the influence of the exogenous phosphate ion concentration on the level of antigen synthesis by these organisms were also examined. Approximately 4% of the total antigen synthesized by the organism is noncovalently bound to the cell surface, and the difference in level of the noncovalently associated type-specific antigen between virulent and avirulent strains was negligible. In contrast, when the cell-associated covalently bound type antigens were evaluated, virulent strains were demonstrated to have two- to threefold higher levels than those of avirulent strains during the exponential and stationary phases of growth under various growth conditions. Furthermore, virulent strains that had high levels of cell-associated type antigen also secreted more extracellular type antigen than did avirulent strains. Thus, the data were consistent with the hypothesis that an overall production of type-specific antigen correlated with virulence in mice. However, the cell-associated type-specific antigen probably represented a better indicator for virulence potential since the addition of purified extracellular type-specific antigen to a mutant strain that lacks cell surface type antigen did not alter the 50% lethality value of the organism. To account for variation in the level of type-specific antigen produced by these strains, the kinetics of both the group- and type-specific antigens synthesis was investigated at the cell membrane level by utilizing an intact protoplast system.(ABSTRACT TRUNCATED AT 250 WORDS)     

Association between expression of immunoglobulin G-binding proteins by group A streptococci and virulence in a mouse skin infection model.

In this study, we developed a mouse model of skin infection to test the association between expression of immunoglobulin-binding proteins by and infectivity of group A streptococci. Group A streptococci capable of crossing tissue barriers and establishing a lethal systemic infection in mice showed a higher level of immunoglobulin-binding protein expression. The group A streptococci recovered from the spleen of a mouse that died following a skin infection were found to be more virulent when injected into the skin of naive mice. Together, these results suggest that immunoglobulin-binding protein expression by group A streptococci correlates with their ability to establish invasive skin infections.     

Prevention of C3 deposition by capsular polysaccharide is a virulence mechanism of type III group B streptococci.

Strains of type III group B streptococci isolated from patients with neonatal sepsis are generally resistant to complement-mediated phagocytic killing in the absence of specific antibody. It has been suggested that the resistance of type III group B streptococci to phagocytosis results from inhibition of alternative-complement-pathway activation by sialic acid residues of the type III polysaccharide. To better define the relationship between structural features of the type III capsule and resistance of type III group B streptococci to complement-mediated phagocytic killing, we measured deposition of human C3 on group B streptococcal strains with altered capsule phenotypes. C3 binding was quantified by incubating bacteria with purified human 125I-C3 in 10% serum. Wild-type group B Streptococcus sp. strain COH1 bound eightfold fewer C3 molecules than did either of two isogenic mutant strains, one expressing a sialic acid-deficient capsule and the other lacking capsule completely. Similar results were obtained when the incubation with 125I-C3 was performed in serum chelated with Mg-ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'- tetraacetic acid (MgEGTA), suggesting that the majority of C3 deposition occurred via the alternative pathway. In contrast to the wild-type strain, which was relatively resistant, both mutant strains were killed by human leukocytes in 10% serum with or without MgEGTA. We also measured C3 binding to 14 wild-type strains of type III group B streptococci expressing various amounts of capsule. Comparison of degree of encapsulation with C3 binding revealed a significant inverse correlation (r = -0.72; P less than 0.01). C3 fragments released by methylamine treatment of wild-type strain COH1 were predominantly in the form of C3bi, while those released from the acapsular mutant were predominantly C3b and those from the asialo mutant represented approximately equal amounts of C3b and C3bi. We conclude from these studies that the sialylated type III capsular polysaccharide inhibits alternative-pathway activation, prevents C3 deposition on group B streptococci, and protects the organisms from phagocytic killing.     

Properties of high and low density subpopulations of group B streptococci: enhanced virulence of the low density variant

From the group B streptococcus (GBS) reference strain 090 la Colindale two subpopulations, which differed markedly regarding their capacities for biosynthesis of type-specific polysaccharide, were obtained by separation on a hypotonic Percoll density gradient. In the original strain and the high and low density variants, there was a negative correlation between buoyant density and bio-synthesis of type-specific polysaccharide as determined by ultrastructure and quantitative assays. The invasiveness of these variants was investigated by infecting rabbits via subcutaneously implanted tissue cages. In the animals infected with highly encapsulated bacteria, heavy bacteremia was detected 8 h post-infection, whereas in the animals which received high density bacteria with small amount of capsule, heavy bacteremia was not detected until after five days. All isolates recovered from the blood or organs of these rabbits were of the capsule rich phenotype, indicating a phenotypic shift in the subpopulation of high density bacteria. An apparently similar phenotypic shift was noted in an isolate from a baby with early onset septicemia. There was a dominance of low density bacteria in the isolate obtained from the baby as compared with the colonizing population of bacteria isolated from the cervix of the mother. From these type III isolates, subpopulations with different density maxima were obtained. A reversed shifting towards dominance of less encapsulated, high density bacteria was observed during in vitro passage of these subpopulations.     

Effects on virulence of mutations in a locus essential for hyaluronic acid capsule expression in group A streptococci.

Mucoid or highly encapsulated strains of group A streptococci have been associated both with unusually severe infections and with acute rheumatic fever. Previously, we described an acapsular mutant, TX4, derived from a mucoid M-type 18 strain of a group A streptococcus by transposon mutagenesis (M. R. Wessels, A. E. Moses, J. B. Goldberg, and T. J. DiCesare, Proc. Natl. Acad. Sci. USA 88:8317-8321, 1991). We now report studies further characterizing strain TX4 as well as an additional acapsular mutant, TX72. Strain TX4 was found to contain a 9.5-kb deletion of chromosomal DNA adjacent to the site of transposon Tn916 insertion. Cloned chromosomal DNA from TX4 flanking the transposon insertion site was used as a probe to demonstrate the presence of homologous regions in 11 of 11 wild-type group A streptococcal strains of various M protein types. A second acapsular mutant, TX72, had a single transposon insertion and had no apparent deletion of chromosomal DNA. The Tn916 insertion in TX72 was mapped to the hasA locus (encoding hyaluronate synthase), which lies within the chromosomal region deleted in TX4. Strain TX72 was avirulent in mice and sensitive to phagocytic killing in vitro. Transduction of either the insertion-deletion mutation from TX4 or the simple insertion mutation from TX72 to a type 24 group A streptococcus strain also resulted in loss of capsule expression, demonstrating that a homologous region of the chromosome controls capsule expression in another serotype of group A streptococci. We conclude that the hyaluronic acid capsule plays an important role in virulence and that a region of the chromosome essential for capsular polysaccharide expression is conserved among diverse group A streptococcal strains.     

Bacteriological and serological aspects of group a streptococcal pharyngotonsillitis caused by group a streptococci

Several bacteriological and serological variables were studied in connection with a clinical treatment trial in 212 patients with group A streptococcal pharyngotonsillitis. Anaerobic incubation was not superior to incubation in 5 % CO₂ in air for the detection of group A streptococci. Saliva cultures were inferior to conventional throat cultures in detecting group A streptococci. No strains from patients with recurrences were found to be tolerant to penicillin. In several patients (all asymptomatic), group C and G streptococci were found in follow-up cultures. Group A streptococci serology was more often positive after two months than after one month, also in patients without recurrence.     

Immunochemistry of capsular type polysaccharide and virulence properties of type VI Streptococcus agalactiae (group B streptococci).

The immunochemistry of capsular type polysaccharide and virulence characteristics of group B streptococci (GBS), type VI, were studied. By high-pressure anion-exchange chromatography and pulsed amperometric detection, as well as by 13C nuclear magnetic resonance analysis, both extracellular and cell-bound polysaccharides were found to contain glucose, galactose, and N-acetylneuraminic acid in the molar ratio of 2:2:1, respectively. At variance with all other GBS serotypes described to date (Ia, Ib, II, III, IV, and V), no N-acetylglucosamine was present, whatever the source of the material (secreted or cell bound; reference or clinical isolate). Sialic acid was probably involved in the immunodeterminant structure of this new serotype since cleavage of this sugar from the polysaccharide gave rise to an antigen which reacted very weakly with type VI antiserum and to a precipitation line in immunodiffusion with no identity with the native type VI polysaccharide. By using type VI antiserum and the protein A-gold technique, a large capsule was observed in the type VI GBS reference strain by electron microscopy. All type VI strains examined were lethal for CD-1 mice, the 50% lethal dose after intraperitoneal challenge ranging from 1.0 (+/- 0.9, standard deviation) x 10(5) to 2.5 (+/- 1.5, standard deviation) x 10(5) CFU per mouse. A rabbit antiserum against capsular type polysaccharide exhibited both protective activity for mice injected intraperitoneally with type VI reference strain or with clinical isolates and opsonic activity in a phagocytosis assay.     

Density profile of group B streptococci, type III, and its possible relation to enhanced virulence.

The buoyant densities of virulent and colonizing group B streptococci, type III, were determined by centrifugation of bacteria on a linear, hypotonic density gradient. A total of 28 strains were investigated. Eleven strains were obtained from blood cultures of babies with early-onset disease, and eight strains were isolated from the cerebrospinal fluid of babies with late-onset septicemia and meningitis. Nine colonizing strains were genital isolates from pregnant women subsequently giving birth to healthy children. In each strain the buoyant density was determined before and after neuraminidase treatment. All strains showed an increase in the buoyant density after enzymatic removal of sialic acid, and the density differences before and after desialylation were calculated. The mean values of these differences for blood, cerebrospinal fluid, and colonizing isolates were 23.4, 25.3, and 10.6 mg/ml, respectively. The mean value for the colonizing strains differed significantly from the mean value for each group of virulent strains. All colonizing strains banded singly in the gradient, whereas five of the virulent strains divided into two density populations. Extracts of the low-density cells produced markedly more dense immunoprecipitates with type antiserum than did extracts of the high-density bacteria. One double-banding strain was positive for R protein. After separation of the two density populations, this antigen was detected only in the low-density population. The results indicate that bacterial buoyant density is inversely related to the amount of capsular polysaccharide enveloping the cell and that a determination of the density profile of the bacteria may be used for discriminating strains with an increased pathogenic potential.     

Synergistic effects of streptolysin S and streptococcal pyrogenic exotoxin B on the mouse model of group A streptococcal infection

Streptococcus pyogenes is a group A streptococcus (GAS) and an important human pathogen that causes a variety of diseases. Streptococcal pyrogenic exotoxin B (SPE B) and streptolysin S (SLS) are important virulence factors involved in GAS infection, but it is not clear which one is more virulent. Using an air pouch infection model, the wild-type strain NZ131, its isogenic mutants, and complementary mutants were used to examine the effects of SPE B and SLS on GAS infection. The results of the skin lesion and mouse mortality assays showed that although SPE B and SLS had a synergistic effect on GAS infection, SPE B played a more important role in local tissue damage while SLS had a more prominent effect on mouse mortality. Surveys of the exudates from the air pouch revealed that the expression of inflammatory cytokines was significantly inhibited in the sagB/speB-double-mutant JM4-infected mice. Furthermore, in vivo and in vitro studies showed that the isogenic mutant strains were more susceptible to the immune cell killing than the wild-type strain and that the sagB/speB-double-mutant JM4 was the most sensitive among these strains. Moreover, infection with the sagB/speB-double-mutant JM4 strain caused the least amount of macrophage apoptosis compared to infection with the wild-type NZ131 and the other complementary strains, which express only SPE B or SLS or both. Taken together, these results indicate that both SPE B and SLS contributed to GAS evasion from immune cell killing, local tissue damage, and mouse mortality.