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Journal of Clinical Microbiology, January 2004, p. 186-192, Vol. 42, No. 1
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.1.186-192.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

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

Departments of Bacteriology,¹ Clinical Laboratory Medicine, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya 466-8550,⁴ Department of Central Clinical Laboratory, Kyoto University Hospital, Konoe-cho, Yoshida, Sakyo-ku, Kyoto 606-8501,² Department of Food Science and Technology, National Fisheries University, Shimonoseki, Yamaguchi 759-6595, Japan³

Received 29 March 2003/ Returned for modification 2 June 2003/ Accepted 7 October 2003

Twelve strains (the largest number ever reported) of group C and G₁ streptococci (GCS and GGS, respectively) that caused streptococcal toxic shock syndrome (STSS) were collected and characterized. Eleven strains were identified as Streptococcus dysgalactiae subsp. equisimilis, and one strain was identified as Streptococcus equi subsp. zooepidemicus. We found that it was the first reported case of STSS caused by S. equi subsp. zooepidemicus. Cluster analysis according to the 16S rRNA gene (rDNA) sequences revealed that the S. dysgalactiae strains belonged to clusters I and II, both of which were closely related. The emm 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 S. dysgalactiae 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 spegg gene was detected in seven S. dysgalactiae strains, with none of the other superantigen genes being detected in any of the strains. However, the sagA 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.

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