高毒力A组链球菌致病机制研究进展

A组链球菌(Group A Streptococcus,GAS)常导致咽炎和皮肤感染,也能引起严重侵袭性感染.根据其表面M蛋白编码基因emm可将GAS分为200多型,严重侵袭性感染多由高毒力株引起,以emm1、emm3、emm12、emm28和emm89型常见.研究发现高毒力GAS株中CovRS基因突变可导致细菌逃逸固...     

A族乙型溶血性链球菌对大环内酯类抗生素耐药的研究进展

A族乙型溶血性链球菌（group A streptococcus pyogens,GAS）是链球菌中致病性最强的一种,广泛存在于自然界、人及动物粪便和健康人的鼻咽部,是急性呼吸道感染尤其是上呼吸道感染的重要细菌病原,可以引起儿童和成人急性咽炎和扁桃体炎,也可引起严重的侵袭性感染如坏死性筋膜炎和中毒休克综合征。感染后及时有效的治疗可避免给患者带来的严重伤害。     

054表皮细胞总mRNA表达谱研究揭示化脓性链球菌属FAS调节活性与侵袭性的相关性

化脓性链球菌[A群链球菌（group Astreptococci,GAS）]是感染人类的重要革兰阳性菌。细菌对宿主黏膜表面和皮肤表皮细胞的黏附和内化是感染的关键起始步骤,但对感染宿主细胞的转录反应还了解甚少。作者采用Affymetrix人类基因组DNA芯片分别检测了HEp-2细胞感染M49化脓性链球菌的野生型细菌和△fasX型细菌的总mRNA转录,     

儿童对A群链球菌C5a肽酶的免疫应答

A群链球菌C5a肽酶(SCPA)是促进A群链球菌局部感染建立的一个主要表面毒力蛋白(GAS)，作者使用了标准的间接酶联免疫吸附检测方法测定了对SCPA的免疫应答，并测量了与GAS相关的小儿咽炎急性期和恢复期的双份血清样本，证明了对SCPA的免疫应答不受感染的M型和病人年龄的影响，     

肺炎链球菌溶血素黏膜免疫抗定植保护作用的研究

目的原核表达△A146Ply蛋白,评价△A146Ply黏膜免疫对肺炎链球菌（Streptococcuspneumon—ioe,5．Pn）在宿主鼻咽部定植的保护作用。方法IPTG诱导、Ni—NTA树脂纯化获得纯化的△A146Ply蛋白,经黏膜免疫BALB／C小鼠,制备其特异性抗血清;进行体内抗定植实验,观察小鼠鼻咽部灌洗液和肺部残存的细菌数量,检测△A146Ply黏膜免疫对19F型肺炎链球菌在鼻咽部定植的保护作用。为验证该保护作用是否具有广谱性,培养血清型14型、3型、6型和2型S．pn,经鼻腔感染免疫后小鼠,评价△A146Ply蛋白黏膜免疫对多株肺炎链球菌定植的保护作用。进行体外抗黏附实验,检测△A146Ply蛋白及其抗血清是否对无荚膜的肺炎链球菌R6黏附A549细胞具有抑制作用。结果获得了纯度〉90％的目的蛋白;体内实验结果显示,△A146Ply黏膜免疫可以显著降低肺炎链球菌19F在宿主鼻咽部和肺部残存的细菌数量（P〈0．01）;14型和3型肺炎链球菌在免疫后小鼠鼻咽部及肺部定植的数量均显著下降（P〈0．05）,2型肺炎链球菌在免疫后小鼠肺部定植的数量显著下降（P〈0．05）,6B型肺炎链球菌在免疫组与对照组小鼠鼻咽部及肺部均无显著差异（P〉0．05）;△A146Ply特异性抗血清△A146Ply蛋白对R6黏附A549细胞的抑制效应呈剂量依赖性。结论△A146Ply蛋白经黏膜免疫BALB／C小鼠可以对多种血清型的肺炎链球菌在宿主鼻咽部及肺部的定植提供显著保护作用,为Ply作为肺炎链球菌疫苗候选蛋白的应用提供了实验依据。     

A群链球菌疫苗研究：历史的要略和新的视角

化脓性链球菌通常是指Lancefield分类中的A群链球菌(GAS),它是一群革兰阳性致病菌,能引起人们包括咽炎、腥红热、化脓性筋膜炎和链球菌毒素中毒性休克综合症(streptococcal toxic shock syndrome,STSS)等在内的广泛的疾病。感染后遗症有急性风湿热(acute rheumatic fever,ARF),并发病症有风湿性心脏病(rheumatic heart disease,RHD),     

含ICE-emm12和ΦHKU.vir化脓链球菌引起的猩红热1例

2011年中国开始出现猩红热疫情,病例以普通型为主,外科型较少报道。ICE-emm12和ΦHKU.vir是中国香港地区猩红热暴发株中首次发现的2个可移动遗传元件,尚不清楚其是否存在于中国内地的猩红热致病株中。本文报道1例猩红热病例,其咽部和皮肤伤口皆分离出同一克隆株的化脓链球菌,该菌株携带ICE-emm12和ΦHKU.vir,从而证实这2个新元件存在于中国内地的化脓链球菌中。因此,国内有必要对猩红热分离株进行ICE-emm12和ΦHKU.vir检测,以监测致病株在基因水平的变化。     

肺炎链球菌疫苗的研究进展

肺炎链球菌疫苗研制对于肺炎链球菌感染的防治具有重要意义。常见的荚膜多糖疫苗存在很大缺陷,需要更为有效的疫苗来替代。本文综述肺炎链球菌疫苗研制中的一些进展,包括结合疫苗的研制、几种公认的蛋白疫苗因子的研究进展和新的蛋白疫苗因子的筛选。同时还介绍肺炎链球菌疫苗研制过程中的一些新思路（联合疫苗、活疫苗、DNA疫苗）,它们是对肺炎链球菌疫苗研制方法的丰富。     

咽外A群链球菌感染:快速抗原检测法诊断的准确性和实用性

抗原检测法(ADT)已在临床上广泛地用于咽部A群链球菌(GAS)感染的快速诊断,但很少用于检测咽外其他部位如皮肤的GAS感染,而常用的皮肤标本细胞培养实验需要24～72h,很多实验室也没有条件开展。本文作者对239名平均年龄4．9岁、怀疑为GAS皮肤感染的患者,共采集患处皮肤拭子247次,每次采集3个拭子,分别用3种ADT试剂盒     

肺炎链球菌粘附和毒力因子A研究进展

肺炎链球菌（Streptococcus pneumoniae,SP）普遍定植于呼吸道,是人类重要的侵袭性病原菌之一,是社区获得性肺炎、中耳炎、脑膜炎、菌血症、鼻窦炎的主要病原菌。肺炎链球菌粘附和毒力因子A（pneumococcal adherence and virulence factor A,PavA）是肺炎链球菌早期感染和侵袭过程中关键的毒力因子。体外试验表明,缺失PavA的肺炎链球菌的突变株其粘附和侵入上皮细胞和内皮细胞的能力明显下降。作为一种保护性抗原,其诱导的细胞和体液免疫可以有效的抵抗肺炎链球菌的感染,是肺炎链球菌新一代疫苗的候选蛋白。但是,PavA在肺炎链球菌与人肺上皮细胞交互对话中作用机制的研究尚属空白,本文就肺炎链球菌粘附和毒力因子A得最新研究进展作一综述。     

The fundamental contribution of phages to GAS evolution,genome diversification and strain emergence

The human bacterial pathogen group A Streptococcus (GAS) causes many different diseases including pharyngitis, tonsillitis, impetigo, scarlet fever, streptococcal toxic shock syndrome, necrotizing fasciitis and myositis, and the post-infection sequelae glomerulonephritis and rheumatic fever. The frequency and severity of GAS infections increased in the 1980s and 1990s, but the cause of this increase is unknown. Recently, genome sequencing of serotype M1, M3 and M18 strains revealed many new proven or putative virulence factors that are encoded by phages or phage-like elements. Importantly, these genetic elements account for an unexpectedly large proportion of the difference in gene content between the three strains. These new genome-sequencing studies have provided evidence that temporally and geographically distinct epidemics, and the complex array of GAS clinical presentations, might be related in part to the acquisition or evolution of phage-encoded virulence factors. We anticipate that new phage-encoded virulence factors will be identified by sequencing the genomes of additional GAS strains, including organisms non-randomly associated with particular clinical syndromes.     

Streptococcal superantigens and the return of scarlet fever

Streptococcus pyogenes (group A Streptococcus) is a globally disseminated and human-adapted bacterial pathogen that causes a wide range of infections, including scarlet fever. Scarlet fever is a toxin-mediated disease characterized by the formation of an erythematous, sandpaper-like rash that typically occurs in children aged 5 to 15. This infectious disease is caused by toxins called superantigens, a family of highly potent immunomodulators. Although scarlet fever had largely declined in both prevalence and severity since the late 19th century, outbreaks have now reemerged in multiple geographical regions over the past decade. Here, we review recent findings that address the role of superantigens in promoting a fitness advantage for S. pyogenes within human populations and discuss how superantigens may be suitable targets for vaccination strategies.     

Development and Evaluation of Capture Enzyme-Linked Immunosorbent Assays for Detection of Immunoglobulin G and M Antibodies to Group A Streptococcal Antigens

Capture enzyme-linked immunosorbent assays (ELISAs) were developed to detect immunoglobulin G and M antibodies to group A streptococcal (GAS) antigens, streptolysin O, streptokinase, and group A carbohydrate. The sensitivities and the specificities of the IgM capture ELISAs to each GAS antigen were high enough to distinguish the patients with GAS infections (diagnosed as GAS pharyngitis or scarlet fever) from the control groups (healthy people and patients with pharyngitis from whom GAS could not be isolated). On the other hand, the specificities of the IgG capture ELISAs were not very effective in diagnosis of GAS infections. When the capture ELISA and an indirect ELISA detecting IgM antibodies to group A carbohydrate were compared, false-positive reactions due to rheumatoid factor occurred in the indirect ELISA, but did not occur in the capture ELISA. These results indicate that the capture ELISA works better than the indirect ELISA in detecting the IgM antibody, and that the IgM capture ELISA to GAS antigen provides a rapid and highly reliable serodiagnosis for GAS infections employing only a single serum.     

A comparative study of alteration in lymphocyte subsets among varicella, hand-foot-and-mouth disease, scarlet fever, measles, and Kawasaki disease

Changes in the lymphocyte subsets of 13 patients with varicella, 5 with hand-foot-and-mouth disease, 4 with scarlet fever, 10 with measles and 20 with Kawasaki disease were examined by immunofluorescent flow cytometric analysis using monoclonal antibodies against lymphocyte cell surface antigens. The results were compared with those of age-matched normal controls. A significant increase in the percentage of Leu-2a positive (Leu-2a+) cells was shown during the early convalescence of varicella, scarlet fever and measles. A significant decrease in the percentage of Leu-3a+ cells during the acute phase was common to all the diseases examined, and a significant decrease of Leu-4+ cells was observed except in measles. As a result, a significant decrease in the Leu-3a+/Leu-2a+ ratio was common to all the diseases examined during the acute and/or early convalescent phases. Leu-M3+ cells increased significantly in varicella, scarlet fever, and Kawasaki disease. HLA-DR+ cells increased significantly in varicella and Kawasaki disease. No significant changes in the proportions of Leu-7+, Leu-10+, and 2H7+ cells were found throughout the course of all the diseases examined.     

Molecular insight into invasive group A streptococcal disease

Streptococcus pyogenes is also known as group A Streptococcus (GAS) and is an important human pathogen that causes considerable morbidity and mortality worldwide. The GAS serotype M1T1 clone is the most frequently isolated serotype from life-threatening invasive (at a sterile site) infections, such as streptococcal toxic shock-like syndrome and necrotizing fasciitis. Here, we describe the virulence factors and newly discovered molecular events that mediate the in vivo changes from non-invasive GAS serotype M1T1 to the invasive phenotype, and review the invasive-disease trigger for non-M1 GAS. Understanding the molecular basis and mechanism of initiation for streptococcal invasive disease may expedite the discovery of novel therapeutic targets for the treatment and control of severe invasive GAS diseases.     

Group A streptococcus cell-associated pathogenic proteins as revealed by growth in hyaluronic acid-enriched media

Group A streptococcus (GAS), also know as Streptococcus pyogenes, is a human pathogen and can cause several fatal invasive diseases such as necrotising fasciitis, the so-called flesh-eating disease, and toxic shock syndrome. The destruction of connective tissue and the hyaluronic acid (HA) therein, is a key element of GAS pathogenesis. We therefore propagated GAS in HA-enriched growth media in an attempt to create a simple biological system that could reflect some elements of GAS pathogenesis. Our results show that several recognised virulence factors were up-regulated in HA-enriched media, including the M1 protein, a collagen-like surface protein and the glycolytic enzyme glyceraldehyde-3-phosphate dehydrogenase, which has been shown to play important roles in streptococcal pathogenesis. Interestingly, two hypothetical proteins of unknown function were also up-regulated and detailed bioinformatics analysis showed that at least one of these hypothetical proteins is likely to be involved in pathogenesis. It was therefore concluded that this simple biological system provided a valuable tool for the identification of potential GAS virulence factors.     

Epidemiological pattern of scarlet fever in recent years

During the period of 1953-2001 scarlet fever morbidity level fluctuated from 670.3 to 65.9 per 100,000 of the population in Moscow and from 531.9 to 35.0 per 100,000 of the population of the Russian Federation. In recent years an increased morbidity was more pronounced in Moscow than in the Russian Federation as a whole. Children formed the greater part of scarlet fever patients, the cases of scarlet fever among children in Moscow occurring more often than, on the average, in Russia. As before, annual morbidity among children attending children's institutions was higher 3- to 4-fold than among children brought up at home. This difference was most sharply pronounced among young children during the first two years of their life. In contrast to morbidity observed during previous 20-30 years, a drop in morbidity among children during the first two years of their life was registered, while morbidity level among children aged 3-6 years and 7-14 years increased. Scarlet fever morbidity had a pronounced seasonal (autumn-winter) pattern. In a group of children aged 3-5 years who attended organized groups, on the average, 78.6% of scarlet fever cases fell on seasonal morbidity, the most prolonged one.     

Streptococcal Superantigen,Mitogenic Factor,and Pyrogenic Exotoxin B Expressed by Streptococcus pyogenes

Abstract

Streptococcus pyogenes is a Gram-positive human bacterial pathogen that causes pharyngitis, tonsillitis, skin infections (impetigo, erysipelis, and other forms of pyoderma), acute rheumatic fever (ARF), scarlet fever (SF), poststreptococcal glomerulonephritis (PSGN), a streptococcal toxic shock syndrome (STSS), and necrotizing fasciitis. These infections are some of the most economically and medically important conditions that affect humans. For example, globally, ARF is the most common cause of pediatric heart disease. It is estimated that in India more than six million school-aged children suffer from rheumatic heart disease (1). In the United States, “sore throat” is the third most common reason for physician office visits and S. pyogenes is recovered from about 30% of children with this complaint (2). It has been estimated that there are 25–35 million cases of streptococcal pharyngitis per year in the United States, and these infections cause 1–2 billion dollars per year in direct health care costs (3,4). Although the continued great morbidity and mortality caused by S. pyogenes in developing nations, the significant health care financial burden attributable to group A streptococci in the United States, and increasing levels of antibiotic resistance (5), have highlighted the need for a fuller understanding of the molecular pathogenesis of streptococcal infection, it has been the relatively recent intercontinental increase in streptococcal disease frequency and severity (6,7) that has resulted in renewed interest in S. pyogenes virulence factors and host-parasite interactions.     

Use of tomicid in prophylaxis of respiratory streptococcal infection in the organized groups of children of pre-school age

The results of the approbation of the use of Tomicid for the prophylaxis of scarlet fever and other manifestations of streptococcal infection in an organized group of children of pre-school age are presented. The pronounced prophylactic effect of Tomicid, manifested by a reliable decrease of group A streptococcal carrier state, as well as in a decrease in morbidity in respiratory streptococcal infection among children in the test group in comparison with those in the control one. The simplicity of the use of the preparation (as throat gargle for 5 days) makes it possible to regard this preparation as a promising remedy for the urgent prophylaxis of scarlet fever.