| Abstract: | Streptococcus gallolyticus (formerly known as Streptococcus bovis biotype I) is an increasing cause of endocarditis among streptococci and frequently associated with colon cancer. S. gallolyticus is part of the rumen flora but also a cause of disease in ruminants as well as in birds. Here we report the complete nucleotide sequence of strain UCN34, responsible for endocarditis in a patient also suffering from colon cancer. Analysis of the 2,239 proteins encoded by its 2,350-kb-long genome revealed unique features among streptococci, probably related to its adaptation to the rumen environment and its capacity to cause endocarditis. S. gallolyticus has the capacity to use a broad range of carbohydrates of plant origin, in particular to degrade polysaccharides derived from the plant cell wall. Its genome encodes a large repertoire of transporters and catalytic activities, like tannase, phenolic compounds decarboxylase, and bile salt hydrolase, that should contribute to the detoxification of the gut environment. Furthermore, S. gallolyticus synthesizes all 20 amino acids and more vitamins than any other sequenced Streptococcus species. Many of the genes encoding these specific functions were likely acquired by lateral gene transfer from other bacterial species present in the rumen. The surface properties of strain UCN34 may also contribute to its virulence. A polysaccharide capsule might be implicated in resistance to innate immunity defenses, and glucan mucopolysaccharides, three types of pili, and collagen binding proteins may play a role in adhesion to tissues in the course of endocarditis.Several studies have reported that the proportion of infective endocarditis due to Streptococcus gallolyticus has increased during the last decades, concomitantly with a decrease of cases due to oral streptococci (35). S. gallolyticus is now becoming the first cause of infectious endocarditis among streptococci in Europe (16). Furthermore, S. gallolyticus endocarditis is associated with rural residency, suggesting transmission from animals (29). However, the reasons for the emergence of this pathogen remain poorly understood. S. gallolyticus belongs to the Streptococcus bovis group known for more than 60 years to cause endocarditis (45). Recently, the former species S. bovis has been divided into four major species (50, 53). S. gallolyticus corresponds to S. bovis biotype I (mannitol fermentation positive), the closely related species S. pasteurianus to biotype II/2 (mannitol negative and β-glucuronidase positive), and the more distantly related species S. infantarius to biotype II/1 (mannitol negative and β-glucuronidase negative). S. macedonicus, the fourth species, commonly found in cheese, is nonpathogenic and also considered a S. gallolyticus subspecies (53, 62). A majority of endocarditis cases was due, among the formerly S. bovis group, to S. gallolyticus strains (4).Multiple studies have shown that endocarditis due to S. gallolyticus as well as positive blood culture for this species is often associated with gastrointestinal malignancy (4, 6). This association has led to a strong indication for gastrointestinal investigation and endoscopic follow-up in the case of S. gallolyticus infections (66). The association of S. gallolyticus infection with colon cancer is a major but still unsolved issue. It may be just incidental, as the alteration of the digestive mucosa may favor the translocation of the bacteria into the bloodstream. Alternatively, the tumor may contribute to the proliferation of S. gallolyticus in close proximity to the gut epithelium, increasing its probability of translocating through the gut barrier. It has also been suggested that the bacterium itself contributes to carcinogenesis (60, 69). In addition to human disease, S. gallolyticus may also cause diseases in animals, like septicemia in pigeons (19), outbreaks in broiler flocks (11), or bovine mastitis (28).Independent from its association to disease, S. gallolyticus has been isolated as a tannin-resistant bacterium from the feces of different mammalian herbivores, including the koala (48) or the Japanese large wood mouse (52), and it is also a normal inhabitant of the rumen (39). Its resistance to tannins is linked to its tannase activity, a characteristic which also led this bacterium to be named “gallolyticus” as it is able to decarboxylate gallate, an organic acid derived from tannin degradation. S. gallolyticus is also known to express other degradative functions unique among streptococci, like a bile salt hydrolase or an amylase. These properties allow its multiplication outside the animal host, as S. gallolyticus was isolated from a digester fed with shea cake (derived from the nuts of the African tree Vitellaria paradoxa) rich in tannins and aromatic compounds (12). S. gallolyticus is a commensal of the human intestinal tract but remains a rarely detected (2.5 to 15%) low-abundance species (10, 40). In herbivores, overgrowth of S. bovis may become deleterious. For example, ingestion of large amounts of rapidly fermented cereal grains leads to a destabilization of the rumen flora and to the proliferation of acid-tolerant bacteria, including S. gallolyticus. This is accompanied by the overproduction of mucopolysaccharides that stabilize the foam, resulting in feedlot bloat, a significant cause of economical loss (14).Virulence and colonization factors of S. gallolyticus in humans are largely unknown. Studies of the bird host have shown that this Streptococcus species expresses a capsular polysaccharide, and five different serotypes have been described (19). In addition, electron microscopy studies have revealed the presence of fimbria-like structures on the surface of S. gallolyticus. It was hypothesized that capsules and/or fimbriae are involved in virulence (63). S. gallolyticus isolates responsible for endocarditis exhibited heterogeneous patterns of adherence to extracellular matrix (ECM) proteins, which suggests that they produce different surface components (55). Recently, a collagen binding adhesin together with 10 putative ECM binding proteins were identified in the draft genome sequence of a human isolate of S. gallolyticus (54).Here we describe the sequence and analysis of the genome of S. gallolyticus strain UCN34 isolated from a human case of endocarditis associated with colon cancer. Analysis of the predicted proteins revealed unique metabolic and cell surface features among streptococci, which contribute to its adaptation to the rumen and to its ability to cause endocarditis. We showed by comparative genomics that many of the corresponding genes were probably acquired by lateral gene transfer (LGT) from other Firmicutes of the gut microbiota. |
