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KMID : 1039620140040040255
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Korean Journal of Family Practice
2014 Volume.4 No. 4 p.255 ~ p.261
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The Current Opinion of Pathogenesis and Antimicrobial Resistance of Streptococcus pyogenes
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Yoon Jeong-Sook
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Abstract
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Streptococcus pyogenes (GAS) is the most common cause of school aged bacterial pharyngitis and cause of the necrotizing fasciitis and streptococcal toxic shock syndromes. To classify GAS, serological T or M typing has been used, however now emm genotypes are used. Emm 78 was the most common type in Jinju, Korea, revealing 16.7%. The erythromycin resistant rate was 11.6%. In this review, we studied current opinions of GAS pathogenesis and antimicrobial resistance rate. Although decades of study, it is unclear how GAS virulence influences host. Although there had been reports that M protein is related to the disease type, complete genome sequencings revealed no diff erence of emm or M proteins in strains. Instead, about 10% of gene content heterogeneity in the same M serotype aff ects disease and virulence. Conclusively, insertion or deletion of prophage to the specifi c integration site decides virulence. In addition, extensive variability occurs by recombination events. Prophage and integrated conjugative element (ICEs) decide virulence. ICEs are mobile structure and have a capacity of acquirement exogenous genetic element by horizontal gene transfer. ICEs are chimeric structure composed of multiple antimicrobial resistance gene, horizontal gene transfer machinery, extracellular proteins. Until now 55 prophages and 12 ICEs and 21 integration sites have been discovered. Recently it has been studied in the nucleotide level, and there have been many theories of regulatory axis and hypothesis single base mutation or deletions increase or decrease the specifi c disease.
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KEYWORD
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Streptococcus pyogenes, Prophage, Integrated Conjugative Element
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