title: Genetic diversity and exotoxin A production of group A streptococci causing sepsis.
abstract: The M protein and streptococcus pyrogenic exotoxin (SPE A) are important virulence factors in group A streptococci (GAS) infections. The emm types of GAS strains isolated from patients with sepsis were determined by sequencing the 5' N-terminus of the emm gene, encoding the M protein, and clonality analysis using pulsed-field gel electrophoresis. The presence of speA and production of SPE A were also examined. There were no predominant GAS clones. The emm genotypes were variable, and the most common genotype was emm13 (17.9%). The production prevalence of SPE A was 21.4%. The low mortality rate (7.1%) of GAS sepsis might be attributable to the low incidence of virulent strains such as emm1 (10.7%) and emm3 (7.1%), as well as to low production rate of SPE A.
authors.affiliation: Department of Laboratory Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Chilamdong, Jinju, Korea.
authors.forename: Eun Ha
authors.initials: EH
authors.lastname: Koh
authors.forename: Nam Yong
authors.initials: NY
authors.lastname: Lee
authors.forename: Eui Chong
authors.initials: EC
authors.lastname: Kim
authors.forename: Sunjoo
authors.initials: S
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001426:Bacterial Proteins / Q000096:biosynthesis* / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification; D005098:Exotoxins / Q000096:biosynthesis* / Q000235:genetics*; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D007223:Infant; D008297:Male; D008565:Membrane Proteins / Q000096:biosynthesis* / Q000235:genetics*; D008875:Middle Aged; D018805:Sepsis / Q000209:etiology* / Q000382:microbiology; D013290:Streptococcal Infections / Q000209:etiology* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000235:genetics* / Q000472:pathogenicity*; D014774:Virulence / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; D005098:Exotoxins; D008565:Membrane Proteins; C117980:SpeA protein, Streptococcus pyogenes