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Journal of Clinical Microbiology, November 2000, p. 4126-4130, Vol. 38, No. 11
Respiratory Diseases Branch, Centers for
Disease Control and Prevention, Atlanta, Georgia
30333,1 and Department of
Nephrology, Hospital São João de Deus, Divinópolis,
Brazil2
Received 28 June 2000/Returned for modification 16 August
2000/Accepted 5 September 2000
The etiologic agent of a large 1998 outbreak of poststreptococcal
acute glomerulonephritis (PSGN) in Nova Serrana, Brazil, was found
likely to be a specific strain of Streptococcus equi subsp.
zooepidemicus from contaminated cheese (S. Balter et al., Lancet 355:1776-1780, 2000). In the present study, we used a serologic screen for a known surface-exposed virulence factor to confirm the
epidemiologic findings. Using primers flanking a previously characterized M-like protein gene (J. F. Timoney et al., Infect. Immun. 63:1440-1445, 1995), we amplified and sequenced the M-like protein (designated Szp5058) gene and found it to be identical among
four independent acute-phase PSGN patient isolates. Convalescent-phase sera from 33 of 44 patients in the PSGN outbreak were found to contain
antibodies highly reactive to a purified Szp5058 fusion protein,
compared with 1 of 17 control sera (P < 0.0001),
suggesting that Szp5058 was expressed during infection and further
implicating this strain as the cause of the PSGN outbreak. The
predicted signal sequence and cell wall association motif of Szp5058
were highly conserved with the corresponding sequence from S. equi subsp. zooepidemicus SzpW60, while the predicted
surface-exposed portions differed markedly between these two proteins.
The 5' end of the szp5058 gene, including its variable
region, was identical to the szp gene from another strain
associated with a previous PSGN outbreak in England (M. Barham et al.,
Lancet i:945-948, 1983), and the corresponding szp
sequence found from the Lancefield group C type strain isolated from a
guinea pig. In addition, the hypervariable (HV) portion of
szp5058 was identical to a previously published HV sequence
from a horse isolate (J. A. Walker and J. F. Timoney, Am. J. Vet. Res. 59:1129-1133, 1998). Three other strains of
S. equi subsp. zooepidemicus, including another
strain previously associated with a PSGN outbreak, were each found to
contain a distinct szp gene. Two of these szp
genes had HV regions identical to szp regions from isolates
recovered from different host species.
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Copyright © 2000, American Society for Microbiology. All rights reserved.
Analysis of Immunoreactivity to a
Streptococcus equi subsp. zooepidemicus M-Like
Protein To Confirm an Outbreak of Poststreptococcal
Glomerulonephritis, and Sequences of M-Like Proteins from Isolates
Obtained from Different Host Species
*
Corresponding author. Mailing address: Centers for
Disease Control and Prevention, Mailstop C02, 1600 Clifton Rd., NE,
Atlanta, GA 30333. Phone: (404) 639-1237. Fax: (404) 639-3123. E-mail: BBeall{at}cdc.gov.
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