Streptococcus pyogenes

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Streptococcus pyogenes is a spherical, Gram-positive bacterium that grows in long chains and is the cause of Group A streptococcal infections.[1] S. pyogenes displays streptococcal group A antigen on its cell wall. S. pyogenes typically produces large zones of beta-hemolysis (the complete disruption of erythrocytes and the release of hemoglobin) when cultured on blood agar plates, and are therefore also called Group A (beta-hemolytic) Streptococcus (abbreviated GAS).

Streptococci are catalase-negative. In ideal conditions, S. pyogenes has an incubation period of approximately 1-3 days[2]. It is an infrequent, but usually pathogenic, part of the skin flora.

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Serotyping

In 1928, Rebecca Lancefield published a method for serotyping S. pyogenes based on its M protein, a virulence factor displayed on its surface.[3] Later in 1946, Lancefield described the serologic classification of S. pyogenes isolates based on their surface T antigen.[4] Four of the 20 T antigens have been revealed to be pili, which are used by bacteria to attach to host cells.[5] Over 100 M serotypes and approximately 20 T serotypes are known.

Pathogenesis

S. pyogenes is the cause of many important human diseases, ranging from mild superficial skin infections to life-threatening systemic diseases.[1] Infections typically begin in the throat or skin. Examples of mild S. pyogenes infections include pharyngitis ("strep throat") and localized skin infection ("impetigo"). Erysipelas and cellulitis are characterized by multiplication and lateral spread of S. pyogenes in deep layers of the skin. S. pyogenes invasion and multiplication in the fascia can lead to necrotizing fasciitis, a potentially life-threatening condition requiring surgical treatment.

Infections due to certain strains of S. pyogenes can be associated with the release of bacterial toxins. Throat infections associated with release of certain toxins lead to scarlet fever. Other toxigenic S. pyogenes infections may lead to streptococcal toxic shock syndrome, which can be life-threatening.[1]

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