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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 ofStreptococcus 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 &lt; 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 fromS. equi subsp.zooepidemicus SzpW60, while the predicted surface-exposed portions differed markedly between these two proteins. The 5′ end of theszp5058 gene, including its variable region, was identical to theszp gene from another strain associated with a previous PSGN outbreak in England (M. Barham et al., Lancet i:945–948, 1983), and the correspondingszp sequence found from the Lancefield group C type strain isolated from a guinea pig. In addition, the hypervariable (HV) portion ofszp5058 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 ofS. equi subsp.zooepidemicus , including another strain previously associated with a PSGN outbreak, were each found to contain a distinctszp gene. Two of theseszp genes had HV regions identical toszp regions from isolates recovered from different host species.

journal of clinical microbiology

Analysis of Immunoreactivity to a <i>Streptococcus equi</i> subsp. <i>zooepidemicus</i> M-Like Protein To Confirm an Outbreak of Poststreptococcal Glomerulonephritis, and Sequences of M-Like Proteins from Isolates Obtained from Different Host Species

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