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Volume 13, Number 11—November 2007

Epidemiology of Streptococcus dysgalactiae subsp. equisimilis in Tropical Communities, Northern Australia

Malcolm McDonald*†Comments to Author , Rebecca J. Towers*, Ross M. Andrews*, Jonathan R. Carapetis*, and Bart J. Currie*
Author affiliations: *Menzies School of Health Research, Darwin, Northern Territory, Australia; †Royal Children’s Hospital, Melbourne, Victoria, Australia;

Main Article

Figure 1

Monthly recovery rates of most common Streptococcus dysgalactiae subsp. equisimilis (group C and group G streptococci) emm sequence subtypes (STs) in community 1, Northern Territory, Australia. Values along the y-axes are no. bacterial isolates per 100 consultations. No obvious pattern of sequential strain replacement was seen as with Streptococcus pyogenes (group A streptococci) (17).

Figure 1. Monthly recovery rates of most common Streptococcus dysgalactiae subsp. equisimilis (group C and group G streptococci) emm sequence subtypes (STs) in community 1, Northern Territory, Australia. Values along the y-axes are no. bacterial isolates per 100 consultations. No obvious pattern of sequential strain replacement was seen as with Streptococcus pyogenes (group A streptococci) (17).

Main Article

  1. Lancefield  RC. A serological differentiation of human and other groups of hemolytic streptococci. J Exp Med. 1933;57:57195. DOIGoogle Scholar
  2. Lancefield  RC, Hare  R. The serological differentiation of pathogenic and non-pathogenic strains of hemolytic streptococci from parturient women. J Exp Med. 1935;61:33549. DOIGoogle Scholar
  3. Williams  GS. Group C and G streptococci infections: emerging challenges. Clin Lab Sci. 2003;16:20913.
  4. Bisno  AL, Collins  CM, Turner  JC. M proteins of group C streptococci isolated from patients with acute pharyngitis. J Clin Microbiol. 1996;34:25115.
  5. Kalia  A, Enright  MC, Spratt  BG, Bessen  DE. Directional gene movement from human-pathogenic to commensal-like streptococci. Infect Immun. 2001;69:485869. DOIGoogle Scholar
  6. Schnitzler  N, Podbielski  A, Baumgarten  G, Mignon  M, Kaufhold  A. M or M-like protein gene polymorphisms in human group G streptococci. J Clin Microbiol. 1995;33:35663.
  7. Widdowson  JP, Maxted  WR, Pinney  AM. An M-associated protein antigen (MAP) of group A streptococci. J Hyg (Lond). 1971;69:55364. DOIGoogle Scholar
  8. Maxted  WR, Widdowson  JP, Fraser  CA, Ball  LC, Bassett  DC. The use of serum opacity reaction in the typing of group A streptococci. J Med Microbiol. 1973;6:8390. DOIGoogle Scholar
  9. Bessen  DE, Veasy  LG, Hill  HR, Augustine  NH, Fischetti  VA. Serologic evidence for a Class 1 group A streptococcal infection among rheumatic fever patients. J Infect Dis. 1995;172:160811.
  10. Centers for Diseases Control and Prevention. Streptococcus laboratory. 2006 [cited 2006 Oct 15]. Available from
  11. Haidan  A, Talay  SR, Rohde  M, Sriprakash  KS, Currie  BJ, Chhatwal  GS. Pharyngeal carriage of group C and group G streptococci and acute rheumatic fever in an Aboriginal population. Lancet. 2000;356:11679. DOIGoogle Scholar
  12. McDonald  MI, Towers  RJ, Andrews  R, Benger  N, Currie  BJ, Carapetis  JR. Low rates of streptococcal pharyngitis and high rates of pyoderma in communities where rheumatic fever is hyperendemic. Clin Infect Dis. 2006;43:6839. DOIGoogle Scholar
  13. Streeton  CL, Hanna  JN, Messer  RD, Merianos  A. An epidemic of acute post-streptococcal glomerulonephritis among Aboriginal children. J Paediatr Child Health. 1995;31:2458. DOIGoogle Scholar
  14. McDonald  M, Towers  R, Fagan  P, McKinnon  M, Benger  N, Andrews  R, Recovering streptococci from the throat in remote tropical communities: a practical alternative to direct plating. J Clin Microbiol. 2006;44:54751. DOIGoogle Scholar
  15. Ruoff  KL, Whiley  RA, Beighton  D. Streptococcus. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH, editors. Manual of clinical microbiology, 8th ed. Washington: American Society for Microbiology Press; 2003. p. 405–21.
  16. McKay  FC, McArthur  JD, Sanderson-Smith  ML, Gardam  S, Currie  BJ, Sripakash  KS, Plasminogen binding by group A streptococcal isolates from a region of hyperendemicity for streptococcal skin infection and a high incidence of invasive infection. Infect Immun. 2004;72:36470. DOIGoogle Scholar
  17. McDonald  MI, Towers  RJ, Andrews  R, Benger  N, Fagan  P, Currie  BJ, The dynamic nature of group A streptococcal epidemiology in tropical communities with high rates of rheumatic heart disease. [Epub ahead of print]. Epidemiol Infect. 2007; 111.
  18. Williams  S, Markey  P. Acute post-streptococcal glomerulonephritis in a remote community. Northern Territory Communicable Disease Bulletin. 2005;12:168.
  19. Meier  FA, Centor  RM, Graham  L Jr, Dalton  HP. Clinical and microbiological evidence for endemic pharyngitis among adults due to group C streptococci. Arch Intern Med. 1990;150:8259. DOIGoogle Scholar
  20. Cimolai  N, Morrison  BJ, MacCulloch  L, Smith  DF, Hlady  J. Beta-haemolytic non-group A streptococci and pharyngitis: a case-control study. Eur J Pediatr. 1991;150:7769. DOIGoogle Scholar
  21. Martin  NJ, Kaplan  EL, Gerber  MA, Menegus  MA, Randolph  M, Bell  K, Comparison of epidemic and endemic group G streptococci by restriction enzyme analysis. J Clin Microbiol. 1990;28:18816.
  22. Hayden  GF, Murphy  TF, Hendley  JO. Non-group A streptococci in the pharynx. Pathogens or innocent bystanders? Am J Dis Child. 1989;143:7947.
  23. Zaoutis  T, Attia  M, Gross  R, Klein  J. The role of group C and group G streptococci in acute pharyngitis in children. Clin Microbiol Infect. 2004;10:3740. DOIGoogle Scholar
  24. Martin  JM, Green  M, Barbadora  KA, Wald  ER. Group A streptococci among school-aged children: clinical characteristics and the carrier state. Pediatrics. 2004;114:12129. DOIGoogle Scholar
  25. Huovinen  P, Lahtonen  R, Ziegler  T, Meurman  O, Hakkarainen  K, Miettinen  A, Pharyngitis in adults: the presence and coexistence of viruses and bacterial organisms. Ann Intern Med. 1989;110:6126.
  26. Navaneeth  BV, Ray  N, Chawda  S, Selvarani  P, Bhaskar  M, Suganthi  N. Prevalence of beta-hemolytic streptococci carrier rate among schoolchildren in Salem. Indian J Pediatr. 2001;68:9856. DOIGoogle Scholar
  27. Ahmed  J, Zaman  MM, Keramat Ali  SM. Identification of serogroups of beta hemolytic streptococci in children with tonsillo-pharyngitis. Medical Research Council Bulletin. 2003;29:1137.
  28. Ogunbi  O, Lasi  Q, Lawal  S. An epidemiological study of beta-hemolytic streptococcal infections in a Nigerian (Lagos) urban population. In: Streptococcal disease and the community. Proceedings of the Fifth International Symposium on Streptococcus pyogenes. Amsterdam: Excerpta Medica; 1972.
  29. Anthony  BF, Kaplan  EL, Wannamaker  LW, Chapman  SS. The dynamics of streptococcal infections in a defined population of children: serotypes associated with skin and respiratory infections. Am J Epidemiol. 1976;104:65266.
  30. Bisno  AL, Gaviria  JM. Murine model of recurrent group G streptococcal cellulitis: no evidence of protective immunity. Infect Immun. 1997;65:492630.
  31. Kishore  J, Singh  OP, Gupta  U. Bacteriology of pyoderma including anaerobes. Indian J Med Res. 1989;89:2614.
  32. Reid  HF, Bassett  DC, Poon-King  T, Zabriskie  JB, Read  SE. Group G streptococci in healthy school-children and in patients with glomerulonephritis in Trinidad. J Hyg (Lond). 1985;94:618. DOIGoogle Scholar
  33. Kalia  A, Bessen  DE. Natural selection and evolution of streptococcal virulence genes involved in tissue-specific adaptations. J Bacteriol. 2004;186:11021. DOIGoogle Scholar
  34. Svensson  MD, Sjobring  U, Luo  F, Bessen  DE. Roles of the plasminogen activator streptokinase and the plasminogen-associated M protein in an experimental model for streptococcal impetigo. Microbiology. 2002;148:393345.
  35. Bessen  DE, Kalia  A. Genomic localization of a T serotype locus to a recombinatorial zone encoding extracellular matrix-binding proteins in Streptococcus pyogenes. Infect Immun. 2002;70:115967. DOIGoogle Scholar
  36. Towers  RJ, Gal  D, McMillan  D, Sriprakash  KS, Currie  BJ, Walker  MJ, Fibronectin-binding protein gene recombination and horizontal transfer between group A and G streptococci. J Clin Microbiol. 2004;42:535761. DOIGoogle Scholar
  37. Bessen  DE, Manoharan  A, Luo  F, Wertz  JE, Robinson  DA. Evolution of transcription regulatory genes is linked to niche specialization in the bacterial pathogen Streptococcus pyogenes. J Bacteriol. 2005;187:416372. DOIGoogle Scholar
  38. Bessen  DE, Carapetis  JR, Beall  B, Katz  R, Hibbie  M, Currie  BJ, Contrasting molecular epidemiology of group A streptococci causing tropical and nontropical infections of the skin and throat. J Infect Dis. 2000;182:110916. DOIGoogle Scholar
  39. Davies  MR, Tran  TN, McMillan  DJ, Gardiner  DL, Currie  BJ, Sriprakash  KS. Inter-species genetic movement may blur the epidemiology of streptococcal diseases in endemic regions. Microbes Infect. 2005;7:112838. DOIGoogle Scholar
  40. Carapetis  JR, McDonald  M, Wilson  NJ. Acute rheumatic fever. Lancet. 2005;366:15568. DOIGoogle Scholar

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