Streptococcus pyogenes

DEBBIE S. RETNONINGRUM
SEKOLAH FARMASI
INSTITUT TEKNOLOGI BANDUNG
Streptococcus pyogenes
SUPERFICIAL INFECTIONS
 DEEP INFECTIONS

∗ tis,
CELLULITIS

NECROTIZING FASCIITIS
 TOXIN-MEDIATED DISEASES

STREPTOCOCCAL TOXIC SHOCK SYNDROME

SCARLET FEVER
 IMMUNE SEQUALE:
IMMUNOLOGICALLY-MEDIATED
VIRULENCE FACTORS
M PROTEIN
 PROTEIN M:
PROTEIN DENGAN MULTI FUNGSI
 PROTEIN M: SEROTYPING
∗ Streptococcus pyogenes ~ 230 SEROTIPE BERDASARKAN
URUTAN ASAM AMINO VARIABEL PADA UJUNG AMINO
∗ PHARYNGITIS: M1, M3, M5, M6, M12, M14, M17, M18, M19, M24
∗ IMPETIGO: M2, M33, M41, M49, M52, M53, M57, M59, M60,
M61, M70
∗ M PROTEIN (emm) PATTERNS:
∗ A-C: PHARINGITIS (47%) + IMPETIGO (8%) → CLASSICAL THROAT
STRAINS (THROAT SPECIALISTS)
∗ D: IMPETIGO (50% ) + PHARYNGITIS (2%) → CLASSICAL SKIN
STRAINS (SKIN SPECIALISTS)
∗ E: IMPETIGO (~50% ) + PHARYNGITIS (~50%) → GENERALISTS
 SEVERE INVASIVE DISEASE
∗ NECROTIZING FASCIITIS: M1 AND M3
∗ PHARYNGITIS STRAIN → INVASIVE STRAIN
∗ INVASIVE STRAIN ≠ PHARYNGITIS STRAIN
∗ INVASIVE STRAIN CONTAINS FRAME-SHIFT
MUTATION → DEREPRESSION OF GENE ENCODING FOR
∗ SpeA (STREPTOCOCCAL PYROGENIC EXOTOXIN A)
∗ SagA (STREPTOLISIN S)
∗ Ska (STRETOKINASE)
∗ Spd3 (Dnase)
∗ ScpC (cleaves IL-8: CHEMOATTRACTANT FOR NEUTROPHIL)
DIVERSITY OF VIRULENCE FACTOR
 POST STREPTOCOCCAL
GLOMERULONEPHRITIS (PSGN)
NEPHRITOGENIC STRAINS
PREDOMINANTLY M-types 1, 2, 4, 12, 25, 49, 56, 57, and 60
MOLECULAR MIMICRY

INFECTIONS M TYPES
THROAT M1, M12
SKIN M1, M12, M55,
M49, M60, M73,
M48, M55, M57,
M59
THROAT AND SKIN M12, M18, M49