Journal Article

The Importance of the Group A <i>Streptococcus</i> Capsule in the Pathogenesis of Human Infections: A Historical Perspective

Gene H. Stollerman and James B. Dale

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 46, issue 7, pages 1038-1045
Published in print April 2008 | ISSN: 1058-4838
Published online April 2008 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/529194
The Importance of the Group A Streptococcus Capsule in the Pathogenesis of Human Infections: A Historical Perspective

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The virulence of group A streptococci (GAS) correlates closely with expression of its surface antigen, M protein, and its hyaluronic acid capsule. In studies of human GAS infection, the former has received considerable attention. For several decades, however, systematic identification of encapsulated virulent strains by the mucoid colonies they produce has been neglected in clinical studies. In part, this may be due to the capsule's evanescent expression on artificial media, its repression during convalescent carriage, lack of expertise in recognizing its colonial morphology, and the growing tendency for clinical laboratories to eschew throat cultures in favor of rapid laboratory tests for group A polysaccharide. Older and more recent studies are reviewed here that emphasize the capsule's basic role in infection. We believe that it is time to refocus newer clinical studies and techniques on achieving early recognition of potentially dangerous, heavily encapsulated strains of GAS for which spread may be prevented.

Journal Article.  5645 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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