{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:21:23Z","timestamp":1784258483767,"version":"3.55.0"},"reference-count":62,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,1,14]],"date-time":"2016-01-14T00:00:00Z","timestamp":1452729600000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microbiology and Immunology"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:label\/><jats:p><jats:italic>Streptococcus pyogenes<\/jats:italic>, a group A <jats:italic>Streptococcus<\/jats:italic> (GAS), has been recognized as the causative pathogen in patients with severe invasive streptococcal infection with or without necrotizing fasciitis. In recent epidemiological studies, <jats:italic>Streptococcus dysgalactiae<\/jats:italic> subsp. <jats:italic>equisimilis<\/jats:italic> (SDSE) has been isolated from severe invasive streptococcal infection. Complete genome sequence showed that SDSE is the closest bacterial species to GAS, with approximately 70% of genome coverage. SDSE, however, lacks several key virulence factors present in GAS, such as SPE\u2010B, the hyaluronan synthesis operon and active superantigen against human immune cells. A key event in the ability of GAS to cause severe invasive streptococcal infection was shown to be the acquisition of novel genetic traits such as phages. Strikingly, however, during severe invasive infection, GAS destroys its own <jats:italic>covRS<\/jats:italic> two\u2010component system, which negatively regulates many virulence factor genes, resulting in a hyper\u2010virulent phenotype. In contrast, this phenomenon has not been observed in SDSE. The present review describes the epidemiology of severe invasive streptococcal infection and the detailed pathogenic mechanisms of GAS and SDSE, emphasizing findings from their genome sequences and analyses of gene expression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1348-0421.12334","type":"journal-article","created":{"date-parts":[[2015,11,2]],"date-time":"2015-11-02T13:24:06Z","timestamp":1446470646000},"page":"1-9","source":"Crossref","is-referenced-by-count":42,"title":["Severe invasive streptococcal infection by <i>Streptococcus pyogenes<\/i> and <i>Streptococcus dysgalactiae<\/i> subsp. <i>equisimilis<\/i>"],"prefix":"10.1111","volume":"60","author":[{"given":"Shinya","family":"Watanabe","sequence":"first","affiliation":[{"name":"Division of Bacteriology Department of Infection and Immunity School of Medicine Jichi Medical University 3311\u20101 Yakushiji Shimotsuke\u2010shi Tochigi 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