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''Streptococcus zooepidemicus'' is a Lancefield group C
streptococcus ''Streptococcus'' is a genus of gram-positive ' (plural ) or spherical bacteria that belongs to the family Streptococcaceae, within the order Lactobacillales (lactic acid bacteria), in the phylum Bacillota. Cell division in streptococci occu ...
that was first isolated in 1934 by P. R. Edwards, and named Animal pyogens A. It is a mucosal commensal and opportunistic pathogen that infects several animals and humans, but most commonly isolated from the uterus of mares. It is a subspecies of ''
Streptococcus equi ''Streptococcus'' is a genus of gram-positive ' (plural ) or spherical bacteria that belongs to the family Streptococcaceae, within the order Lactobacillales (lactic acid bacteria), in the phylum Bacillota. Cell division in streptococci o ...
'', a contagious upper respiratory tract infection of horses, and shares greater than 98% DNA homology, as well as many of the same virulence factors.


Morphology

''Streptococcus zooepidemicus'' are
gram-positive In bacteriology, gram-positive bacteria are bacteria that give a positive result in the Gram stain test, which is traditionally used to quickly classify bacteria into two broad categories according to their type of cell wall. Gram-positive bac ...
, non-sporulating, non-motile,
catalase Catalase is a common enzyme found in nearly all living organisms exposed to oxygen (such as bacteria, plants, and animals) which catalyzes the decomposition of hydrogen peroxide to water and oxygen. It is a very important enzyme in protecting t ...
and oxidase negative cocci. S. zooepidemicus is encapsulated, with a capsular polysaccharide containing hyaluronic acid, as well as being
facultative anaerobes A facultative anaerobic organism is an organism that makes ATP by aerobic respiration if oxygen is present, but is capable of switching to fermentation if oxygen is absent. Some examples of facultatively anaerobic bacteria are ''Staphylococcus' ...
. The cells usually form in pairs, or as long chains. When plated on agar, colonies are usually 0.5-1.5 mm in diameter, circular, and opaque colored. They also have a smooth surface and a convex elevation. Its optimal temperature of growth is 37 degrees Celsius.


Biochemistry

Hemolysis Hemolysis or haemolysis (), also known by several other names, is the rupturing (lysis) of red blood cells (erythrocytes) and the release of their contents (cytoplasm) into surrounding fluid (e.g. blood plasma). Hemolysis may occur in vivo o ...
on blood agar is beta-hemolytic. It ferments D-glucose, lactose, maltose, sucrose, salicin, D-sorbitol, and starch, but is negative for others like D-mannitol, glycerol, and inulin. S. zooepidemicus is also positive for Ala-Phe-Pro, Leucine, and Tyrosine arylamidase, all of which catalyze hydrolysis of amino acid residues from amino terminus of polypeptide chains. Antibiotic wise, ''S. zooepidemicus'' is highly susceptible to Penicillin, usually give for treatment, as well as Ampicillin and Erythromycin, but is extremely resistant to Novobiocin, Optochin, and Tribrissen.


Genomic structure

The
genome In the fields of molecular biology and genetics, a genome is all the genetic information of an organism. It consists of nucleotide sequences of DNA (or RNA in RNA viruses). The nuclear genome includes protein-coding genes and non-coding ...
of ''S. zooepidemicus'' is a single circular chromosome of 2,024,171 base pairs. The
G+C content G, or g, is the seventh letter in the Latin alphabet, used in the modern English alphabet, the alphabets of other western European languages and others worldwide. Its name in English is ''gee'' (pronounced ), plural ''gees''. History The ...
of the genome is 42.59%, very close in value to S. equi, which is at the higher end of the genus for G+C content. It has 1961 predicted protein coding sequences, with an average length of 879 base pairs each, and coding for an approximate value of 292 amino acids. These coding regions make up approximately 85% of the genome. The genome has five ribosomal RNA operons, and 57 tRNAs. The overall similarity between ''S. zooepidemicus'' and ''S. equi'', is over 92%. ''S. zooepidemicus'' also produces a variety of extracellular proteins, about 100 genes identified so far, making up 5% of the total genome. These genes coding for extracellular proteins are slightly longer in length then others, approximately 478 amino acids each. 44 of these proteins are cell wall anchored surface proteins, which is a high number for Streptococcus species. This is one of the factors that lead to the high pathogenicity of ''S. zooepidemicus''.


Strains

Known strains include: * ATCC 43079 * CCUG 23256 * CIPP 103228 * DSM 20727 * LMG 16030 * NCDO 1358 * NCIMB 701358 * NCTC 4676


Metabolism

The by-products of ''S. zooepidemicus'' fermentation is hyaluronic and lactic acid. The fermentation process is regulated by the production of
hyaluronic acid Hyaluronic acid (; abbreviated HA; conjugate base hyaluronate), also called hyaluronan, is an anionic, nonsulfated glycosaminoglycan distributed widely throughout connective, epithelial, and neural tissues. It is unique among glycosaminoglycan ...
. When high concentrations of the hyaluronic acid by-product are present, it will inhibit the production of more fermentation product. However, this fermentation process consumes high amounts of energy due to a number of factors. These factors include hyaluronic acid being severely limited, strong competition between hyaluronic synthesis and cell growth, and lactic acid being the main by-product of fermentation; which also will inhibit the overall fermentation process. Since hyaluronic acid is important for the
virulence Virulence is a pathogen's or microorganism's ability to cause damage to a host. In most, especially in animal systems, virulence refers to the degree of damage caused by a microbe to its host. The pathogenicity of an organism—its ability to ...
of ''S. zooepidemicus'', as well as a valuable commercial production, hyaluronic acid production is constantly trying to be increased in industry and within the organism. Commercial uses for hyaluronic acid include an ingredient in cosmetics, skin filler for anti-aging and lip injections, in viscosurgery, and a lubricating substance in arthritic joints.


Virulence

Pathogenic gram positive bacteria species express cell-wall associated proteins that interact in various ways with the extracellular environment. These are made in order to benefit the organism for survival, as well as to help with establishing infection. Attachment to the epithelium cell surfaces is a critical step in the establishment of infection, and starting colonization. Overall, ''S. zooepidemicus'' is known to be more pathogenic then the ''S. equi'' species.


Virulence factors

Some cell-surface
virulence factor Virulence factors (preferably known as pathogenicity factors or effectors in plant science) are cellular structures, molecules and regulatory systems that enable microbial pathogens (bacteria, viruses, fungi, and protozoa) to achieve the followin ...
s, which all contribute to the pathogenicity of S. zooepidemicus, include: * SzP proteins: similar to a surface M-protein, this protein is anti-phagocytic and anti-opsonization, with impairs with host protection. This is one of the most important virulence factors. * FNZ protein: binds specifically to fibronectin, which is present on most host cell walls. This allows it to easily bind to and enter cells. * FNZ2 protein: binds to collagen, also present on host cell walls, and fibronectin (similar to FNZ). * SodA protein: destroys toxic free radicals, which are made by the host as a defensive mechanism. * SeM: produces enterotoxins.


Pathology

''Streptococcus zooepidemicus'' is able to infect many different animals, such as horses, cows, rabbits, pigs, dogs, and cats. In animals, these symptoms can include fever, inflammation of thorax, lymph nodes, or abdomen,
bronchopneumonia Bronchopneumonia is a subtype of pneumonia. It is the acute inflammation of the bronchi, accompanied by inflamed patches in the nearby lobules of the lungs. citing: Webster's New World College Dictionary, Fifth Edition, Copyright 2014 It is ofte ...
,
sepsis Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is foll ...
,
mastitis Mastitis is inflammation of the breast or udder, usually associated with breastfeeding. Symptoms typically include local pain and redness. There is often an associated fever and general soreness. Onset is typically fairly rapid and usually occurs ...
, and more. In Horses, ''S. zooepidemicus'' is normal flora bacterium, but is opportunistic and therefore will infect wounds, the respiratory system, and uterine, if given the chance. In horses, which are most commonly infected, this bacterium causes an upper respiratory tract infection (along with the other symptoms). This infection causes a highly contagious and deadly disease in horses. This will be caused by spreading of nasal discharge or lymph nodes in feed troughs, bedding, etc.


Human disease

''S. zooepidemicus'', which is considered a
zoonotic A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human. ...
pathogen, has rarely been isolated in humans, and infection is usually very rare. Infections are only known to be severe in immunocompromised people, namely the elderly who spent time around horses. There has also been cases of people acquiring the pathogen from homemade or unpasteurized milk or cheese. Most common symptoms of
glomerulonephritis Glomerulonephritis (GN) is a term used to refer to several kidney diseases (usually affecting both kidneys). Many of the diseases are characterised by inflammation either of the glomeruli or of the small blood vessels in the kidneys, hence the ...
,
rheumatic fever Rheumatic fever (RF) is an inflammation#Disorders, inflammatory disease that can involve the heart, joints, skin, and brain. The disease typically develops two to four weeks after a Streptococcal pharyngitis, streptococcal throat infection. Sign ...
, meningitis, arthritis and more, leading to the death of several patients.


Outbreaks

Before 2017, there has been 32 reported cases of infections due to ''Streptococcus zooepidemicus''. In 2004, a 63-year-old man developed left thigh pain and swelling, which evolved into fevers, rigors, and skin rash. Two days, he experienced vertigo and vomiting, and was emitted into the hospital where he was treated with acute
labyrinthitis Labyrinthitis is inflammation of the labyrinth – a maze of fluid-filled channels in the inner ear. Vestibular neuritis is inflammation of the vestibular nerve – the nerve in the inner ear that sends messages related to motion and position t ...
, followed by meningococcal sepsis. Hypertension ensued, and edema of the left thigh muscle was discovered during surgery. These treatments were continued, but the patient went into progressive organ failure, followed by muscle necrosis, and
ventricular tachycardia Ventricular tachycardia (V-tach or VT) is a fast heart rate arising from the lower chambers of the heart. Although a few seconds of VT may not result in permanent problems, longer periods are dangerous; and multiple episodes over a short perio ...
. The patient later went into circulatory and respiratory failure, before passing away less than 48 hours after being emitted into the hospital. Muscle biopsies determined ''S. zooepidemicus'', as well as evidence of an unidentified superantigen exotoxin, to be the cause of infection, and toxic-shock like syndrome to be the cause of death. It was always noteworthy that the patient had frequent contact with horses, pigs, and cattle. This case study specifically is interesting as it strongly suggests an unidentified novel exotoxin, possibly produced by ''S. zooepidemicus''. In 2008, a 59-year-old woman was admitted to the emergency room due to body weakness and lightheadedness when standing, which starting three weeks prior. Over the past couple of days before being emitted she also reported shortness of breath, as well as resting tremors, rhinorrhea, and a chronic cough. She had a vast medicine history including hypertension, diabetes, obesity, chronic
kidney failure Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...
, and more. She was treated for severe orthostatic hypo-tension, but in the following days complained of symptoms, and had test results that suggested meningitis. Various symptoms continued for almost a month until a blood culture tested positive for ''Streptococcus zooepidemicus''. The patient was treated with intravenous antibiotics for six weeks, and her condition gradually improved. The patient stated there was a horse stable on her property, but she only visited it occasionally.


References

{{Taxonbar, from=Q7623365 Streptococcaceae