School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia.
Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
Nat Rev Microbiol. 2023 Jul;21(7):431-447. doi: 10.1038/s41579-023-00865-7. Epub 2023 Mar 9.
Streptococcus pyogenes (Group A Streptococcus; GAS) is exquisitely adapted to the human host, resulting in asymptomatic infection, pharyngitis, pyoderma, scarlet fever or invasive diseases, with potential for triggering post-infection immune sequelae. GAS deploys a range of virulence determinants to allow colonization, dissemination within the host and transmission, disrupting both innate and adaptive immune responses to infection. Fluctuating global GAS epidemiology is characterized by the emergence of new GAS clones, often associated with the acquisition of new virulence or antimicrobial determinants that are better adapted to the infection niche or averting host immunity. The recent identification of clinical GAS isolates with reduced penicillin sensitivity and increasing macrolide resistance threatens both frontline and penicillin-adjunctive antibiotic treatment. The World Health Organization (WHO) has developed a GAS research and technology road map and has outlined preferred vaccine characteristics, stimulating renewed interest in the development of safe and effective GAS vaccines.
化脓性链球菌（A 组链球菌；GAS）与人类宿主高度适应，导致无症状感染、咽炎、脓疱病、猩红热或侵袭性疾病，并可能引发感染后免疫后遗症。GAS 部署了一系列毒力决定因素，以允许定植、在宿主内传播和传播，破坏对感染的先天和适应性免疫反应。全球 GAS 流行病学的变化特点是新的 GAS 克隆的出现，通常与获得新的毒力或抗生素决定因素有关，这些因素更适应感染环境或逃避宿主免疫。最近发现的青霉素敏感性降低和大环内酯类药物耐药性增加的临床 GAS 分离株威胁着一线和青霉素辅助抗生素治疗。世界卫生组织（WHO）制定了 GAS 研究和技术路线图，并概述了首选疫苗的特点，这激发了人们对开发安全有效的 GAS 疫苗的重新兴趣。
