Abstract
Streptococcus pyogenes is indigenous to the human pharynx and causes acute pharyngitis. Balanoposthitis is an inflammatory disease of the glans and the foreskin. However, balanoposthitis caused by S. pyogenes is not widely recognized as a sexually transmitted disease. In addition, bacteriological features of the isolates causing balanoposthitis are unclear. The four S. pyogenes strains isolated from adult balanoposthitis were examined. We performed emm typing, T antigen typing, RAPD assay, PCR assay for the streptococcal pyrogenic exotoxin-related genes and antibiotic-resistant genes, and antibiotic susceptibility assay. All four strains were suspected to be transmitted by penile-oral sexual intercourse, were found to be different by genetic analysis, and also harbored some antibiotic-resistant factors. We propose that S. pyogenes should be considered as a causative agent of sexually transmitted disease. The drug resistant S. pyogenes must be taken into account when balanoposthitis patients are treated with antibiotic.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alsterholm M, Flytstrom I, Leifsdottir R et al (2008) Frequency of bacteria, candida and malassezia species in balanoposthitis. Acta Derm Venereol 88:331–336
Beall B, Facklam R, Thompson T (1996) Sequencing emm-specific PCR products for routine and accurate typing of group A streptococci. J Clin Microbiol 34:953–958
Billal DS, Fedorko DP, Yan SS et al (2007) In vitro induction and selection of fluoroquinolone-resistant mutants of Streptococcus pyogenes strains with multiple emm types. J Antimicrob Chemother 59:28–34
Cunningham MW (2000) Pathogenesis of group A streptococcal infections. Clin Microbiol Rev 13:470–511
Deliyanni VA, Boniatsi LS, Photinou AS (1989) Balanitis caused by group A beta-hemolytic Streptococcus in an 8-year-old boy. Pediatr Infect Dis J 8:61–62
Drusin LM, Wilkes BM, Gingrich RD (1975) Streptococcal pyoderma of the penis following fellatio. Br J Vener Dis 51:61–62
Edwards S (1996) Balanitis and balanoposthitis: a review. Genitourin Med 72:155–159
Guerrero-Vazquez J, Sebastian-Planes M, Olmedo-Sanlaureano S (1990) Group A streptococcal proctitis and balanitis. Pediatr Infect Dis J 9:223
Guilherme L, Fae K, Oshiro SE et al (2005) Molecular pathogenesis of rheumatic fever and rheumatic heart disease. Expert Rev Mol Med 7:1–15
Hasegawa T, Torii K, Hashikawa S et al (2002) Cloning and characterization of two novel DNases from Streptococcus pyogenes. Arch Microbiol 177:451–456
Hasegawa T, Hashikawa SN, Nakamura T et al (2004) Factors determining prognosis in streptococcal toxic shock-like syndrome: results of a nationwide investigation in Japan. Microbes Infect 6:1073–1077
Hashikawa S, Iinuma Y, Furushita M et al (2004) Characterization of group C and G streptococcal strains that cause streptococcal toxic shock syndrome. J Clin Microbiol 42:186–192
Hotomi M, Billal DS, Shimada J et al (2005) Current status of antimicrobial susceptibility of clinical isolates of Streptococcus pyogenes in Japan: report of a countrywide surveillance study. J Infect Chemother 11:48–51
Ikebe T, Hirasawa K, Suzuki R et al (2005) Antimicrobial susceptibility survey of Streptococcus pyogenes isolated in Japan from patients with severe invasive group A streptococcal infections. Antimicrob Agents Chemother 49:788–790
Kyriazi NC, Costenbader CL (1991) Group A beta-hemolytic streptococcal balanitis: it may be more common than you think. Pediatrics 88:154–156
Leung AK, Kellner JD (2004) Group A beta-hemolytic streptococcal pharyngitis in children. Adv Ther 21:277–287
Leverkus M, Mayer J, Brocker EB et al (2002) Isolated streptococcal balanoposthitis in an adult patient. Dermatology 204:153–154
Lisboa C, Ferreira A, Resende C et al (2009) Infectious balanoposthitis: management, clinical and laboratory features. Int J Dermatol 48:121–124
Lucks DA, Venezio FR, Lakin CM (1986) Balanitis caused by group B streptococcus. J Urol 135:1015
Moody MD, Padula J, Lizana D et al (1965) Epidemiologic characterization of group A streptococci by T-agglutination and M-precipitation tests in the public health laboratory. Health Lab Sci 2:149–162
Orden B, Manjavacas CG, Martinez R et al (1995) Streptococcal balanitis in a healthy adult male. Eur J Clin Microbiol Infect Dis 14:920–921
Orden B, Martin R, Franco A et al (1996) Balanitis caused by group A beta-hemolytic streptococci. Pediatr Infect Dis J 15:920–921
Rodriguez-Iturbe B, Batsford S (2007) Pathogenesis of poststreptococcal glomerulonephritis a century after Clemens von Pirquet. Kidney Int 71:1094–1104
Seppala H, He Q, Osterblad M et al (1994) Typing of group A streptococci by random amplified polymorphic DNA analysis. J Clin Microbiol 32:1945–1948
Tanaka M, Hasegawa T, Okamoto A et al (2005) Effect of antibiotics on group A Streptococcus exoprotein production analyzed by two-dimensional gel electrophoresis. Antimicrob Agents Chemother 49:88–96
Wakatsuki A (2005) Clinical experience of streptococcal balanoposthitis in 47 healthy adult males. Hinyokika Kiyo 51:737–774
Acknowledgment
This study was supported by a Grant-in-Aid for Research from Nagoya City University, grant number 19590452 from the Ministry of Education, Science and Culture of the Japanese government, and a grant for Research on Publicly Essential Drugs and Medical Devices, No. KHC1021 from the Japan Health Sciences Foundation.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Minami, M., Wakimoto, Y., Matsumoto, M. et al. Characterization of Streptococcus pyogenes Isolated from Balanoposthitis Patients Presumably Transmitted by Penile-Oral Sexual Intercourse. Curr Microbiol 61, 101–105 (2010). https://doi.org/10.1007/s00284-010-9581-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00284-010-9581-x