Survival of Streptococcus anginosus in blood is linked to hydrogen peroxide production

Streptococcus anginosus is an opportunistic pathogen causing bacteremia, respiratory tract infections, abscesses, odontogenic infections and has recently been associated with gastric cancer. While numerous genes encoding putative virulence factors have been detected in whole genome sequences, a detailed molecular characterization is missing for most of them. To address putative virulence determinants, we investigated hydrogen peroxide production by S. anginosus and assessed its functional significance for survival in human blood. In Streptococcus pneumoniae the pyruvate oxidase, encoded by the spxB gene, is responsible for H2O2 production and represents a major virulence factor. Interestingly, S. anginosus harbors two genetic variants of the spxB gene, one with high homology to the S. pneumoniae spxB (sequence identity: approx. 94 %) gene, while the other appears to be specific for S. anginosus. Strains carrying the S. pneumoniae variant demonstrate higher H2O2 production (10-20 M) compared to strains harboring the anginosus variant (<1 M). Incubation of S. anginosus strains in human blood showed that bacterial survival was correlated to the amount of hydrogen peroxide production. Assessing H2O2 production in an S. anginosus strain carrying a deletion of the CcpA regulator revealed the control of spxB and H2O2 production by carbon catabolite repression. In conclusion, we found evidence for the presence of a major S. pneumoniae virulence factor in S. anginosus, and we were able to demonstrate that it increases the ability of S. anginosus to survive in human blood.