However, strains resistant to penicillin and multiple antibiotics are rapidly emerging. Vancomycin resistance among the enterococci is an emerging microbial threat.
Extracellular toxins GAS produces a large number of extracellular products that may be important in local and systemic toxicity and in the spread of infection through tissues. The best defined virulence factor is the polysaccharide capsule, which protects the bacterium against phagocytosis.
This enigma remains to be reconciled. In the remaining cases, pneumonia, meningitis, endophthalmitis, peritonitis, myocarditis, joint infection, and intrauterine infection have been described.
Transcriptional regulation of SpeB is quite complex and involves direct and indirect actions of numerous GAS regulators, as recently reviewed by Carroll and Musser It is now appreciated that GAS, like many other bacterial species, do not necessarily exclusively live in a planktonic lifestyle.
The original surgical plan was to debride all involved tissue, however because of being unstable it was decided to wait and observe.